Planned and Unplanned Sarcoma Resections: Comparative Analysis of Local Recurrence, Metastasis, and Mortality.

cancer-specific mortality early detection metastasis planned excision/resection predictive tools sarcoma sarcoma management surgical outcomes tumor characteristics unplanned excision/whoops/resection

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
07 Oct 2024
Historique:
received: 14 08 2024
revised: 02 10 2024
accepted: 04 10 2024
medline: 16 10 2024
pubmed: 16 10 2024
entrez: 16 10 2024
Statut: epublish

Résumé

Sarcomas, a diverse group of malignant tumors arising from mesenchymal tissues, pose significant diagnostic and therapeutic challenges. This study compares the outcomes of planned resections (PEs) and unplanned resections (UEs) to inform better clinical practices. Data were analyzed from the Swiss Sarcoma Network (SSN), including patients with soft tissue and bone sarcomas treated at two major hospitals. This study utilized logistic regression and Cox regression models to examine the odds of UEs and their impact on local recurrence-free survival. Among 429 patients registered by SSN members, 323 (75%) underwent PEs and 106 (25%) experienced UEs. PEs were associated with significantly larger tumors (94 mm vs. 47 mm, PEs achieve superior immediate surgical outcomes but are linked to higher metastasis and cancer-specific mortality due to the advanced stage of tumors. UEs, while associated with higher local recurrence rates, do not significantly impact MFS or OS. Early detection, comprehensive diagnostics, and timely referrals to specialized sarcoma hubs are essential to avoid UEs and reduce metastatic risk. Future research should focus on developing diagnostic tools using individual tumor and patient characteristics to improve sarcoma management.

Sections du résumé

BACKGROUND BACKGROUND
Sarcomas, a diverse group of malignant tumors arising from mesenchymal tissues, pose significant diagnostic and therapeutic challenges. This study compares the outcomes of planned resections (PEs) and unplanned resections (UEs) to inform better clinical practices.
METHODS METHODS
Data were analyzed from the Swiss Sarcoma Network (SSN), including patients with soft tissue and bone sarcomas treated at two major hospitals. This study utilized logistic regression and Cox regression models to examine the odds of UEs and their impact on local recurrence-free survival.
RESULTS RESULTS
Among 429 patients registered by SSN members, 323 (75%) underwent PEs and 106 (25%) experienced UEs. PEs were associated with significantly larger tumors (94 mm vs. 47 mm,
CONCLUSIONS CONCLUSIONS
PEs achieve superior immediate surgical outcomes but are linked to higher metastasis and cancer-specific mortality due to the advanced stage of tumors. UEs, while associated with higher local recurrence rates, do not significantly impact MFS or OS. Early detection, comprehensive diagnostics, and timely referrals to specialized sarcoma hubs are essential to avoid UEs and reduce metastatic risk. Future research should focus on developing diagnostic tools using individual tumor and patient characteristics to improve sarcoma management.

Identifiants

pubmed: 39410028
pii: cancers16193408
doi: 10.3390/cancers16193408
pii:
doi:

Types de publication

Journal Article

Langues

eng

Auteurs

Kim N Nydegger (KN)

Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland.
Sarkomzentrum, Kliink für Orthopädie und Unfallchirurgie, LUKS University Hospital, Luzerner Kantonsspital, 6000 Lucerne, Switzerland.

Timothy T A F Obergfell (TTAF)

Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland.
Sarkomzentrum, Kliink für Orthopädie und Unfallchirurgie, LUKS University Hospital, Luzerner Kantonsspital, 6000 Lucerne, Switzerland.

Philip Heesen (P)

Medical Faculty, University of Zurich, 8032 Zurich, Switzerland.

Georg Schelling (G)

Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland.
Sarkomzentrum, Kliink für Orthopädie und Unfallchirurgie, LUKS University Hospital, Luzerner Kantonsspital, 6000 Lucerne, Switzerland.

Gabriela Studer (G)

Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland.
Sarkomzentrum, Kliink für Orthopädie und Unfallchirurgie, LUKS University Hospital, Luzerner Kantonsspital, 6000 Lucerne, Switzerland.

Beata Bode-Lesniewska (B)

Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland.
Sarkomzentrum, Kliink für Orthopädie und Unfallchirurgie, LUKS University Hospital, Luzerner Kantonsspital, 6000 Lucerne, Switzerland.

Bruno Fuchs (B)

Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland.
Sarkomzentrum, Kliink für Orthopädie und Unfallchirurgie, LUKS University Hospital, Luzerner Kantonsspital, 6000 Lucerne, Switzerland.
Sarkomzentrum KSW, Klinik für Orthopädie und Traumatologie, Kantonsspital Winterthur, 8400 Winterthur, Switzerland.

Classifications MeSH