Clinical characteristics of patients with undergoing unplanned excisions of malignant soft tissue tumors

Morinaga, Sei; Miwa, Shinji; Yamamoto, Norio; Hayashi, Katsuhiro; Takeuchi, Akihiko; Igarashi, Kentaro; Tada, Kazuhiro; Langit, Mickhael Bang; Yonezawa, Hirotaka; Araki, Yoshihiro; Asano, Yohei; Tsuchiya, Hiroyuki

doi:10.1177/23094990211057597

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…Regarding the diagnosis of malignant soft tissue tumors, the guidelines mentioned that a tumor "size ≥ 5 cm" www.nature.com/scientificreports/ and "deep location" are typical findings suggestive of malignant soft tissue tumors, especially among orthopedic oncologists. Nevertheless, in practice, the inappropriate management of malignant soft tissue sarcomas has been continuously reported [12][13][14] . Therefore, it is necessary to obtain feedback regarding physicians' commitment to this guideline.…”

Section: Discussionmentioning

confidence: 99%

Review of the referral documents of patients with malignant soft tissue tumors

Hoshi

Oebisu

Iwai

et al. 2022

Sci Rep

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Fifteen years have passed since the soft tissue tumor practice guidelines were first published in Japan. Tumor size of ≥ 5 cm and tumor depth were key findings suggestive of malignant soft tissue tumors. We reviewed the referral documents provided by the referring physicians to see if these two findings were reported. The study was conducted from January 2007 to December 2021 and included 142 patients (83 men and 59 women; median age, 64 [6–94] years) with malignant soft tissue tumors. Patient referral documents from physicians were screened for descriptions of the tumor size and depth. The tumor size, depth, and both were described in 51.4%, 36.6%, and 23.2% of the referrals, respectively. Both findings were mentioned in 23.8%, 21.7%, and 25.0% of referrals in 2007–2011, 2012–2016, and 2017–2021, respectively. Of orthopedic surgeons and other physicians, 61.2% and 38.6%, respectively, described the tumor size. Whether the general physicians could follow the soft tissue tumor practice guidelines was difficult to conclude by reviewing patient referral documents. However, orthopedic surgeons seemed to pay more attention to tumor size. Awareness regarding soft tissue tumor practice guidelines should be increased to help diagnose malignant soft tissue tumors early.

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Section: Discussionmentioning

confidence: 99%

Review of the referral documents of patients with malignant soft tissue tumors

Hoshi

Oebisu

Iwai

et al. 2022

Sci Rep

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“…Despite the addition of these treatments, previous studies have shown that unplanned surgery is always associated with poor outcomes [14,15]. The reasons for "whoops" surgery include difficulty in clinically discriminating benign from malignant soft tissue masses [16]. Indeed, sarcomas can mimic lipoma, benign neurogenic tumor, certain infections, and thrombosis, among others [17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…The reasons for “whoops” surgery include difficulty in clinically discriminating benign from malignant soft tissue masses [ 16 ]. Indeed, sarcomas can mimic lipoma, benign neurogenic tumor, certain infections, and thrombosis, among others [ 17 - 21 ].…”

Section: Introductionmentioning

confidence: 99%

Shortening the Time Interval for the Referral of Patients With Soft Tissue Sarcoma to Expert Centers Using Mobile Health: Retrospective Study

Nannini¹,

Penel²,

Bompas³

et al. 2022

JMIR Mhealth Uhealth

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Background According to guidelines, all patients with sarcoma must be managed from initial diagnosis at expert sarcoma centers. However, in everyday practice, the time interval to an expert center visit can be long, which delays presentation to an expert multidisciplinary tumor board and increases the risk of inappropriate management, negatively affecting local tumor control and prognosis. The advent of mobile health offers an easy way to facilitate communication and cooperation between general health care providers (eg, general practitioners and radiologists) and sarcomas experts. We developed a mobile app (Sar’Connect) based on the algorithm designed by radiologists from the French Sarcoma Group. Through a small number of easy-to-answer questions, Sar’Connect provides personalized advice for the management of patients and contact information for the closest expert center. Objective This retrospective study is the first to assess this mobile app’s potential benefits in reducing the time interval for patient referral to an expert center according to the initial clinical characteristics of the soft tissue tumor. Methods From May to December 2021, we extracted tumor mass data for 78 patients discussed by the multidisciplinary tumor boards at 3 centers of the French Sarcoma Group. We applied the Sar’Connect algorithm to these data and estimated the time interval between the first medical description of the soft tissue mass and the referral to expert center. We then compared this estimated time interval with the observed time interval. Results We found that the use of Sar’Connect could potentially shorten the time interval to an expert center by approximately 7.5 months (P<.001). Moreover, for half (31/60, 52%) of the patients with a malignant soft tissue tumor, Sar’Connect could have avoided inappropriate management outside of the reference center. We did not identify a significant determinant for shortening the time interval for referral. Conclusions Overall, promoting the use of a simple mobile app is an innovative and straightforward means to potentially accelerate both the referral and management of patients with soft tissue sarcoma at expert centers.

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Brachytherapy for Soft Tissue Sarcoma: Maintaining Local Control While Minimizing Complications

Montreuil,

Kholodovsky,

Markowitz

et al. 2024

Journal of Surgical Oncology

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BackgroundThis study aims to assess the clinical and oncologic outcomes of high‐dose brachytherapy (BRT) versus both preoperative and postoperative external beam radiation therapy (EBRT) in the setting of high‐grade soft tissue sarcoma.MethodsThis is a retrospective cohort study of 144 patients treated surgically for soft tissue sarcoma at the same institution from 2010 to 2021. Patients treated for a soft tissue sarcoma with surgery and radiation therapy in the form of BRT, Neoadjuvant EBRT (Neo‐EBRT) or adjuvant EBRT (AD‐EBRT) were included.Results56 patients were treated with BRT, 42 with Neo‐EBRT, and 46 with AD‐EBRT. There was a greater incidence of grouped wound complications in Neo‐EBRT with 50% compared to both BRT with 25% and AD‐EBRT with 28.3% (p = 0.02). Univariate and multivariate analysis showed that there was an increased risk of wound complications with Neo‐EBRT when compared to brachytherapy (p = 0.03 and p = 0.007, respectively). Univariate and multivariate analysis showed that there was no difference in risk of LR between treatment groups (p = 0.28).ConclusionBrachytherapy is a valuable treatment modality that offers clinical and logistical advantages when compared to the conventional Neo‐EBRT in soft tissue sarcomas. Brachytherapy offers a lower risk of wound complications and a comparable local control. This manuscript presents decision‐making strategies for determining the appropriate radiation modality for specific circumstances.

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Clinical characteristics of patients with undergoing unplanned excisions of malignant soft tissue tumors

Cited by 4 publications

References 35 publications

Review of the referral documents of patients with malignant soft tissue tumors

Review of the referral documents of patients with malignant soft tissue tumors

Shortening the Time Interval for the Referral of Patients With Soft Tissue Sarcoma to Expert Centers Using Mobile Health: Retrospective Study

Brachytherapy for Soft Tissue Sarcoma: Maintaining Local Control While Minimizing Complications

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