Clinical Surgical Oncology最新文献

{"title":"Understanding the impact of mandibular invasion on oral squamous cell carcinoma: A clinicoradiopathological perspective","authors":"Japneet Kaur ,&nbsp;Elizabeth Mathew Iype ,&nbsp;Shaji Thomas ,&nbsp;Bipin Varghese ,&nbsp;Nebu Abraham George ,&nbsp;Ankit Vishwani ,&nbsp;Jagathnath Krishna","doi":"10.1016/j.cson.2025.100076","DOIUrl":"10.1016/j.cson.2025.100076","url":null,"abstract":"<div><div>In Head and neck squamous cell carcinoma (HNSCC), the clinical assessment of mandibular involvement is often inaccurate and unreliable. Involvement of mandible, upstages the disease to stage IV. An important role of imaging in evaluating patients with SCC of the oral cavity is to evaluate the presence and extent of mandibular bone invasion. AIM-To determine the correlation between clinical, radiological and pathological findings in detecting mandibular invasion by squamous cell carcinoma in oral cavity. METHODOLOGY - Prospective study including patients who presented to Head and Neck oncology clinic, RCC TRIVANDRUM, with squamous cell carcinoma of the oral cavity with tumour clinically fixed to or near to mandible in biopsy proven SCC planned for treatment as per department protocol. RESULTS- 131 patients were studied in 1 year, out of which 79 percent were males, 40 percent had clinical bone erosion, and 34 percent had radiological bone erosion. SENSITIVITY of CT - 88%, SPECIFICITY-77.4%, PPV-47.8%, NPV-96.5%, ACCURACY - 79.4%. CONCLUSION-Precise assessment of the extent of mandibular invasion is therefore important for treatment planning to obtain both tumour resection and good functional results of jaw. CT scan is a sensitive tool for predicting bone erosion and should be routinely used in all cases of oral cavity malignancy and combined with thorough clinical examination.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 1","pages":"Article 100076"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563106","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":"Post-operative and short-term oncological outcomes in patients with early-onset colorectal cancer: A prospective observational study","authors":"Kanai Debnath ,&nbsp;Yashwant Sakaray ,&nbsp;Santosh Irrinki ,&nbsp;Satish Subbiah Nagaraj ,&nbsp;Cherring Tandup ,&nbsp;Siddhant Khare ,&nbsp;Ajay Savlania ,&nbsp;Divya Dahiya ,&nbsp;Periasamy Kannan ,&nbsp;Arvind Sekar ,&nbsp;Anupam Kumar Singh ,&nbsp;Lileswar Kaman","doi":"10.1016/j.cson.2025.100077","DOIUrl":"10.1016/j.cson.2025.100077","url":null,"abstract":"<div><h3>Background</h3><div>In recent years the incidence of early-onset colorectal cancer (EOCRC) has increased. This disease entity presents with a different clinical and pathological pattern, unlike late-onset colorectal cancer (LOCRC).</div></div><div><h3>Materials and methods</h3><div>117 patients with colorectal cancer were included and divided into EOCRC (≤45 years) and LOCRC (&gt;45 years) from July 2022 to Dec 2023. Descriptive statistics were used for data presentation. Mann-Whitney test was used for skewed data. Frequencies and proportions were used to characterize categorical variables. Fisher's Exact Test or Chi-square was used to compare the proportions.</div></div><div><h3>Results</h3><div>37(31.6%) were EOCRC, and 80(68.4%) were LOCRC. EOCRC patients presented more frequently with stage III disease 15(48.4%) vs LOCRC 29(42%) <strong>(p ​= ​0.288)</strong>. Majority were left-sided tumors 26(70.2%) in EOCRC vs 55(68.8%) in LOCRC, and rectum was involved in 18(48.6%) vs 39(48.8%) respectively. Poorly differentiated cancer was more common in five (19.2%) vs five (10.4%) in both groups <strong>(p ​= ​0.538)</strong>. Signet ring cell morphology and mucin positivity respectively were significantly higher in the EOCRC group nine (32.1%) vs three (5.6%) in the LOCRC <strong>(p ​= ​0.0023),</strong> EOCRC group 18(66.7%) vs LOCRC 18(33.3%) <strong>(p ​= ​0.0042)</strong>. Overall, there were seven (6.3%) 30-day perioperative mortalities three (8.3%) in EOCRC, and four (5.3%) in the LOCRC group <strong>(p ​= ​0.68)</strong>. 30-day perioperative complications are more common in the LOCRC group <strong>(p ​= ​0.0192)</strong>.</div></div><div><h3>Conclusion</h3><div>Clinical outcomes, in the form of post-operative morbidity and length of stay, were significantly lower among the younger group of patients. However, high rates of advanced-stage, poorly differentiated, and mucin-secreting tumor patients were seen in the younger age group.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 1","pages":"Article 100077"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551636","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":"Confirmation of the importance of lymphatic leakage in the formation of axillary fluid collections after lymph node dissection for breast cancer","authors":"Roman Mirela Mariana ,&nbsp;Karler Clarence ,&nbsp;Del Marmol Véronique ,&nbsp;Bourgeois Pierre","doi":"10.1016/j.cson.2024.100071","DOIUrl":"10.1016/j.cson.2024.100071","url":null,"abstract":"<div><h3>Background</h3><div>In patients undergoing complete axillary lymph node dissection (CALND) for breast cancer, axillary lymphatic leakages can be detected using near-infrared fluorescence imaging after subcutaneous injection of indocyanine green (ICG) into the ipsilateral hand. This study investigates the impact of these leaks on postoperative fluid volumes collected in drains (Vd) and through punctures (Vp).</div></div><div><h3>Methods</h3><div>A total of 55 patients received a single subcutaneous ICG injection in the ipsilateral hand either the day before or on the day of surgery. Postoperative fluid volumes, including drain output (Vd) and puncture collections (Vp), were analyzed and compared in relation to the presence or absence of fluorescence detected perioperatively in axillary lymph nodes (AxLNs) and drains.</div></div><div><h3>Results</h3><div>Fluorescen<strong>ce in AxLN</strong>: The absence of fluorescence in the AxLN was associated with a tendency for lower Vd but showed no significant effect on Vp or the total volume of fluid collected (Vt ​= ​Vd ​+ ​Vp). <strong>Fluorescent Axillary Leak</strong>: Similar trends were observed for the intraoperative detection of a fluorescent axillary leak, although the statistical significance was less pronounced. <strong>Fluorescence in Drains</strong>: The absence of fluorescence in postoperative drains was significantly correlated with lower values for all analyzed parameters, including Vd, Vp, Vt, the proportion of patients requiring punctures, and the number of punctures.</div></div><div><h3>Conclusion</h3><div>The findings support the hypothesis that postoperative fluid collections in the axilla after CALND are due primarily to lymphatic leakage from the arm rather than to the removal of axillary lymph nodes. The detection of fluorescence during surgery offers a foundation for targeted strategies to mitigate lymphatic leakages and associated complications. The efficacy of such approaches should be validated through a prospective, multicenter, randomized trial.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 1","pages":"Article 100071"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679054","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":"Clinical outcome and survival of low-grade appendiceal mucinous neoplasm with different surgical treatment: A multicenter clinical retrospective study","authors":"Cunlong Lu ,&nbsp;Zhenlong Han ,&nbsp;Hui Gao ,&nbsp;Yongke Liu ,&nbsp;Long Li ,&nbsp;Tuo Shi ,&nbsp;Houxin Zhu ,&nbsp;Zhaoli Liu ,&nbsp;Liangdong Cheng ,&nbsp;Yanbing Zhou","doi":"10.1016/j.cson.2025.100075","DOIUrl":"10.1016/j.cson.2025.100075","url":null,"abstract":"<div><h3>Background</h3><div>To explore the effects of different surgical strategies on clinical outcome and survival for the low-grade appendiceal mucinous neoplasm (LAMN), providing evidence support for the best treatment strategy.</div></div><div><h3>Materials and methods</h3><div>This study retrospectively analyzed the clinicopathological and survival outcome of LAMN data between 2013 and 2023 from multicenter, including preoperative, intraoperative, and postoperative data. Kaplan-Meier method and Cox regression analysis model were used for survival analysis.</div></div><div><h3>Results</h3><div>184 patients pathologically diagnosed with LAMN were included. The median age was 59 (50,69) years. All the patients were performed surgery, including simple appendectomy, appendectomy with caecal resection, ileocecectomy and right hemicolectomy (RHC). Compared with extended resection, local resection achieved better short-term outcome. Appendectomy has higher OS rate compared to the RHC with pairwise comparison (97% vs. 79.2%, χ ​= ​11.14, <em>P</em> ​&lt; ​0.001). Multivariate Cox regression analysis showed that age&gt;60 years (hazard radio (HR) ​= ​1.125, 95%CI: 1.051–1.205, <em>P</em> ​&lt; ​0.01), tumor recurrence (HR ​= ​7.019, 95%CI 2.226–22.135, <em>P</em> ​&lt; ​0.001), adjuvant chemotherapy (HR ​= ​6.486, 95%CI 1.897–22.178, <em>P</em> ​= ​0.003) and recurrence risk (HR ​= ​13.303, 95%CI 4.165–42.493, <em>P</em> ​= ​0.002) were independent risk factors for survival of LAMN.</div></div><div><h3>Conclusion</h3><div>Appendectomy showed favorable short-term outcome and OS rate compared with right hemicolectomy when the tumor is not ruptured and surgical margin is negative. Tumor recurrence, age&gt;60 years, adjuvant chemotherapy and high recurrence risk indicates poor prognosis. Large clinical trials of surgical therapy for LAMN are urgently needed.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 1","pages":"Article 100075"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474712","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":"A comprehensive narrative review on paradigm shift in the treatment of esophageal and rectal cancer","authors":"Dimitrios Chatziisaak ,&nbsp;Pascal Burri ,&nbsp;Thomas Steffen ,&nbsp;Stephan Bischofberger","doi":"10.1016/j.cson.2025.100074","DOIUrl":"10.1016/j.cson.2025.100074","url":null,"abstract":"<div><div>The incidence of esophageal and rectal cancer is rising globally. The combination of neoadjuvant chemoradiotherapy (nCRT) with watchful waiting (W&amp;W) strategies has been shown to be an effective approach for maintaining a high quality of life (QoL), particularly in the treatment of rectal cancer. This approach has recently been experimentally extended to the treatment of esophageal cancer. This narrative review provides an overview of the current status of nCRT and watchful waiting (W&amp;W) strategies in both cancer types.</div><div>The findings of the review indicate that nCRT significantly improves survival and response rates in both cancers. In patients with esophageal cancer, neoadjuvant therapy followed by surgery resulted in a median overall survival that was nearly double the expected survival time and demonstrated high rates of complete pathological response. In the case of rectal cancer, nCRT has been shown to result in high rates of complete response, which in turn has the effect of organ preserving and improving overall oncological outcomes and QoL.</div><div>The review concludes that the W&amp;W strategies, initially developed for rectal cancer, can be safely extended to selected cases of esophageal cancer, making organ preservation a feasible option that improves patients' quality of life. It is imperative that internationally accepted guidelines and precise patient selection criteria are established to ensure consistent outcomes and enhance long-term monitoring.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 1","pages":"Article 100074"},"PeriodicalIF":0.0,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394999","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":"A combined scoring system for tumor budding and poorly differentiated clusters in colorectal cancer: A retrospective study","authors":"Adil Aziz Khan,&nbsp;Sana Ahuja,&nbsp;Sristi Barman,&nbsp;Sufian Zaheer","doi":"10.1016/j.cson.2025.100073","DOIUrl":"10.1016/j.cson.2025.100073","url":null,"abstract":"<div><h3>Background</h3><div>Optimal management of stage II colorectal cancer (CRC) patients is complex due to variability in oncologic outcomes. Tumor budding (TB) and poorly differentiated clusters (PDCs) have emerged as significant prognostic factors. This study evaluates the prognostic significance of a combined scoring system of TB and PDCs in CRC patients.</div></div><div><h3>Materials and methods</h3><div>A retrospective study included 68 patients who underwent curative surgery. H&amp;E-stained sections were assessed for TB and PDCs. TB was graded according to ITBCC recommendations: Bd1 (0–4 buds), Bd2 (5–9 buds), and Bd3 (≥10 buds). PDCs were counted as clusters of ≥5 ​cells without gland formation: PDC1 (0–4 clusters), PDC2 (5–9 clusters), and PDC3 (≥10 clusters). TB and PDC scores were combined, resulting in a score range of 2–4. Histological sections were also evaluated for lymphovascular invasion (LVI), perineural invasion (PNI), and other pathological parameters. Statistical analyses were performed using Chi-Square and Fisher's exact tests.</div></div><div><h3>Results</h3><div>TB was high in 32.35% of cases and low in 47.06%. High PDCs were present in 47.06% of cases. The combined scoring system showed 55.88% of cases with a score of 3, indicating intermediate risk. Statistical significance was observed between combined scores and T stage, LVI, PNI, histological grade, extranodal extension, and tumor size (p ​&lt; ​0.05).</div></div><div><h3>Conclusion</h3><div>The combined scoring system for TB and PDCs demonstrated superior prognostic performance compared to individual assessments. This system provides a more comprehensive risk stratification, which may guide more tailored treatment decisions in CRC management.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 1","pages":"Article 100073"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394998","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":"Patients who have undergone total gastrectomy investigation of self-management experiences on dumping syndrome","authors":"Cansu Şentürk ,&nbsp;Evin Korkmaz","doi":"10.1016/j.cson.2024.100066","DOIUrl":"10.1016/j.cson.2024.100066","url":null,"abstract":"<div><h3>Introduction</h3><div>This study was planned to investigate in-depth patients' experiences with dumping syndrome after total gastrectomy and their self-management in this condition.</div></div><div><h3>Method</h3><div>The research was conducted in a qualitative study design. Data were collected using a face-to-face interview method with patients who underwent total gastrectomy surgery in 2023, using a voice recorder when they came to their outpatient clinic appointments. The interviews were completed in 20–40 ​min. The MAXQDA program was used to analyze the data obtained. The Consolidated Criteria for Reporting Qualitative Research (COREQ) was used as a guide for reporting this study.</div></div><div><h3>Results</h3><div>The study included ten patients who underwent total gastrectomy surgery. The mean age of the patients was 45 years and above. 70% of the patients were male and 30% were female. During the interview with the patients, six main themes and twenty-five sub-themes were formed: 1- Regret about the surgery, 2- Dietary recommendations, 3-Time of complaints, 4- Dietary pattern, 5- What was done for postprandial complaints, 6- Complaints after eating.</div></div><div><h3>Conclusion</h3><div>It is thought that an integrated team-based approach to postoperative care is necessary for patients to gain self-management skills.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 4","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759474","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":"Clinical characteristics and treatment outcomes of Vulvar cancer patients at a tertiary setting in Ethiopia: A 6-year review","authors":"Meseret Jeldu,&nbsp;Abraham Fessehaye Sium,&nbsp;Bethel Dereje","doi":"10.1016/j.cson.2024.100068","DOIUrl":"10.1016/j.cson.2024.100068","url":null,"abstract":"<div><h3>Objective</h3><div>To describe clinical characteristics and treatment outcomes of vulvar cancer patients managed at a gynecologic oncology treatment center in Ethiopia.</div></div><div><h3>Methods and materials</h3><div>This was a 6-year review of vulvar cancers patients (with and without HIV co-infection) that were managed at St. Paul’s Hospital Millennium Medical College (Ethiopia) between 2017 and 2022. Data were extracted from patient’s medical records using a data extraction tool. Data were analyzed using SPSS version 26. Simple descriptive statistics and Chi-squared test were carried out as appropriate.</div></div><div><h3>Results</h3><div>After excluding 10 patients for incomplete data, a total of 96 patients were included in the final analysis, out of which 65(67.7%) patients had HIV co-infection. Surgery with or without chemotherapy was the most common (62/96, 64.8%) treatment modality provided for the patients while the remaining 34 patients were treated with primary chemoradiation. Among those who had surgery, the majority of them (43/62, 69.4%) were managed with surgery alone, followed by another 16(25.8%) patients who were treated with neoadjuvant chemotherapy followed by surgery.</div></div><div><h3>Conclusion</h3><div>In this study, most vulvar cancer patients (more than three-quarters) had favorable survival outcomes at a median follow-up of 3 years post-standard treatment for vulvar cancer.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 4","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759475","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":"Robotic distal pancreatectomy: Initial experience with the Versius robotic surgical system. Stage 2a IDEAL prospective case series","authors":"Francesco Lancellotti ,&nbsp;Affan Iqbal ,&nbsp;Jenifer Barrie ,&nbsp;Panagiotis Stathakis ,&nbsp;Thomas Satyadas ,&nbsp;Rahul Deshpande ,&nbsp;Jegatheeswaran Santhalingam ,&nbsp;Nicola de Liguori-Carino ,&nbsp;Aali Sheen ,&nbsp;Ajith Kumar Siriwardena ,&nbsp;Saurabh Jamdar","doi":"10.1016/j.cson.2024.100063","DOIUrl":"10.1016/j.cson.2024.100063","url":null,"abstract":"<div><h3>Background</h3><div>Distal pancreatectomy (DP) is a well-established minimally invasive procedure. However, feasibility and technical details when using Versius robotic surgical system are still unexplored.</div></div><div><h3>Method</h3><div>This is a prospective stage 2a development IDEAL (Idea, Development, Exploration, Assessment and Long-term monitoring) case series. All consecutive robotic DP (RDP), including both splenectomy (DPS) and spleen-preserving DP (SPDP), were analysed. Pre- intra- and post-operative details were prospectively recorded.</div></div><div><h3>Results</h3><div>6 DPS and 3 SPDP were performed between May 2022 and May 2024. Conversion to open was recorded in one case. The average operating time and robot docking time were 185 ​min (range: 118–300) and 9.3 ​min (range: 3–15), respectively. No reoperation or 90-days mortality were recorded. Ports placement, instruments used, and surgical strategy are described in detail.</div></div><div><h3>Conclusion</h3><div>We present the first series on RDP performed by Versius robotic surgical system. The procedure is safe and feasible, and careful patient selection is required for the first cases.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 4","pages":"Article 100063"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143166220","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":"Pleomorphic dermal sarcoma. UK multidisciplinary team members have wide variation in opinions on management and pathways","authors":"Carrie Newlands ,&nbsp;Elizabeth Gruber ,&nbsp;Franel Le Grange ,&nbsp;Rajiv Anand ,&nbsp;Simon Whitley ,&nbsp;Stephen Keohane","doi":"10.1016/j.cson.2024.100061","DOIUrl":"10.1016/j.cson.2024.100061","url":null,"abstract":"<div><h3>Background</h3><div>Pleomorphic Dermal Sarcoma (PDS) is increasing in incidence and evidence-based guidelines as to optimal management are lacking. It is unclear from guidance which cancer MDTs should be involved in the care of patients with PDS and there is anecdotally widespread variation in patient pathways and management.</div></div><div><h3>Objective</h3><div>To determine current pathways and opinions regarding management of PDS amongst members of relevant UK MDTs.</div></div><div><h3>Methods</h3><div>A survey was devised, piloted, and circulated to MDT members, via national organisations. Responses were analysed using online SurveyMonkey tools.</div></div><div><h3>Results</h3><div>105 consultant members of a relevant MDT responded, including 19 skin and 2 sarcoma MDT Chairs. There was widespread variation in referral pathways, with 25.7% of participants reporting no sarcoma MDT involvement in a hypothetical case of a patient with a 2.1 ​cm primary PDS of the scalp, with no clinically apparent regional or distant metastases (N0M0). Opinions on the correct peripheral and deep surgical excision margins (PM/DM) varied, with the majority choosing a 10 ​mm PM (53.3%). Taking periosteum as the deep margin was preferred by 50.5%. Histological clearance margins of at least 5 ​mm at the PM and at least 1 ​mm at the DM were preferred by 33.3% of participants and deemed to be acceptable as definitive treatment. Imaging at diagnosis and for surveillance showed wide variation, with 24.8% not offering any imaging at diagnosis, in the above case.</div></div><div><h3>Conclusions</h3><div>PDS pathways and clinical management have been shown to vary widely amongst UK MDT members. A modified Delphi study is proposed to develop consensus-based guidance.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 4","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143166219","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}