Real-world Referral Pattern of Unplanned Excision in Patients With Soft-tissue Sarcoma: A Multicenter Study Conducted by the Bone and Soft-tissue Tumor Study Group of the Japan Clinical Oncology Group

被引：2

作者：

Nakamura, Tomoki ^{[1
]}

Ogura, Koichi ^{[2
]}

Hayakawa, Keiko ^{[3
]}

Ikuta, Kunihiro ^{[4
,5
]}

Nezu, Yutaka ^{[6
]}

Miwa, Shinji ^{[7
]}

Yoshida, Shinichiro ^{[8
]}

Nakai, Sho ^{[9
,10
]}

Kinoshita, Hideyuki ^{[11
]}

Kawabata, Yusuke ^{[12
]}

Hamada, Shunsuke ^{[13
]}

Nabeshima, Akira ^{[14
]}

Outani, Hidetatsu ^{[10
]}

Kobayashi, Hiroshi ^{[15
]}

Hara, Hitomi ^{[16
]}

Tsugita, Masanori ^{[17
]}

Koyanagi, Hirotaka ^{[18
]}

Setsu, Nokitaka ^{[19
]}

Maekawa, Akira ^{[20
]}

Daisaku, Akihiro ^{[21
]}

Mori, Tomoaki ^{[22
]}

Oike, Naoki ^{[23
]}

Kubota, Yuta ^{[24
]}

Tanaka, Takaaki ^{[25
]}

Noguchi, Takashi ^{[26
]}

Tajima, Takashi ^{[27
]}

Tanaka, Kazuhiro ^{[28
]}

Ozaki, Toshifumi ^{[29
]}

机构：

[1] Mie Univ, Grad Sch Med, Dept Orthopaed Surg, 2-174 Edobashi, Tsu, Mie 5148507, Japan

[2] Natl Canc Ctr, Dept Musculoskeletal Oncol & Rehabil Med, Tokyo, Japan

[3] Japanese Fdn Canc Res, Canc Inst Hosp, Dept Orthopaed Oncol, Tokyo, Japan

[4] Nagoya Univ, Grad Sch, Dept Orthopaed Surg, Nagoya, Aichi, Japan

[5] Sch Med, Nagoya, Aichi, Japan

[6] Kanagawa Canc Ctr, Dept Musculoskeletal Tumor Surg, Yokohama, Kanagawa, Japan

[7] Kanazawa Univ, Grad Sch Med Sci, Dept Orthopaed Surg, Kanazawa, Ishikawa, Japan

[8] Tohoku Univ, Sch Med, Dept Orthopaed Surg, Sendai, Miyagi, Japan

[9] Osaka Int Canc Inst, Dept Musculoskeletal Oncol Serv, Osaka, Japan

[10] Osaka Univ, Grad Sch Med, Dept Orthopaed Surg, Osaka, Japan

[11] Chiba Canc Ctr, Div Orthopaed Surg, Chiba, Japan

[12] Yokohama City Univ, Dept Orthopaed Surg, Yokohama, Kanagawa, Japan

[13] Aichi Canc Ctr Hosp, Dept Orthopaed Surg, Nagoya, Aichi, Japan

[14] Kyushu Univ, Grad Sch Med Sci, Dept Orthopaed Surg, Fukuoka, Japan

[15] Univ Tokyo, Grad Sch Med, Dept Orthopaed Surg, Tokyo, Japan

[16] Kobe Univ, Grad Sch Med, Dept Orthopaed Surg, Kobe, Hyogo, Japan

[17] Gifu Univ, Grad Sch Med, Dept Orthopaed Surg, Gifu, Japan

[18] Saitama Canc Ctr, Dept Rehabil, Saitama, Japan

[19] NHO Kyushu Canc Ctr, Dept Orthopaed Surg, Fukuoka, Japan

[20] Kyushu Rosai Hosp, Dept Orthopaed Surg, Kitakyushu, Fukuoka, Japan

[21] Kurume Univ, Dept Orthopaed Surg, Kurume, Fukuoka, Japan

[22] Keio Univ, Sch Med, Dept Orthopaed Surg, Tokyo, Japan

[23] Niigata Univ, Grad Sch Med & Dent Sci, Dept Regenerat & Transplant Med, Div Orthopaed Surg, Niigata, Japan

[24] Oita Univ, Dept Orthopaed Surg, Oita, Japan

[25] Univ Fukui, Dept Orthopaed & Rehabil Med, Fukui, Japan

[26] Kyoto Univ, Dept Orthopaed Surg, Kyoto, Japan

[27] Kyorin Univ, Fac Med, Dept Orthopaed Surg, Tokyo, Japan

[28] Oita Univ, Dept Adv Med Sci, Oita, Japan

[29] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Orthopaed Surg, Okayama, Japan

来源：

IN VIVO | 2024年 / 38卷 / 06期

关键词：

Soft-tissue sarcoma; unplanned excision; re-excision; RESECTION;

D O I：

10.21873/invivo.13749

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

Background/Aim: Despite the well-publicized clinical outcomes after unplanned excision (UE) and re-excision (re-excision) in patients with soft-tissue sarcoma (STS), there is little information about the real-life referral patterns for UE, such as patient profile, details of procedures, and subsequent management after UE. We aimed to investigate the characteristics of patients with UE who were referred to sarcoma-specific centers. Patients and Methods: Between May 2022 and June 2023, we registered 97 patients who underwent UE and were referred to sarcoma-specific centers in Japan. We excluded those with well-differentiated liposarcomas and dermatofibrosarcoma protuberances. We investigated the details of UE and additional treatment after UE. Results: There were 49 men and 48 women, with a mean age of 62 years. A broad range of surgeons performed UE; 36 plastic surgeons, 22 orthopedic surgeons, 17 general surgeons, 17 dermatologists, and 5 others. The mean tumor size was 4.1 cm. Local anesthesia was administered to 58 patients. Forty-five patients underwent UE without prior magnetic resonance imaging. Inappropriate transverse skin incisions were performed in 42 patients. Of the 97 patients, 82 underwent re-excision after UE. The mean time between UE and date of initial presentation at the referral hospital was 46 days. The mean interval between UE and re-excision was 96 days. Of the 82 patients, 59 underwent soft-tissue reconstruction after re-excision. Conclusion: A broad range of surgeons performed UE. Continuous education about STS should be considered for all surgeons. UE should be avoided because residual tumors are common, and reconstructive surgery may be necessary.

引用

页码：2712 / 2717

页数：6

共 22 条

[1]

9The Japanese Orthopaedic Association, 2020, Clinical Practice Guidelines on the Management of Soft Tissue Tumors

[2] The Financial Burden of Reexcising Incompletely Excised Soft Tissue Sarcomas: A Cost Analysis [J].

Alamanda, Vignesh K. ;

Delisca, Gadini O. ;

Mathis, Shannon L. ;

Archer, Kristin R. ;

Ehrenfeld, Jesse M. ;

Miller, Mark W. ;

Homlar, Kelly C. ;

Halpern, Jennifer L. ;

Schwartz, Herbert S. ;

Holt, Ginger E. .

ANNALS OF SURGICAL ONCOLOGY, 2013, 20 (09) :2808-2814

[3] Unplanned Sarcoma Excisions: Understanding How They Happen [J].

Belzarena, Ana Cecilia ;

Binitie, Odion ;

Letson, George Douglas ;

Joyce, David Michael .

JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS, 2024, 8 (01)

[4] MR imaging in the assessment of residual tumour following inadequate primary excision of soft tissue sarcomas [J].

Davies, AM ;

Mehr, A ;

Parsonage, S ;

Evans, N ;

Grimer, RJ ;

Pynsent, PB .

EUROPEAN RADIOLOGY, 2004, 14 (03) :506-513

[5] Watch and Wait Approach for Re-excision After Unplanned Yet Macroscopically Complete Excision of Extremity and Superficial Truncal Soft Tissue Sarcoma is Safe and Does Not Affect Metastatic Risk or Amputation Rate [J].

Decanter, Gauthier ;

Stoeckle, Eberhard ;

Honore, Charles ;

Meeus, Pierre ;

Mattei, Jean Camille ;

Dubray-Longeras, Pascale ;

Ferron, Gwenael ;

Carrere, Sebastien ;

Causeret, Sylvain ;

Guilloit, Jean-Marc ;

Fau, Magali ;

Rosset, Philippe ;

Machiavello, Jean-Christophe ;

Delhorme, Jean Baptiste ;

Regenet, Nicolas ;

Gouin, Francois ;

Blay, Jean-Yves ;

Coindre, Jean-Michel ;

Penel, Nicolas ;

Bonvalot, Sylvie .

ANNALS OF SURGICAL ONCOLOGY, 2019, 26 (11) :3526-3534

[6] Impact of the national sarcoma guidelines on the prevalence and outcome of inadvertent excisions of soft tissue sarcomas: An observational study from a UK tertiary referral centre [J].

Fujiwara, Tomohiro ;

Evans, Scott ;

Stevenson, Jonathan ;

Tsuda, Yusuke ;

Gregory, Jonathan ;

Grimer, Robert ;

Abudu, Adesegun .

EJSO, 2022, 48 (03) :533-540

[7] The Impact of Re-Excision of Inadequately Resected Soft Tissue Sarcomas on Surgical Therapy, Results, and Prognosis: A Single Institution Experience With 682 Patients [J].

Funovics, Philipp T. ;

Vaselic, Sanja ;

Panotopoulos, Joannis ;

Kotz, Rainer I. ;

Dominkus, Martin .

JOURNAL OF SURGICAL ONCOLOGY, 2010, 102 (06) :626-633

[8] Predictors of residual disease after unplanned excision of soft tissue sarcomas [J].

Gingrich, Alicia A. ;

Elias, Alexandra ;

Lee, Chia-Yuan Michael ;

Nakache, Yves-Paul N. ;

Li, Chin-Shang ;

Shah, Dhruvil R. ;

Boutin, Robert D. ;

Canter, Robert J. .

JOURNAL OF SURGICAL RESEARCH, 2017, 208 :26-32

[9] Inadvertent excision of malignant soft tissue tumours [J].

Grimer, Robert ;

Parry, Michael ;

James, Steven .

EFORT OPEN REVIEWS, 2019, 4 (06) :321-329

[10] Soft tissue and visceral sarcomas: ESMO-EURACAN-GENTURIS Clinical Practice Guidelines for diagnosis, treatment and follow-up [J].

Gronchi, A. ;

Miah, A. B. ;

DeiTos, A. P. ;

Abecassis, N. ;

Bajpai, J. ;

Bauer, S. ;

Biagini, R. ;

Bielack, S. ;

Blay, J. Y. ;

Bolle, S. ;

Bonvalot, S. ;

Boukovinas, I ;

Bovee, J. V. M. G. ;

Boye, K. ;

Brennan, B. ;

Brodowicz, T. ;

Buonadonna, A. ;

De Alava, E. ;

Del Muro, X. G. ;

Dufresne, A. ;

Eriksson, M. ;

Fagioli, F. ;

Fedenko, A. ;

Ferraresi, V ;

Ferrari, A. ;

Frezza, A. M. ;

Gasperoni, S. ;

Gelderblom, H. ;

Gouin, F. ;

Grignani, G. ;

Haas, R. ;

Hassan, A. B. ;

Hecker-Nolting, S. ;

Hindi, N. ;

Hohenberger, P. ;

Joensuu, H. ;

Jones, R. L. ;

Jungels, C. ;

Jutte, P. ;

Kager, L. ;

Kasper, B. ;

Kawai, A. ;

Kopeckova, K. ;

Krakorova, D. A. ;

Le Cesne, A. ;

LeGrange, F. ;

Legius, E. ;

Leithner, A. ;

Lopez-Pousa, A. ;

Martin-Broto, J. .

ANNALS OF ONCOLOGY, 2021, 32 (11) :1348-1365

← 1 2 3 →