Surgical Management of Metastatic Disease

Keung, Emily Z.; Fairweather, Mark; Raut, Chandrajit P.

doi:10.1016/j.suc.2016.05.010

Cited by 12 publications

(7 citation statements)

References 69 publications

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“…In terms of surgical resection, it is considered a standard of care for most sarcomas [ 8 ]. Surgery can provide good local control and symptom relief, but it may be associated with significant morbidity and long-term complications [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment Outcomes of Leiomyosarcoma Metastasis Affecting the Brachial Plexus: A Comparative Case Report Using Chat Generative Pre-trained Transformer (ChatGPT)

Zamarud¹,

Marianayagam²,

Sekar³

et al. 2023

Cureus

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Sarcomas are a rare type of cancer that can develop in various parts of the body, including the brachial plexus. Leiomyosarcomas (LMs) are a subtype of sarcoma that develops in smooth muscle tissue and can metastasize to different parts of the body. In this case report, we present two patients with LM metastasized to the brachial plexus, one treated with CyberKnife (Accuray, Sunnyvale, CA) stereotactic radiosurgery (CK SRS) and the other with surgical resection. The aim of this case report is to present the treatment outcomes and adverse effects of CK SRS and surgical resection in brachial plexus LM metastasis. Patient 1 was a 39year-old female who received CK SRS, and at three months of follow-up, the lesion was smaller, and she reported symptomatic improvement. At 15 months, the lesion was stable in size, and there was no evidence of local invasion of the adjacent vascular structures or nerves. Patient 2 was a 52-year-old male who underwent surgical resection, and at one-month follow-up, the patient was asymptomatic with no recurrence of his symptoms. The size of the residual axillary tumor was stable at three months and showed a slight interval decrease in size at five months of follow-up. He was followed for over 12 months, with no recurrence of his symptoms.Both treatments appear to have been effective in controlling LM growth and relieving symptoms. CK SRS provides a non-invasive option. However, more research is needed to fully understand the effectiveness and safety of these treatments for brachial plexus sarcoma. This case report highlights the importance of considering different treatment options for brachial plexus sarcoma and the need for further studies to understand the best approach for these rare cases.

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Section: Discussionmentioning

confidence: 99%

Treatment Outcomes of Leiomyosarcoma Metastasis Affecting the Brachial Plexus: A Comparative Case Report Using Chat Generative Pre-trained Transformer (ChatGPT)

Zamarud¹,

Marianayagam²,

Sekar³

et al. 2023

Cureus

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“…26,27 Some studies have shown that even for patients with metastases (such as lung and liver metastases), active surgical treatment can still achieve a good survival rate. [28][29][30][31] As either a supplement to surgery or a type of palliative treatment, radiotherapy can effectively relieve pain in STS patients. 19 In a study of 9068 retroperitoneal STS patients, Nussbaum et al 32 indicated that surgery combined with adjuvant radiotherapy can improve patient survival in comparison to surgery alone.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of Novel Nomograms for Predicting Specific Distant Metastatic Sites and Overall Survival of Patients With Soft Tissue Sarcoma

Zhang

et al. 2021

Technol Cancer Res Treat

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Purpose: The goal of this study is to construct nomograms to effectively predict the distant metastatic sites and overall survival (OS) of soft tissue sarcoma (STS) patients. Methods: STS case data between 2010 and 2015 for retrospective study were gathered from public databases. According to the chi-square and multivariate logistic regression analysis determined independent predictive factors of specific metastatic sites, the nomograms based on these factors were consturced. Subsequently, combined metastatic information a nomogram to predict 1-, 2-, and 3-year OS of STS patients was developed. The performance of models was validated by the area under the curve (AUC), calibration plots, and decision curve analyses (DCA). Results: A total of 7001 STS patients were included in this retrospective study, including 4901 cases in the training group and the remaining 2,100 patients in the validation group. Three nomograms were established to predict lung, liver and bone metastasis, and satisfactory results have been obtained by internal and external validation. The AUCs for predicting lung, liver, and bone metastases in the training cohort were 0.796, 0.799, and 0.766, respectively, and in the validation cohort were 0.807, 0.787, and 0.775, respectively, which means that the nomograms have good discrimination. The calibration curves showed that the models have high precision, and the DCA manifested that the nomograms have great clinical application prospects. Through univariate and multivariate COX regression analyses, 8 independent prognosis factors of age, grade, histological type, tumor size, surgery, chemotherapy, radiatiotherapy and lung metastasis were determined. A nomogram was then constructed to predict the 1-, 2-, and 3-years OS, which has a good performance in both internal and external validations. Conclusion: The nomograms for predicting specific metastatic sites and OS have good discrimination, accuracy and clinical applicability. The models could accurately predict the metastatic risk and survival information, and help clinical decision-making.

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“…Moreover, the differentiation between normal and tumor tissue can be extremely challenging in the case of liposarcomas (LPS). While surgical management of sarcomas is critical for potential curative treatment in clinical practice, 1,2 a substantial portion of resections have presence of tumor cells at the resection margins, leading to earlier recurrence and/or need for reoperation. In current practice, the success of surgery in term of radicality is assessed by histopathology on resected tissue, which can take days to weeks before being reported.…”

Section: Introductionmentioning

confidence: 99%

Lipid profiling of electrosurgical vapors for real‐time assistance of soft tissue sarcoma resection

Vaysse,

van den Hout,

Engelen

et al. 2023

Journal of Surgical Oncology

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BackgroundSoft tissue sarcomas (STS) constitute a heterogeneous group of rare tumor entities. Treatment relies on challenging patient‐tailored surgical resection. Real‐time intraoperative lipid profiling of electrosurgical vapors by rapid evaporative ionization mass spectrometry (REIMS) may aid in achieving successful surgical R0 resection (i.e., microscopically negative‐tumor margin resection). Here, we evaluate the ex vivo accuracy of REIMS to discriminate and identify various STS from normal surrounding tissue.MethodsTwenty‐seven patients undergoing surgery for STS at Maastricht University Medical Center+ were included in the study. Samples of resected STS specimens were collected and analyzed ex vivo using REIMS. Electrosurgical cauterization of tumor and surrounding was generated successively in both cut and coagulation modes. Resected specimens were subsequently processed for gold standard histopathological review. Multivariate statistical analysis (principal component analysis‐linear discriminant analysis) and leave‐one patient‐out cross‐validation were employed to compare the classifications predicted by REIMS lipid profiles to the pathology classifications. Electrosurgical vapors produced during sarcoma resection were analyzed in vivo using REIMS.ResultsIn total, 1200 histopathologically‐validated ex vivo REIMS lipid profiles were generated from 27 patients. Ex vivo REIMS lipid profiles classified STS and normal tissues with 95.5% accuracy. STS, adipose and muscle tissues were classified with 98.3% accuracy. Well‐differentiated liposarcomas and adipose tissues could not be discriminated based on their respective lipid profiles. Distinction of leiomyosarcomas from other STS could be achieved with 96.6% accuracy. In vivo REIMS analyses generated intense mass spectrometric signals.ConclusionLipid profiling by REIMS is able to discriminate and identify STS with high accuracy and therefore constitutes a potential asset to improve surgical resection of STS in the future.

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Surgical Management of Metastatic Disease

Cited by 12 publications

References 69 publications

Treatment Outcomes of Leiomyosarcoma Metastasis Affecting the Brachial Plexus: A Comparative Case Report Using Chat Generative Pre-trained Transformer (ChatGPT)

Treatment Outcomes of Leiomyosarcoma Metastasis Affecting the Brachial Plexus: A Comparative Case Report Using Chat Generative Pre-trained Transformer (ChatGPT)

Development and Validation of Novel Nomograms for Predicting Specific Distant Metastatic Sites and Overall Survival of Patients With Soft Tissue Sarcoma

Lipid profiling of electrosurgical vapors for real‐time assistance of soft tissue sarcoma resection

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