Clinical Surgical Oncology最新文献

{"title":"Diagnostic sensitivity of immune-inflammatory cell proportion in early diagnosis of endometrial cancer","authors":"Li Sun ,&nbsp;Shujie Zhai ,&nbsp;Guojia Wu ,&nbsp;Jie Gu ,&nbsp;Yiran Huang ,&nbsp;Dandan Hong ,&nbsp;Jianmei Wang ,&nbsp;Yongmei Li","doi":"10.1016/j.cson.2024.100058","DOIUrl":"10.1016/j.cson.2024.100058","url":null,"abstract":"<div><h3>Background</h3><p>Previous studies have shown that inflammation is closely linked to the occurrence and progression of cancer. While the role of immune-inflammatory cell proportions in cancer prognosis has been demonstrated, further research is required to fully understand their predictive value. This study aims to investigate the potential of immune-inflammatory cell proportions, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), red blood cell distribution width-to-platelet ratio (RPR), and monocyte-to-lymphocyte ratio (MLR), in predicting endometrial cancer (EC).</p></div><div><h3>Methods</h3><p>In this study, 18 patients with EC were included to create receiver operating characteristic (ROC) curves for NLR, MLR, PLR, and RPR, and the area under the curve (AUC) was calculated. Binary LOGISTIC regression analysis was then used to develop composite indicators. Subsequently, ROC curves were generated for the combined indicators, and the corresponding AUCs were calculated to evaluate the diagnostic efficacy of NLR, MLR, PLR, and RPR individually and in combination. The model was validated in an additional cohort.</p></div><div><h3>Result</h3><p>In the single-indicator ROC analysis, the baseline AUC for NLR was 0.724, with a significance level of <em>p</em> ​&lt; ​0.05, indicating good predictive power. For the two-indicator combined ROC analysis, the combined AUC of NLR with each of the three other indicators was greater than 0.724 with a significance level of <em>p</em> ​&lt; ​0.05. In the three-indicator combined ROC analysis, the baseline AUC of the combined indicators (including NLR) was greater than 0.766, and a <em>p</em> value of 0.001. Moreover, the baseline AUC of the validation set was 0.726.</p></div><div><h3>Conclusion</h3><p>Our findings suggest that the immune-inflammatory cell ratios, especially NLR, have a good predictive value for EC. Furthermore, the combined predictive value of the immune-inflammatory cell ratio is more effective than using individual applications.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 3","pages":"Article 100058"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000266/pdfft?md5=a41404e3d16b6c42364faf4ca54363fd&pid=1-s2.0-S2773160X24000266-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese expert consensus on the pelvic exenteration for primary rectal cancer beyond total mesorectal excision planes and locally recurrent rectal cancer","authors":"Meng Zhuang ,&nbsp;Yingchao Wu ,&nbsp;Bin Tang ,&nbsp;Jian Zhang ,&nbsp;Tenghui Ma ,&nbsp;Xicheng Wang ,&nbsp;Yuan Tang ,&nbsp;Yong Wu ,&nbsp;Xin Wang ,&nbsp;Xishan Wang ,&nbsp;Jianqiang Tang","doi":"10.1016/j.cson.2024.100053","DOIUrl":"10.1016/j.cson.2024.100053","url":null,"abstract":"<div><p>Pelvic exenteration is often required for primary rectal cancer beyond total mesorectal excision (PRC-bTME) and locally recurrent rectal cancer (LRRC). Some patients with radical resection can achieve long-term survival, but they need to face risks, such as huge surgical trauma, serious perioperative complications, permanent loss of organ function and decline in quality of life. Preoperative evaluation of PRC-bTME and LRRC should emphasize multidisciplinary collaboration and develop individualized diagnosis and treatment strategies. The principles of function preservation and risk-benefit balance in surgery oncology should be followed, and R₀ resection should be emphasized. Perioperative complications, surgical trauma and organ function loss should be minimized to achieve the best quality control and balance point. This consensus was formulated by the Colorectal Cancer Committee of the Chinese Medical Doctor Association and the Gastrointestinal Surgery Committee of China International Exchange and Promotive Association for Medical and Health Care. The draft was formed based on the summary of domestic and foreign research progress and expert experience. After discussion, review and modification by experts, an anonymous voting was conducted for each major opinion, and in-depth verification was carried out according to the principles of evidence-based medicine. Finally, the Chinese expert consensus on the pelvic exenteration with primary rectal cancer beyond total mesorectal excision planes and locally recurrent rectal cancer (2023 edition) was formed. This consensus mainly summarizes the indications and contraindications of pelvic exenteration (PE) for PRC-bTME and LRRC, preoperative diagnosis and evaluation, perioperative treatment, as well as the resection scope, surgical methods, reconstruction of related organs, safety and complications of PE, postoperative follow-up and other issues, in order to provide guidance for PE in patients with PRC-bTME and LRRC.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 3","pages":"Article 100053"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000217/pdfft?md5=241911fb65a464f33f5d78b6e59475f2&pid=1-s2.0-S2773160X24000217-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Top 50 most influential publications in robotic-assisted pulmonary lobectomy","authors":"Lauren C. Ladehoff ,&nbsp;Kristie M. Labib ,&nbsp;Richard Rivera ,&nbsp;William J. West III ,&nbsp;Cole R. Fiedler ,&nbsp;Eric M. Toloza","doi":"10.1016/j.cson.2024.100054","DOIUrl":"10.1016/j.cson.2024.100054","url":null,"abstract":"<div><h3>Background</h3><p>Since the early 2000s, robotic-assisted surgery has evolved in the field of thoracic surgery, and robotic-assisted pulmonary lobectomy (RAPL) has become a popular and safe treatment method for patients seeking removal of lung cancer. The purpose of the current study was to identify and examine the top-50 most influential articles in RAPL from 2003 to 2021 using bibliometric analysis.</p></div><div><h3>Hypothesis, materials, and methods</h3><p>The Clarivate Web of Science Core Collection was systematically searched to gather data on RAPL. Descriptive information for each article was collected and reported using descriptive statistics. The terms “robotic” AND “pulmonary” AND “lobectomy” were used to search this database and returned 468 articles published since 2003.</p></div><div><h3>Results</h3><p>Bibliometric analysis of the top-50 most influential manuscripts concluded that these articles were published between the years 2003 and 2021 and were collectively cited 2476 times. Mean number of total citations per article was 49.5 (95% confidence interval [37.8, 61.2]). The most influential articles experienced greatest increase in citations in 2020 with 450 total citations and an average of 9.0 citations per article. Our analysis demonstrated an increase in total number of citations for RAPL from 2003 to 2021, and 68% of the most cited articles were published after 2016. All 50 articles were published in English, and the United States (32) and the People's Republic of China (6) had the top number of publications. The top affiliation was the University of Michigan with 6 publications. The most popular journals were Annals of Thoracic Surgery and the Journal of Thoracic and Cardiovascular Surgery, with 7 and 6, respectively, of the top 50 manuscripts.</p></div><div><h3>Conclusion</h3><p>Given the rising popularity of RAPL since 2003, a current list of the most influential articles in RAPL can provide a reference point to guide better practice and address future areas of thoracic research.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 3","pages":"Article 100054"},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000229/pdfft?md5=ccff1531ebef604d774c569d8ef1f8e9&pid=1-s2.0-S2773160X24000229-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of three new wireless non-radiation techniques for localisation of non-palpable breast cancer - An updated systematic review and pooled meta-analysis","authors":"Kumaresh Timma Subramanian ,&nbsp;Abdolazeem Elnour ,&nbsp;Vijay Kurup","doi":"10.1016/j.cson.2024.100051","DOIUrl":"https://doi.org/10.1016/j.cson.2024.100051","url":null,"abstract":"<div><p>With a logistical advantage, new wire-free procedures have simplified implantation and retrieval of non-palpable breast cancers with enhanced clinical outcomes. The objective of current systematic review and meta-analysis is to assess the clinical effectiveness between three new wireless non-radiation localisation techniques, such as <strong>Magseed</strong>, <strong>Radiofrequency identification TAG</strong> and <strong>Savi-scout reflector</strong> from published literature over a 3 year period. The study, following PRISMA guidelines, identified 26 studies from 2020 to 2022 involving 6275 innovative agents, analyzing three groups. Statistical analysis using Medcalc software showed a pooled positive margin rate of <strong>12.28% (95% CI, 10–15%</strong>) and a re-excision rate of <strong>11.29% (95%CI, 9–14%)</strong> for all three wireless group combined whereas studies that compare them with wire showed higher positive margin rate of <strong>14.87% (95% CI, 12–18%)</strong> and re-excision rate of <strong>16.23% (95% CI, 14–18%)</strong> for wire-guided localisation. Compared with odd's ratio, there was no statistical significance for margin involvement between WGL and novel agents <strong>OR 0.870 95% CI (0.707</strong>–<strong>1.071); z=-1.310 p=0.190;</strong> however, there was a statistical significance with fewer re-excision for wireless group <strong>OR 0.791; 95% CI (0.648</strong>–<strong>0.965); z=-2.309 p=0.021</strong>. In sub group analysis with kruskal-wallis test, there was no statistical significance between each group for both margin-positivity <strong>(p=0.797; Chi</strong>^{<strong>2</strong>} <strong>0.605)</strong> and re-excision rates (<strong>p=0.464; chi</strong>^{<strong>2</strong>}<strong>1.535)</strong>. Consolidated insertion and retrieval success for wireless group were <strong>98.13%</strong> and <strong>99.13</strong>% respectively whereas WGL had a similar retrieval success rate of <strong>99.63%.</strong> To establish the best localisation approach, future prospective randomised trials will be required to assess quantitative cost-effective analyses.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 3","pages":"Article 100051"},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000199/pdfft?md5=d109fb7dadd9ac34022192165d22242d&pid=1-s2.0-S2773160X24000199-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141539781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective inguinofemoral node dissection for stage III vulvar squamous cancer: Feasibility and safety","authors":"","doi":"10.1016/j.cson.2024.100050","DOIUrl":"10.1016/j.cson.2024.100050","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the feasibility and outcomes of selective inguinal lymph node dissection (ILND) in stage III vulvar squamous cancer.</div></div><div><h3>Methods</h3><div>This study was approved by the Committee of Fudan University Shanghai Cancer Center. Ninety-one patients with stage III vulvar squamous cancer between March 2018 and March 2021 were included in this study. Thirty-one patients chose radical excision with selective ILND while 60 patients received radical excision with complete ILND voluntarily. After surgery, all the patients received postoperative external beam radiotherapy (EBRT). All the patients were invited to fill out two questionnaires: the EORTC QLQ-C30 and a vulvar specific questionnaire.</div></div><div><h3>Results</h3><div>The median follow-up time was 34 (16–50) months. There was no statistical difference in recurrence (<em>p</em>＞0.05) or overall survival (<em>p</em>＞0.05) in the two groups. Moreover, no difference in overall quality of life was observed between the two groups. The major difference was the increase in complaints of edema and body image after complete ILND.</div></div><div><h3>Conclusions</h3><div>Patients who underwent selective ILND reported less treatment related morbidity without affecting survival and overall quality of life compared to those who underwent complete ILND. Selective ILND may be a reasonable alternative for stage III vulvar squamous cancer in the future.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 4","pages":"Article 100050"},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141395107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Langer's arch?","authors":"Georgi P. Georgiev","doi":"10.1016/j.cson.2024.100049","DOIUrl":"https://doi.org/10.1016/j.cson.2024.100049","url":null,"abstract":"","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100049"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000175/pdfft?md5=b5988e711570db73eef883a9d0be9f30&pid=1-s2.0-S2773160X24000175-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141292319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparation of single or staged surgical management in acute obstructive non-metastatic colorectal cancer patients aged over 75","authors":"Jian Cui ,&nbsp;Jinxin Shi ,&nbsp;Hao Feng ,&nbsp;Danian Tang ,&nbsp;Xianglong Cao ,&nbsp;Wenrui Xu ,&nbsp;Zijian Li ,&nbsp;Tao Yu ,&nbsp;Chunlong Wang ,&nbsp;Qi An ,&nbsp;Gang Zhao","doi":"10.1016/j.cson.2024.100048","DOIUrl":"https://doi.org/10.1016/j.cson.2024.100048","url":null,"abstract":"<div><h3>Purpose</h3><p>Management of obstructive colorectal cancer (OCRC) can be achieved through either emergent resection of the primary tumor (single operation), or the creation of temporary decompression stoma or self-expandable metallic stents (SEMS) insertion followed by tumor resection (staged procedure). The aim of the study was to compare the short-term outcomes of single and staged surgery in acute non-metastatic elderly OCRC patients.</p></div><div><h3>Methods</h3><p>Twenty-two elderly patients (aged over 75) scheduled to receive either single surgery (n ​= ​14) or staged surgery (n ​= ​8) for the management of acute OCRC were enrolled from 2012 to 2017. The stoma rate, postoperative complications were compared.</p></div><div><h3>Results</h3><p>The stoma rate was 42.9% in single surgery group and 25% in SEMS group. No difference was found in the rate of total complications (50% vs 25%, <em>P</em> ​= ​0.25). In the single surgery group, four patients (28.6%) experienced SSIs, and pneumonia occurred in three patients (21.4%), whereas none of the patient in staged surgery had infection related complication. Overall, the rate of infection related complication in single surgery group (50%) was significantly higher than that in staged surgery group (P ​= ​0.015).</p></div><div><h3>Conclusions</h3><p>Either single or stage surgery is feasible for acute elderly OCRC patients. However, single surgery is associated with significant increase in infection related complication.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100048"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000163/pdfft?md5=d4673fd94bd826626e1ea68c4af3a90e&pid=1-s2.0-S2773160X24000163-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141424018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of non-colorectal non-neuroendocrine liver oligometastases: Sarcoma, breast, gastric, and pancreatic cancers","authors":"Huda Muhammad,&nbsp;Brendan Visser","doi":"10.1016/j.cson.2024.100047","DOIUrl":"10.1016/j.cson.2024.100047","url":null,"abstract":"","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100047"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000151/pdfft?md5=462d00407e9a50d1c722b1f0c746a871&pid=1-s2.0-S2773160X24000151-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of preoperative biliary drainage on the outcomes of surgical treatment in cholangiocarcinoma: A propensity score matching analysis","authors":"Poowanai Sarkhampee ,&nbsp;Sunhawit Junrungsee ,&nbsp;Apichat Tantraworasin ,&nbsp;Pongserath Sirichindakul ,&nbsp;Weeris Ouransatien ,&nbsp;Satsawat Chansitthichok ,&nbsp;Nithi Lertsawatvicha ,&nbsp;Paiwan Wattanarath","doi":"10.1016/j.cson.2024.100046","DOIUrl":"10.1016/j.cson.2024.100046","url":null,"abstract":"<div><h3>Background</h3><p>Hyperbilirubinemia is known to increase morbidity and mortality in patients undergoing liver resection for cholangiocarcinoma (CCA). Preoperative biliary drainage (PBD) in patients who have no acute cholangitis or require portal vein embolization is still debatable. The goal of this study is to investigate how PBD affects the surgical results after liver resection.</p></div><div><h3>Methods</h3><p>Between October 2013 and December 2020, CCA patients presenting with obstructive jaundice who underwent liver resection were retrospectively reviewed. The pre-operative, peri-operative and post-operative characteristics were extracted. To compare the outcomes of the PBD and direct surgery groups, propensity score matching analysis (PSM) and multivariable risk regression analysis were used to analyze.</p></div><div><h3>Results</h3><p>A total of 355 patients were enrolled, with 99 of them undergoing PBD. At diagnosis, those with PBD showed significantly greater bilirubin levels than those without (20.7 vs 9.6 ​mg/dL, p ​&lt; ​0.001). However, after drainage, the bilirubin level in the PBD group was lower than the direct surgery group (5.5 vs 9.6 ​mg/dL, p ​&lt; ​0.001). Overall postoperative morbidity and mortality were unaffected by PBD in full patient cohort. However, after PSM, PBD was associated with decreased major post-hepatectomy liver failure (PHLF) and 90-day mortality rate, (20.3% vs 39.24%, p ​= ​0.014 and 3.8% vs 22.8%, p ​= ​0.001, respectively). At multivariable analysis of PSM patient cohort, PBD was associated with decreased major post-operative complication (RR 0.64, 95%CI 0.419–0.986), PHLF (RR 0.40, 95%CI 0.227–0.705) and 90-day mortality (RR 0.21, 95%CI 0.086–0.629).</p></div><div><h3>Conclusion</h3><p>PBD was associated with decreased post-hepatectomy liver failure and postoperative mortality after liver resection in jaundiced CCA patients.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100046"},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X2400014X/pdfft?md5=a80a5d767d9fdb0cb84a2b2fa0857b4e&pid=1-s2.0-S2773160X2400014X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of free flap reconstruction after resection of extremity and trunk soft tissue sarcomas. Results of two referral centers in Argentina","authors":"Sergio D. Quildrian ,&nbsp;Walter S. Nardi ,&nbsp;María G. Vega ,&nbsp;Jorge A. Chapela","doi":"10.1016/j.cson.2024.100042","DOIUrl":"https://doi.org/10.1016/j.cson.2024.100042","url":null,"abstract":"<div><h3>Introduction</h3><p>For patients affected by extremity or trunk soft-tissue sarcomas (STS) large resections might be needed to achieve negative margins. This is a common scenario especially in locally advanced or recurrent tumors often within a pre-irradiated field. The objective of this study was to evaluate the results of free-flap reconstructions (FFR) after sarcoma surgery.</p></div><div><h3>Objective</h3><p>The endpoints were surgical results, quality of surgical margins and oncological outcome.</p></div><div><h3>Methods</h3><p>Retrospective analysis of patients with extremity and trunk STS with free-flap reconstruction between 2008 and 2022. Demographic and tumor data, perioperative treatment, margin status, morbidity and evolution were evaluated.</p></div><div><h3>Results</h3><p>Of 467 patients, 25 (5.35%) required 26 free-flap reconstructions. Surgery was performed on an irradiated field in 8 (32%) patients. Reconstructions were mostly needed for distal lower extremity resections and the most common type of flap used was antero-lateral tight (ALT) flap. No R2 resections were performed. R0 and R1 resections were achieved in 22 (84.6%) and 4 (15.4%), respectively. All R1 resections were preplanned positive along a preserved critical structure. Surgical morbidity rate was 26% (7/26) and the re-operation rate was 15% (4/26) with 7.7% flap losses (2/26). At a median follow-up of 38 months, 7 (28%) patients presented local recurrences.</p></div><div><h3>Conclusion</h3><p>In a referral sarcoma center, having a multidisciplinary surgical team capable of complex resections and reconstructions is of utmost importance for a correct and integral surgical planning. This allows optimal oncologic resections with acceptable morbidity.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100042"},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000102/pdfft?md5=6d17535901518222a974c5e50a578554&pid=1-s2.0-S2773160X24000102-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140647220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}