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Outcome Analysis and Predictive Insights in Soft Tissue Sarcomas: leveraging...
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Outcome Analysis and Predictive Insights in Soft Tissue Sarcomas: leveraging Clinical Data and Integrating Modelling

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: 15 December 2025 | Viewed by 2639

Special Issue Editor

Prof. Dr. Bruno Fuchs

E-Mail Website
Guest Editor
Sarcoma Service & IPU, Faculty of Health Science & Medicine, University of Lucerne, CH-6004 Luzern, Switzerland
Interests: sarcoma surgery; sarcoma MDT; quality indicators; VBHC
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Bone and soft tissue sarcomas represent a diverse and complex group of malignancies with varied clinical outcomes, presenting significant challenges in their management and prognosis. This Special Issue aims to explore recent advancements in outcome analysis and predictive insights for these sarcomas. By leveraging clinical data and integrating predictive modelling, we seek to enhance our understanding of patient trajectories and improve prognostic accuracy. Contributions to this issue will encompass a range of topics, including the development and validation of predictive models, novel biomarkers for prognosis, and the impact of different therapeutic approaches on patient outcomes. We welcome original research articles, reviews, and case studies that provide valuable insights into these aspects, ultimately aiming to inform clinical practise and improve patient care.

We look forward to your valuable contributions to this Special Issue.

Prof. Dr. Bruno Fuchs
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bone sarcomas
  • soft tissue sarcomas
  • outcome analysis
  • predictive modelling
  • prognostic biomarkers
  • therapeutic impact
  • clinical data integration
  • survivorship prediction
  • patient trajectories
  • sarcoma management

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Published Papers (2 papers)

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Research

16 pages, 1981 KiB  
Article
Integrated Care in Specialized Networks: Leveraging Early Referrals to Reduce Local Recurrence in Soft Tissue Sarcoma
by Markus Schärer, Pascale Hösli, Philip Heesen, Georg Schelling, Timothy Obergfell, Kim N. Nydegger, Gabriela Studer, Beata Bode-Lesniewska and Bruno Fuchs
Cancers 2024, 16(21), 3616; https://doi.org/10.3390/cancers16213616 - 26 Oct 2024
Viewed by 903
Abstract
This study evaluated the impact of care pathways on the incidence of local recurrence (LR) in patients with soft tissue sarcomas (STS) and identified factors predictive of LR. It compared outcomes between patients managed entirely within a comprehensive care pathway (CCP) at the [...] Read more.
This study evaluated the impact of care pathways on the incidence of local recurrence (LR) in patients with soft tissue sarcomas (STS) and identified factors predictive of LR. It compared outcomes between patients managed entirely within a comprehensive care pathway (CCP) at the Swiss Sarcoma Network (SSN) and those who experienced fragmented care pathways (FCPs), where initial treatment occurred outside specialized centers. This prospective study utilized real-world-time data from the SSN-Sarconnector, capturing quality indicators through weekly Multidisciplinary Team/Sarcoma-Board (MDT/SB) meetings. The overall incidence of LR was 17.6% (n = 68/386), higher than rates typically reported in sarcoma center-based studies due to the inclusion of patients with prior inadequate management from real-world referrals. In a univariable logistic regression analysis, the FCP was significantly associated with higher LR rates, unplanned “whoops” resections (25.4%, n = 96), and positive surgical margins, emphasizing the detrimental impact of suboptimal initial management outside of specialized centers. Multivariable analysis confirmed that the FCP (aOR 2.7, 95% CI [1.41, 5.12], p = 0.003), tumor size (aOR 1.49, 95% CI [1.1, 2.02], p = 0.01), and biological behavior (aOR 5.84 95% CI [1.8, 18.86], p = 0.0003) are independent predictors of LR. Notably, patients referred to sarcoma centers after an initial FCP presented with inadequately managed disease, such as incomplete resections and unplanned surgeries, leading to increased complexity of subsequent treatments. These findings underscore the critical role of referral patterns on sarcoma center outcomes, highlighting the significant disparity in LR rates between institutions. The need for improved education and standardized early referral strategies at the spoke level is paramount to optimize patient outcomes and reduce the burden of LR. Enhanced spoke-level education and standardized referral protocols are critical to ensuring effective initial management and optimizing patient outcomes within specialized sarcoma networks like the SSN. Full article
(This article belongs to the Special Issue Outcome Analysis and Predictive Insights in Soft Tissue Sarcomas: leveraging Clinical Data and Integrating Modelling)
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17 pages, 437 KiB  
Article
Planned and Unplanned Sarcoma Resections: Comparative Analysis of Local Recurrence, Metastasis, and Mortality
by Kim N. Nydegger, Timothy T. A. F. Obergfell, Philip Heesen, Georg Schelling, Gabriela Studer, Beata Bode-Lesniewska and Bruno Fuchs
Cancers 2024, 16(19), 3408; https://doi.org/10.3390/cancers16193408 - 7 Oct 2024
Cited by 2 | Viewed by 1271
Abstract
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: Data were analyzed from the Swiss [...] Read more.
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: 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: 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, p < 0.001) and higher-grade tumors (Grade 3: 50.5% vs. 37.4%, p = 0.03). Despite achieving superior resection margins (R0: 78.8% vs. 12.6%, p < 0.001), PEs showed higher metastasis rates at follow-up (31.0% vs. 10.4%, p < 0.001) and greater cancer-specific mortality (16.7% vs. 6.6%, p = 0.01). UEs, while linked to higher local recurrence, did not significantly affect metastasis-free survival (MFS) or overall survival (OS). 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. Full article
(This article belongs to the Special Issue Outcome Analysis and Predictive Insights in Soft Tissue Sarcomas: leveraging Clinical Data and Integrating Modelling)
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