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Current Oncology
Special Issues
Sarcoma Surgeries: Oncological Outcomes and Prognostic Factors
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Sarcoma Surgeries: Oncological Outcomes and Prognostic Factors

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Surgical Oncology".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 1991

Special Issue Editor

Dr. Mai-Kim Gervais

E-Mail Website
Guest Editor
Division of Surgical Oncology, Department of Surgery, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC H3C 3J7, Canada
Interests: sarcoma; surgery

Special Issue Information

Dear Colleagues,

Soft tissue sarcomas (STSs) are rare malignant tumors of mesenchymal origin. The World Health Organization describes more than 80 different histological subtypes of sarcomas. STSs most commonly arise in the extremities, whereas retroperitoneal locations occur in 15% of cases. The mainstay treatment for STSs remains surgery. Completeness of resection has been shown to improve survival outcomes in numerous studies. Understanding the unique pathological and anatomical characteristics of sarcoma subtypes can guide surgical oncologists to perform appropriate surgeries.

Various factors have been shown to influence oncological outcomes: from achieving precise biopsies for accurate diagnosis to prompt referral to sarcoma experts are key elements to improve outcomes. Performing a complete resection and offering adjuvant treatments for selected patients are essential to optimize survival. This Special Issue of Current Oncology will focus on sarcoma surgery, from the preoperative steps to postoperative surveillance. It will address intraoperative challenges and discuss prognostic factors determining survival.

Dr. Mai-Kim Gervais
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 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

  • sarcoma
  • surgery
  • resection
  • prognostic factors
  • survival

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Published Papers (4 papers)

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Research

15 pages, 3719 KiB  
Article
Construction and Verification of a Predictive Nomogram for Overall Survival in Patients with Large Retroperitoneal Liposarcoma: A Population-Based Cohort Study
by Huan Deng, Zhenhua Lu, Yajie Wang, Lin Xiao and Yisheng Pan
Curr. Oncol. 2025, 32(8), 473; https://doi.org/10.3390/curroncol32080473 - 21 Aug 2025
Viewed by 84
Abstract
Objective This study aimed to show the clinicopathological characteristics of large retroperitoneal liposarcoma (RLS) and to develop a customized nomogram model for patients with large RLS. Methods A total of 1735 patients diagnosed with RLS were selected from the public SEER database. Among [...] Read more.
Objective This study aimed to show the clinicopathological characteristics of large retroperitoneal liposarcoma (RLS) and to develop a customized nomogram model for patients with large RLS. Methods A total of 1735 patients diagnosed with RLS were selected from the public SEER database. Among them, 1113 patients with a maximum tumor diameter greater than 150 mm were included for further analysis. Nomogram models were developed based on Lasso and multivariate Cox regression analyses. A total of 166 patients that presented in the same period at our institution were used for external validations. Results A larger tumor size in RLS was associated with worse survival outcomes. Lasso and Cox regression analyses consistently identified age, TNM stage, occurrence pattern, histology, and surgery as important prognostic factors for OS. The constructed model demonstrated robust predictive performance, with better time-ROC (time-dependent receiver operating characteristic) for 1-year (83.1%), 3-year (83.8%), and 5-year (81.4%) survival in the training cohort. The concordance index (C-index) was approximately 0.80 in both the training and validation cohorts, reflecting excellent discriminatory ability of the model. Survival risk stratification analysis revealed significant differences in survival outcomes of large RLS (HR = 4.12 [3.31–5.12], p < 0.001, in the training cohort). Decision curve analysis (DCA) confirmed that the nomogram provided greater net benefits across a range of threshold probabilities. Conclusion This study identified important prognostic factors for survival in patients with large RLS and developed a reliable nomogram for predicting OS. The model’s strong predictive performance supports its use in personalized treatment strategies, improving prognosis assessment and clinical decision making for these patients. Full article
(This article belongs to the Special Issue Sarcoma Surgeries: Oncological Outcomes and Prognostic Factors)
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8 pages, 470 KiB  
Article
Preoperative Chemoradiation (Modified Eilber Protocol) Versus Preoperative/Postoperative Radiotherapy for Soft Tissue Sarcomas: A Population-Based Analysis
by Greg M. Padmore, Elizabeth C. Kurien, Michael J. Monument, Lloyd Mack, Antoine Bouchard-Fortier and on behalf of the ISARP Group
Curr. Oncol. 2025, 32(7), 374; https://doi.org/10.3390/curroncol32070374 - 26 Jun 2025
Viewed by 405
Abstract
Background: Local recurrence for high-risk extremities/trunk soft tissue sarcoma (STS) after treatment can range from 15 to 30%. The modified Eilber protocol (MEP) using low-dose intravenous chemotherapy with a reduced dosage of radiation in the preoperative setting has demonstrated excellent local control and [...] Read more.
Background: Local recurrence for high-risk extremities/trunk soft tissue sarcoma (STS) after treatment can range from 15 to 30%. The modified Eilber protocol (MEP) using low-dose intravenous chemotherapy with a reduced dosage of radiation in the preoperative setting has demonstrated excellent local control and reduced wound complications in these patients. The aim of the current study was to assess long-term local control and overall survival in patients with STS treated with the MEP versus standard preoperative or postoperative radiotherapy. Methods: Patients diagnosed with STS from 2004 to 2016 were identified using the Alberta Cancer Registry. Patients with STS treated with the MEP, preoperative or postoperative radiotherapy, were included. Patient and tumor characteristics, treatments and outcomes were abstracted from the registry and primary chart review. Characteristics were compared using one-way ANOVA for continuous variable and chi-square test and Fisher test for the categorical outcomes. Local recurrence-free survival and overall survival were analyzed using Kaplan–Meier Analysis with Log-rank test. Results: A total of 242 patients with STS were included, among which 100 (41.3%) received the MEP prior to surgery, 91 (37.6%) had preoperative radiation, and 51 (21.1%) had postoperative radiation. After a median follow up of 4.9 years, there were no significant differences in local recurrence or local recurrence-free survival between patients treated with the MEP vs. preoperative or postoperative radiotherapy (10 vs. 6.6% and 7.8%, respectively, p-value NS). There were also no significant differences between groups for recurrence-free survival and overall survival. Conclusions: This study demonstrates that the use of the MEP has non-inferior oncologic outcomes compared to standard preoperative or postoperative radiation in a population-based analysis despite reducing the overall dosage of radiation administered. The modified Eilber preoperative chemoradiation protocol may be considered as an additional option for patients with STS. Full article
(This article belongs to the Special Issue Sarcoma Surgeries: Oncological Outcomes and Prognostic Factors)
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17 pages, 1888 KiB  
Article
Textbook Outcomes for Retroperitoneal Sarcoma Resection: A Multi-Centre Review
by Skyle Murphy, Christopher Allan, Andrew Barbour, Victoria Donoghue and B. Mark Smithers
Curr. Oncol. 2025, 32(6), 364; https://doi.org/10.3390/curroncol32060364 - 19 Jun 2025
Viewed by 373
Abstract
For patients with retroperitoneal sarcomas (RPSs), en-bloc resection with macroscopically negative margins remains the only potentially curative treatment. Textbook outcomes (TOs) are composite measures developed to compare ideal surgical outcomes for complex oncologic resections. The aims of this study were as follows: to [...] Read more.
For patients with retroperitoneal sarcomas (RPSs), en-bloc resection with macroscopically negative margins remains the only potentially curative treatment. Textbook outcomes (TOs) are composite measures developed to compare ideal surgical outcomes for complex oncologic resections. The aims of this study were as follows: to define TO for RPS resections; to investigate the impact of treating service and other variables on TO; and to investigate the impact of treating service on achieving a TO. Population-based data from the Queensland Oncology Repository (QOR) was used to perform a retrospective review of all adult patients who underwent resection for primary RPS in Queensland between 2012 and 2022. TO was defined as follows: en-bloc resection; macroscopically negative margins; no unplanned ICU admission, no Clavien–Dindo III or greater complications; hospital length of stay of 14 days or less; no readmission within 30 days; and no 90-day mortality. A TO was achieved in 82 (56.94%) of the 144 patients included in the study. A high-grade histological subtype, the resection of three or more contiguous organs, major vascular resection and treatment outside of a high-volume sarcoma centre (HVSC) were significant negative predictors of achieving TOs (p < 0.05). On multivariate analysis, treatment at a high-volume sarcoma centre was independently associated with a 2.6-fold increase in TO (1.18–5.88, p = 0.02). Achieving a TO was associated with higher five-year DFS (61.5% vs. 41.3%, p = 0.03) and OS (76% vs. 59.4%, p = 0.02). In our state, TOs provide a measure of the quality of RPS resection across multiple health services, with patients treated at high-volume sarcoma centres more likely to achieve a TO. TO rates are associated with improved five-year DFS and OS. Full article
(This article belongs to the Special Issue Sarcoma Surgeries: Oncological Outcomes and Prognostic Factors)
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13 pages, 891 KiB  
Article
The Role of [18F]FDG PET/CT Prior to and During Neoadjuvant Chemotherapy for Soft Tissue Sarcomas
by Stijn J.C. van der Burg, Bernies van der Hiel, Lotte Heimans, J. Martijn Kerst, Michel W.J.M. Wouters, Petur Snaebjornsson, Yvonne M. Schrage, Winette T.A. van der Graaf and Winan J. van Houdt
Curr. Oncol. 2025, 32(5), 257; https://doi.org/10.3390/curroncol32050257 - 28 Apr 2025
Viewed by 633
Abstract
This retrospective, single-center study investigates the association between PET parameters and pathological response or disease recurrence in patients with soft tissue sarcoma (STS) treated with neoadjuvant chemotherapy (NACT). The maximum standardized uptake value (SUVmaxBL), metabolic tumor volume (MTVBL), and [...] Read more.
This retrospective, single-center study investigates the association between PET parameters and pathological response or disease recurrence in patients with soft tissue sarcoma (STS) treated with neoadjuvant chemotherapy (NACT). The maximum standardized uptake value (SUVmaxBL), metabolic tumor volume (MTVBL), and total lesion glycolysis (TLGBL) were measured at baseline [18F]FDG PET/CT and the change in percentage (ΔSUVmax, ΔMTV, ΔTLG) from baseline to early evaluation [18F]FDG PET/CT was calculated. The optimal cutoff values of the different PET parameters for pathological response, defined as <10% residual viable tumor (RVT) or >15% fibrosis/hyalinization, and recurrence-free survival were obtained for analysis. Forty-two patients who underwent baseline [18F]FDG PET/CT and NACT followed by surgery were included between January 2015 and January 2023. The primary diagnoses were angiosarcoma (n = 15), leiomyosarcoma (n = 15), sarcoma not otherwise specified (n = 9) and synovial sarcoma (n = 3). Twenty-eight (66.6%) patients underwent an early evaluation PET/CT. MTVBL, TLGBL, and ΔSUVmax (p = 0.024; p = 0.042, p = 0.009, respectively) values above the cutoff were associated with a pathological response based on RVT. ΔSUVmax, ΔMTV, and ΔTLG (p = 0.002; p = 0.019; p = 0.039, respectively) values above the cutoff were positively related to >15% fibrosis/hyalinization. MTVBL, TLGBL, and ΔMTV (p = 0.014; p = 0.022; p = 0.034, respectively) values above the cutoff were prognostic for the recurrence of disease. [18F]FDG PET/CT has a promising role in STS patients treated with NACT. Full article
(This article belongs to the Special Issue Sarcoma Surgeries: Oncological Outcomes and Prognostic Factors)
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