Prognosis and surgical outcome of soft tissue sarcoma with malignant fungating wounds

2020 ◽  
Vol 51 (1) ◽  
pp. 78-84
Author(s):  
Koichi Okajima ◽  
Hiroshi Kobayashi ◽  
Tomotake Okuma ◽  
Sho Arai ◽  
Liuzhe Zhang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcoma ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Wound Complications ◽  
Limb Salvage Surgery ◽  
High Grade ◽  
Surgical Wound

Abstract Objective Malignant fungating wounds are ulcerating tumors that infiltrate the overlying skin. Little evidence exists regarding the prognosis or treatment of malignant fungating wound in soft tissue sarcoma. This study aimed to reveal the prognosis and outcome of surgical treatment of malignant fungating wound in soft tissue sarcoma. Methods We retrospectively reviewed 26 patients with malignant fungating wound in high-grade soft tissue sarcoma between 2005 and 2018. The patients’ characteristics, treatments, surgical wound complications, local recurrences and prognoses were analyzed. Overall survival was analyzed using the Kaplan–Meier method and compared with that of the control cohort, consisting of 236 consecutive patients with non-malignant fungating wound high-grade soft tissue sarcoma treated during the same period. Results Among the 26 patients, undifferentiated pleomorphic sarcoma was the most common subtype. Twenty-three patients, including 20 (87%) and 3 (13%), underwent limb-salvage surgery and amputation, respectively. Among the 20 patients who underwent limb-salvage surgery, 4 (20%) had surgical wound complications, which required additional surgical procedures. Excluding the patients who underwent palliative surgery, local recurrence occurred in 2 patients (11%). The 5-year overall survival rate for all high-grade malignant fungating wound and non-malignant fungating wound patients was 26.0 and 67.3% (P < 0.0001), respectively. Conclusions Malignant fungating wounds in soft tissue sarcoma were significantly associated with a poor prognosis; however, the incidence of surgical complications and local recurrence after limb-salvage surgery was comparable to that of general soft tissue sarcoma cases. Limb-salvage surgery should be considered, if possible, to preserve the patient’s quality of life because of the dismal prognosis of patients with malignant fungating wound in soft tissue sarcoma.

A new limb salvage surgery in cases of high-grade soft tissue sarcoma using photodynamic surgery, followed by photo- and radiodynamic therapy with acridine orange

2008 ◽  
Vol 97 (6) ◽  
pp. 523-528 ◽  
Author(s):  
Tomoki Nakamura ◽  
Katsuyuki Kusuzaki ◽  
Takao Matsubara ◽  
Akihiko Matsumine ◽  
Hiroaki Murata ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Acridine Orange ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Limb Salvage Surgery ◽  
High Grade

scholarly journals Preoperative surgical risk stratification in osteosarcoma based on the proximity to the major vessels

2019 ◽  
Vol 101-B (8) ◽  
pp. 1024-1031 ◽  
Author(s):  
T. Fujiwara ◽  
M. R. Medellin ◽  
A. Sambri ◽  
Y. Tsuda ◽  
J. Balko ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Blood Vessels ◽  
Limb Salvage ◽  
Local Control ◽  
Salvage Surgery ◽  
Limb Salvage Surgery ◽  
Poor Prognostic Factor ◽  
Type 3

Aims The aim of this study was to determine the risk of local recurrence and survival in patients with osteosarcoma based on the proximity of the tumour to the major vessels. Patients and Methods A total of 226 patients with high-grade non-metastatic osteosarcoma in the limbs were investigated. Median age at diagnosis was 15 years (4 to 67) with the ratio of male to female patients being 1.5:1. The most common site of the tumour was the femur (n = 103) followed by tibia (n = 66). The vascular proximity was categorized based on the preoperative MRI after neoadjuvant chemotherapy into four types: type 1 > 5 mm; type 2 ≤ 5 mm, > 0 mm; type 3 attached; type 4 surrounded. Results Limb salvage rate based on the proximity type was 92%, 88%, 51%, and 0% for types 1 to 4, respectively, and the overall survival at five years was 82%, 77%, 57%, and 67%, respectively (p < 0.001). Local recurrence rate in patients with limb-salvage surgery was 7%, 8%, and 22% for the types 1 to 3, respectively (p = 0.041), and local recurrence at the perivascular area was observed in 1% and 4% for type 2 and 3, respectively. The mean microscopic margin to the major vessels was 6.9 mm, 3.0 mm, and 1.4 mm for types 1 to 3, respectively. In type 3, local recurrence-free survival with limb salvage was significantly poorer compared with amputation (p = 0.025), while the latter offered no overall survival benefit. In this group of patients, factors such as good response to chemotherapy or limited vascular attachment to less than half circumference or longitudinal 10 mm reduced the risk of local recurrence. Conclusion The proximity of osteosarcoma to major blood vessels is a poor prognostic factor for local control and survival. Amputation offers better local control for tumours attached to the blood vessels but does not improve survival. Limb salvage surgery offers similar local control if the tumour attachment to blood vessels is limited. Cite this article: Bone Joint J 2019;101-B:1024–1031.

scholarly journals Demography and Short Term Functional Outcome of Soft Tissue Sarcoma Treated with Limb Salvage Surgery

2020 ◽  
Vol 16 (4) ◽  
pp. 238-245
Author(s):  
Suresh Pandey
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Functional Outcome ◽  
Limb Salvage ◽  
Negative Correlation ◽  
Salvage Surgery ◽  
Demographic Data ◽  
Functional Score ◽  
Limb Salvage Surgery ◽  
Positive Correlation

Background: Limb salvage surgery with or without radiotherapy and/or chemotherapy is the mainstay of treatment of Soft Tissue Sarcoma (STS). Though, many studies are found regarding the demographics and result of such malignancy from other parts of the world, such data is not available from our country. This study aimed to analyze the demographic data and functional outcome of STS treated with limb salvage surgery. Methods: It is a retrospective review of 16 cases of soft tissue sarcoma of extremities and trunk managed with limb salvage surgery followed by adjuvant radiotherapy and/or chemotherapy in indicated cases from 2012 to 2017. Demographic data and functional score after 2 years of surgery were analysed and presented. Results: There were 14 male and 2 female cases of STS with mean age of 32.88 years. The most common STS was liposarcoma (37.5%) followed by rhabdomyosarcoma (25%) and synovial sarcoma (18.8%). Extremity and lower limb were the most common sites. Mean MSTS functional score at the last follow up was 24.56 (81.83%) with range from 19-29 (63.33%-96.66%). There were good to excellent results in 13 cases (81.25%) and moderate result in 3 cases (18.75%) according to MSTS functional score. There was positive correlation of MSTS with age, radiotherapy, chemotherapy and negative correlation with grade of tumor. Conclusions: This study showed good to excellent functional results in 81.25% of cases as per Musculoskeletal Tumor Society Score (MSTS) with positive correlation with radiotherapy, chemotherapy, age and negative correlation with grade of tumor.

Reconstructive limb‐salvage surgery after lower extremity soft tissue sarcoma resection: A 20‐year experience

2019 ◽  
Vol 119 (6) ◽  
pp. 708-716 ◽  
Author(s):  
Kelly M. Bridgham ◽  
Jad M. El Abiad ◽  
Zhen A. Lu ◽  
Deepa Bhat ◽  
Halley Darrach ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Lower Extremity ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Limb Salvage Surgery ◽  
Extremity Soft Tissue Sarcoma

scholarly journals Treatment-Related Prognostic Factors in Managing Osteosarcoma around the Knee with Limb Salvage Surgery: A Lesson from a Long-Term Follow-Up Study

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Jianping Hu ◽  
Chunlin Zhang ◽  
Kunpeng Zhu ◽  
Lei Zhang ◽  
Tao Cai ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Local Recurrence ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Survival Rates ◽  
Tumor Resection ◽  
Limb Salvage Surgery ◽  
Related Factors

Purpose. The aim of this study was to assess the treatment-related factors associated with local recurrence and overall survival of patients with osteosarcoma treated with limb-salvage surgery. Patients and Methods. Treatment-related factors were analyzed to evaluate their effects on local recurrence-free survival (LRFS) and overall survival (OS) in 182 patients from 2004 to 2013. Results. The mean length of follow-up was 73.4 ± 34.7 months (median, 68 months; range, 12-173 months), and 63 patients died by the end of the follow-up. The 5-year and 10-year overall survival rates were 68.6 ± 6.6% and 59.4 ± 10.6%, respectively. Univariate analysis showed that treatment-related prognostic factors for overall survival were prolonged symptom intervals >=60 days, biopsy/tumor resection performed by different centers, previous medical history, incomplete preoperative chemotherapy (<8 weeks), and prolonged postoperative interval >21 days. In the multivariate analysis, biopsy/tumor resection performed by different centers, incomplete implementation of planned new adjuvant chemotherapy, and delayed resumption of postoperative chemotherapy (>21 days) were risk factors for poor prognosis; biopsy/tumor resection performed by different centers and tumor necrosis <90% were independent predictors of local recurrence. Conclusion. For localized osteosarcoma treated with limb-salvage surgery, it is necessary to optimize timely standard chemotherapy and to resume postoperative chemotherapy to improve survival rates. Biopsies should be performed at experienced institutions in cases of developing local recurrence.

scholarly journals Limb salvage surgery for bone and soft tissue sarcoma. A phase II pathologic study of preoperative intraarterial cisplatin

Cancer ◽  
1991 ◽  
Vol 68 (4) ◽  
pp. 738-743 ◽  
Author(s):  
Raymond A. Kempf ◽  
Lowell E. Irwin ◽  
Lawrence Menendez ◽  
Parakrama Chandrasoma ◽  
Susan Groshen ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Limb Salvage ◽  
Phase Ii ◽  
Salvage Surgery ◽  
Limb Salvage Surgery ◽  
Pathologic Study
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