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Evaluating Surgery Quality in Soft Tissue Sarcoma

  • Chapter
Treatment of Bone and Soft Tissue Sarcomas

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 179))

Abstract

To identify pertinent indicators for oncologic outcomes in assessing surgery in soft tissue sarcomas, only local recurrences are considered here. Functional outcomes and treatment morbidity, equally important end-points for evaluating surgery quality, are less frequently reported and are not taken into account in this review. Herein, we review recent publications reporting indicators of surgery quality in soft tissue sarcoma treatment. Local recurrence-free interval is the major end-point in evaluating the quality of surgery. Disease-free survival should not be used because the risk factors for metastases are different from those for local recurrence. Five-year local recurrence-free estimations for limb and trunk wall sarcoma should be below 20%, and best approach 10%. The risk of local recurrence depends on tumour biology (i.e. grade) and quality of surgery as defined by the quality of margins. Better than margin width as measured on the tumour specimen, margin quality determined consensually between surgeons and pathologists is the best indicator for local outcome. Quality of margin should be expressed according the UICC residual disease definitions (R0: in sano, R1: microscopic residual disease, R2: macroscopic residual disease). Other important indicators for surgery quality are treatment in specialised centres, a planned, organised surgery, and treatment within a multi-disciplinary team. Soft tissue sarcoma should also be treated in specialised centres. Surgery quality depends on obtained margins that are determined best by close collaboration between the surgeon and the pathologist.

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  1. Department of Surgery, Institut Bergonie, Regional Cancer Centre, 229 Cours de I'Argonne, Bordeaux Cedex, 33076, France

    Eberhard Stoeckle, Jean-Michel Coindre, Michèle Kind, Guy Kantor & Binh N. Bui

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  1. Eberhard Stoeckle
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  2. Jean-Michel Coindre
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  1. Leiter Department Tumororthopädie Klinik für Orthopädie und Orthopädische Rheumatologie, HELIOS-Klinikum Berlin, Schwanebecker Chaussee 50, Berlin, 13125

    Per-Ulf Tunn

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Stoeckle, E., Coindre, JM., Kind, M., Kantor, G., Bui, B.N. (2009). Evaluating Surgery Quality in Soft Tissue Sarcoma. In: Tunn, PU. (eds) Treatment of Bone and Soft Tissue Sarcomas. Recent Results in Cancer Research, vol 179. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-77960-5_14

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