This past year, the musculoskeletal tumor surgery literature kept up with the rapidly increasing publication volume in the medical literature. Among the thousands of publications in our field, we highlight a chosen few in this Guest Editorial. We are excited to present remarkable collaborations and exciting innovations. Although the majority of research continues to be retrospective, unique approaches are being developed and international cohesion is apparent by the worldwide collaborations and sharing of prospective data sets. Molecular approaches to diagnosis and treatment have made incremental steps forward, and the use of machine learning in prognosis and diagnosis continues to make strides. Finally, surgical approaches to bone and soft-tissue tumors are becoming better understood through large case series.
Soft-Tissue Sarcoma Prognostic Prediction ModelsRecent research has emphasized the crucial role of advanced diagnostic tools and methodologies in improving the prognosis and management of soft-tissue sarcomas. Marques et al. explored how magnetic resonance imaging (MRI) can predict the histological grade of soft-tissue sarcomas, suggesting that MRI features can provide valuable preoperative insights, potentially guiding treatment strategies 1 . Similarly, Kim et al. explored DNA methylation profiling as a means to classify histologic subtypes and grades in soft-tissue sarcomas 2 . Their findings indicate that this molecular approach can complement traditional histopathological evaluation, enhancing diagnostic accuracy and personalized treatment planning.Survival prediction models are also gaining attention. Yeramosu et al. developed a model to predict 5-year mortality in patients with soft-tissue sarcoma, emphasizing factors such as tumor size, patient age, and histological grade 3 . Kamalapathy et al. introduced a machine learning algorithm specifically for predicting 5-year survival in patients with soft-tissue leiomyosarcoma, highlighting the potential of artificial intelligence in clinical decision-making 4 . Additionally, Stauss et al. examined the impact of surgical resection margins on outcomes such as local recurrence, distant metastasis, and overall survival, underscoring the importance of achieving clear margins during the surgical procedure to improve patient prognosis 5 . Although the risk factors identified in these prediction model studies are not new, big data and the machine learning approach are important advancements.
Specific Soft-Tissue Sarcoma SubtypesAn increasing number of studies are approaching soft-tissue sarcoma subtypes as unique entities. In a Phase-2, international, open-label trial (SPEARHEAD-1), D'Angelo et al. investigated the efficacy of afamitresgene autoleucel in patients with advanced synovial sarcoma and myxoid round cell liposarcoma 6 . The study demonstrated promising results, with a notable percentage of patients experiencing tumor reduction and manageable safety profiles. This innovative therapy, which involves engineered T-cells targeting specific cancer antigens,...
