Soft Tissue Sarcomas-The Pitfalls in Diagnosis and Management!!

Chintamani,

doi:10.1007/s13193-012-0141-7

Cited by 9 publications

(8 citation statements)

References 14 publications

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“…По этой причине существует множество проблем в диагностике и лечении сарком -непредвиденные трудности, которые не включают ошибки, вызванные незнанием или недостаточной компетентностью специалистов. Именно недооценка злокачественного потенциала и неоптимальное хирургическое лечение первичной опухоли являются основными трудностями, которые могут привести к летальному исходу [16,17].…”

Section: результатыunclassified

Issues of diagnostic search of soft tissue sarcoma

Сергеев

Maksimov

Морозов

et al. 2022

vmirvz

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Relevance. Soft tissue sarcoma is a heterogeneous group of relatively rare types of tumors, which demonstrates a huge variety of anatomical localization and histopathological characteristics. The rarity of soft tissue sarcomas combined with a variety of subtypes, forms of growth, progression and frequency of relapses makes it difficult to study them, make a correct diagnosis and early referral of patients for specialized care.The purpose of study. To analyze the problem of differential diagnosis of malignant and benign soft tissue neoplasms.Materials and methods. In the course of the work, current literary sources of domestic and foreign authors on a given topic were analyzed.Results. Since it is absolutely impossible to determine the clinical features of the presented sarcoma, soft tissue tumors showing any of the following signs are considered malignant until the opposite is proven: increasing in size, >5 cm, deeply located and/or painful. The greater the number of these clinical signs present, the higher the risk that the soft tissue tumor will turn out to be malignant; at the same time, an increase in size is the best individual indicator. It is worth noting that the absence of concomitant constitutional symptoms, such as fever, chills, night sweats or unintentional weight loss, should not reduce the doctor's suspicion of malignancy.Conclusion. In order to avoid erroneous diagnoses, a standardized diagnostic approach should be followed, starting from the moment of collecting the patient's medical history, clinical examination and ending with the use of appropriate imaging methods and biopsy.

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Section: результатыunclassified

Issues of diagnostic search of soft tissue sarcoma

Сергеев

Maksimov

Морозов

et al. 2022

vmirvz

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“…And with so many different histological subtypes, it may be nearly impossible for a single general pathologist to encounter all subtypes in adequate numbers in one lifetime (45). This argues strongly for the training of an expert sarcoma pathologist in each MDT.…”

Section: Pathologistmentioning

confidence: 99%

Soft tissue sarcoma in Asia

Poon¹,

Quek²

2018

Chin. Clin. Oncol.

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Sarcoma is an uncommon and heterogeneous group of malignancies linked by their mesenchymal origin. They are rare and account for 1% of adult cancers, and 10-20% of adolescent and young adult (AYA) cancers. While there is good published literature on the incidence and distribution of sarcoma subtypes in the western populations, there is a paucity of data from Asia, particularly on the epidemiology, treatment and outcomes of STS in Asia. Formalized prospective national registries in soft tissue sarcoma (STS) are lacking and little is known about how sarcomas are treated and managed throughout the Asia-Pacific region. Due to geographical and varying affluence levels across over 50 countries, no single uniform guideline exists across Asia to inform of chemotherapeutic options. Any existent guidelines tend to be country-specific, reflecting resource availability and geographical limitation. To understand and improve STS care in Asia, one must appreciate the macroeconomics and healthcare structures in place and to work within the limitations imposed by them. Concurrently, there exists an urgency to develop strong sarcoma centres of excellence (SCE) across Asia to deliver state-of-art care to our patients. Equally important is the need to facilitate sarcoma education to patients and healthcare workers. Development of such centres is vital in improving clinical care as they provide high-quality sub-specialized care to patients within that geographical location, serve as reference centres for knowledge and education as well as nerve centres for care-coordination in a hub-and-spoke model. Key to these centres of excellence is the sarcoma multi-disciplinary team (MDT). Studies have consistently shown that patients managed in high-volume sarcoma centres, by an expert sarcoma MDT, achieve better clinical outcomes. This report serves to highlight the challenges and opportunities of sarcoma care in Asia, map out a vision for the development of SCE across Asia and highlight the areas of potential collaboration between centres to advance the science of sarcoma.

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“…Soft tissue sarcoma (STS) is a rare malignancy of mesenchymal origin that develops in any of the soft tissues (e.g., fat, muscle, nerves, and blood vessels) of the body [1,2]. There are over 50 subtypes of STS that can vary by molecular, histological, and clinical characteristics, making diagnosis and treatment challenging [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the accuracy of algorithms to identify soft tissue sarcoma (STS) in administrative claims

et al. 2020

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Background Lack of using a validated algorithm to select patients is a source of selection bias in oncology studies using administrative claims. The objective of this study to evaluate published algorithms to identify patients with soft tissue sarcoma (STS) in administrative claims and to evaluate new algorithms to improved performance. Methods Two cancer populations including STS cases and non-STS controls were selected from the MarketScan Explorys Linked Claims-Electronic Medical Record (EMR) Database between January 1, 2000 and July 31, 2018. Eligible cases had a diagnosis on a clinical record for STS in the EMR while controls had no evidence of STS on any EMR records. Both cases and controls were enrolled in administrative claims during a period of observation and were aged ≥ 18 years. A split sample was used to test and validate algorithms using data from administrative claims. Values for sensitivity, specificity, and positive predictive value (PPV) were calculated for 14 algorithms. Prior literature validating algorithms in administrative claims across other cancer types report both sensitivity and specificity ranging from as low as 73% to as high as 95%. This was used as a benchmark for defining algorithm success. Results There were 784 STS cases and 249,062 non-STS cancer controls eligible for analysis. Requiring at least two claims with an ICD-CM diagnosis code for STS achieved a sensitivity of 67% but had a specificity of 72%. Algorithms that required NCCN-recommended systemic treatment for STS improved the specificity to over 90% but dropped the sensitivity to below 20%. Other combinations of diagnostic tests, symptoms, and procedures did not improve performance. Conclusions The algorithms tested in this study sample did not achieve sufficient performance and suggest the ability to accurately identify the STS population in administrative data is problematic. Difficulties are likely due to the origin of STS in a variety of locations, the non-specific symptoms of STS, and the common diagnostic tests recommended to diagnose the disease. Future research applying machine learning to examine timing and patterns of variables that comprise the diagnostic process may further investigate the ability to accurately identify STS cases in claims databases.

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Soft Tissue Sarcomas-The Pitfalls in Diagnosis and Management!!

Cited by 9 publications

References 14 publications

Issues of diagnostic search of soft tissue sarcoma

Issues of diagnostic search of soft tissue sarcoma

Soft tissue sarcoma in Asia

Evaluation of the accuracy of algorithms to identify soft tissue sarcoma (STS) in administrative claims

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