• intraoperative margin assessment
• peripheral margins
• soft tissue sarcoma

• Humans
• Margins of Excision
• Sarcoma/surgery
• Sarcoma/pathology
• Surveys and Questionnaires
• Practice Patterns, Physicians'/statistics & numerical data
• Societies, Medical
• Surgical Oncology
• Intraoperative Care
• Soft Tissue Neoplasms/surgery
• Soft Tissue Neoplasms/pathology

• The authors received no specific funding for this work.

• intraoperative margin assessment
• peripheral margins
• sarcoma
• soft tissue sarcoma
• surgical margins

• Humans
• Sarcoma/surgery
• Sarcoma/pathology
• Margins of Excision
• Retrospective Studies
• Female
• Male
• Middle Aged
• Frozen Sections
• Aged
• Adult
• Intraoperative Care
• Cost-Benefit Analysis
• Soft Tissue Neoplasms/surgery
• Soft Tissue Neoplasms/pathology
• Aged, 80 and over
• Young Adult

• UL1 TR001860 NCATS NIH HHS
• The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant number UL1 TR001860.

• Humans
• Lymphedema/surgery
• Lymphedema/etiology
• Lymphedema/prevention & control
• Anastomosis, Surgical/methods
• Thigh/surgery
• Lymphocele/etiology
• Lymphocele/surgery
• Lymphocele/prevention & control
• Female
• Middle Aged
• Lymphatic Vessels/surgery
• Male
• Sarcoma/surgery
• Adult
• Postoperative Complications/prevention & control
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Postoperative Complications/surgery
• Soft Tissue Neoplasms/surgery
• Aged
• Treatment Outcome
• Veins/surgery
• Follow-Up Studies
• Retrospective Studies

• Allograft transplantation
• Osteoarthritis
• Prosthesis
• Unicompartmental knee arthroplasty
• Unicondylar resection

• Humans
• Femoral Neoplasms/surgery
• Bone Transplantation/methods
• Plastic Surgery Procedures/methods
• Femur/surgery

• 2023YFE0126900 National Key Research and Development Program of China
• 2023YFB3813002 National Key Research and Development Program of China
• 2022NSFSC0845 Sichuan Science and Technology Agency
• 23ZDYF2641 the Department of Science and Technology of Sichuan Province
• 2023-GH02-00075-HZ Department of Science and Technology of Chengdu
• National Key Research and Development Program of China

• Humans
• Margins of Excision
• Sarcoma/surgery
• Soft Tissue Neoplasms/surgery
• Cell Proliferation
• Combined Modality Therapy

• bone tissue engineering
• nanoparticles
• nanotherapeutics
• osteosarcoma
• scaffolds

• Humans
• Tissue Engineering
• Osteosarcoma/drug therapy
• Tissue Scaffolds
• Bone Neoplasms/drug therapy
• Drug Delivery Systems

• brain neoplasms
• breast neoplasms
• confocal microscopy
• margins of excision
• prostatic neoplasms

• Male
• Humans
• Microscopy, Confocal/methods
• Microscopy, Fluorescence/methods
• Neoplasms/diagnostic imaging
• Neoplasms/surgery

• Competitive Research Funding of Helsinki University Hospital
• Finnish Cancer Society

• margins
• pediatric/adolescent oncology
• radiotherapy
• soft tissue sarcoma
• surgery

• chemotherapy
• osteosarcoma
• surgical treatment
• targeted therapy

• Humans
• Bone Neoplasms/pathology
• Osteosarcoma/pathology
• Molecular Targeted Therapy
• Bone and Bones/pathology
• Immunologic Factors/therapeutic use

Liposarcoma is a locally aggressive tumor that may originate in soft tissue sites such as the retroperitoneum or the extremities, or less frequently, from the bone. The fatty tumor may have an insidious growth pattern and be present incidentally on imaging, or it may be present with symptoms such as small bowel or ureter obstruction. The diagnosis can be confirmed post-operatively via fluorescence in situ hybridization (FISH) with the presence of mouse double minute 2 (MDM2) homolog protein and cyclin-dependent kinase 4 (CDK4) gene amplification. The rate of recurrence may be high depending on the subtype of liposarcoma, so it is always recommended to have the patient undergo routine imaging every six months to a year. In this case report, we present a patient who presented with a massive, incidental liposarcoma found on imaging after coming to the emergency department for lower extremity trauma.

Myxofibrosarcoma (MFS) is a common entity of adult soft tissue sarcomas (STS) characterized by a predilection of the extremities and a high local recurrence rate. Originally classified as a myxoid variant of malignant fibrous histiocytoma, this musculoskeletal tumor has been recognized since 2002 as a distinct histotype showing a spectrum of malignant fibroblastic lesions with myxoid stroma, pleomorphism and curvilinear vessels. Currently, the molecular pathogenesis of MFS is still poorly understood and its genomic profile exhibits a complex karyotype with a number of aberrations including amplifications, deletions and loss of function. The diagnosis is challenging due to the unavailability of specific immunohistochemical markers and is based on the analysis of cytomorphologic features. The mainstay of treatment for localized disease is represented by surgical resection, with (neo)-adjuvant radio- and chemotherapy. In the metastatic setting, chemotherapy represents the backbone of treatments, however its role is still controversial and the outcome is very poor. Recent advent of genomic profiling, targeted therapies and larger enrollment of patients in translational and clinical studies, have improved the understanding of biological behavior and clinical outcome of such a disease. This review will provide an overview of current diagnostic pitfalls and clinical management of MFS. Finally, a look at future directions will be discussed.

• chemotherapy
• musculoskeletal tumor
• myxofibrosarcoma
• soft tissue sarcoma
• targeted therapy
• translational models

Fluorescence-guided surgery (FGS) with 5-aminolevulinic acid (5-ALA) and other contrast agents has shown its efficacy in improving resection margins, local recurrence and survival rates in several medical disciplines. It is the objective of this study to analyze the engraftment rate of musculoskeletal tumor specimens on the chick chorio-allantoic membrane (CAM), the rate of tumor fluorescence (PDD), and the effects of photodynamic therapy (PDT) after exposure of tumors to 5-ALA in an in vivo environment.

A total of 486 CAMs were inoculated with macroscopic tumor grafts (n = 26; n = 478 eggs) and primary cell culture suspensions (n = 2; n = 8 eggs) from 26 patients on day 10 of egg development. On day 16, 2 mg/200 µl 5-ALA were topically applied per egg. After 4 h of incubation, Protoporphyrin IX was excited using blue light (420 ± 10 nm). Tumor fluorescence (PDD) was photo-documented. A subgroup of specimens was additionally exposed to red light (635 nm ± 10 nm; PDT). After the termination of the experiment, CAM-grown tumors were histopathologically analyzed.

Benign and borderline tumors (chondroblastoma, giant cell tumor of bone and atypical chondrogenic tumor) presented with high rates of detectable fluorescence. Comparable results were found for chondrosarcoma, osteosarcoma and Ewing’s sarcoma among bone and dedifferentiated liposarcoma, myxofibrosarcoma and undifferentiated pleomorphic sarcoma among soft tissue sarcomas. Overall, tumor fluorescence was negative for 20.2%, single-positive (+) for 46.9% and double-positive (++) for 32.9% of macroscopic xenografts, and negative in 20% and (+) in 80% of primary cell culture tumors. Macroscopic tumor xenografts (n = 478) were identified as viable in 14.8%, partially viable in 2.9% and partially to completely regressive in 45.2%. All (n = 8) tumors grown from primary cell culture were viable. After PDT, tumor samples were found viable in 5.5%, partially viable in 5.5% and partially to completely regressive in 68%. Egg survival increased with decreasing PDT doses.

The CAM model proves to be a suitable in vivo model for the investigation of short-term observation questions in musculoskeletal tumors. The findings of this study warrant further investigation of PDT effects on musculoskeletal tumors and a possible incorporation of 5-ALA FGS in clinical Orthopedic Oncology care.

• 5-Aminolevulinic acid
• Chick chorio-allantoic membrane model
• Musculoskeletal tumor
• Photodynamic detection
• Sarcoma
• Tumor fluorescence

• Amputation, Surgical
• Hand
• Humans
• Male
• Middle Aged
• Sarcoma/diagnosis
• Sarcoma/surgery

Many classifications to assess margins status for soft tissue sarcomas are reported in the literature. Most of the series are heterogeneous and variable in size, making it difficult to compare results from study to study. Thus, which is the best way to assess margins in order to predict the risk of local recurrence is still debated. The aim of this narrative review is to provide a comprehensive assessment of the literature on margins, and to highlight the need for a uniform description of the margin status for patients with soft tissue sarcomas (STS).

Adequacy of margins must take into consideration both the resection margin width (quantity) and anatomic barrier (quality). There are several classification schemes for reporting surgical resection margin status for soft tissue sarcomas (STS). Most of the studies regarding treatment outcomes in STS included all histologic grades and histological subtypes, which include infiltrative and non-infiltrative subtypes and are very heterogeneous in terms of both histologic characteristics and treatment modalities (adjuvant treatments or not). This lack of consistency makes it difficult to compare results from study to study. Therefore, there is a great need for evidence-based standardization concerning the width of resection margins. The aim of this narrative review is to provide a comprehensive assessment of the literature on margins, and to highlight the need for a uniform description of the margin status for patients with STS. Patient cases should be discussed at multidisciplinary tumor boards and treatments should be individualized to clinical and demographic characteristics, which must include also a deep knowledge of specific histotypes behaviors, particularly infiltrative ones.

• classification
• infiltrative
• local recurrence
• margins
• soft tissue sarcoma

• Distant metastasis
• Local recurrence
• Modified glasgow prognostic score
• Neutrophils/lymphocytes ratio
• Overall survival
• Soft tissue sarcoma

Standard treatment for soft tissue sarcoma, based on complete surgical resection with or without adjuvant radiotherapy and chemotherapy, has not substantially changed during the last several decades. Nevertheless, recent advances have contributed to considerable improvement in the management of these patients; for example, new magnetic resonance imaging sequences such as diffusion-weighted imaging and magnetic resonance imaging radiomics can better assess tumor extension and even estimate its grade. Detection of circulating genetic material (liquid biopsy) and next-generation sequencing are powerful techniques for genetic analysis, which will increase our understanding of the underlying molecular mechanisms and may reveal potential therapeutic targets. The role of chemotherapy in non-metastatic disease is still controversial, and there is a need to identify patients who really benefit from this treatment. Novel chemotherapeutic regimens have entered clinical praxis and can change the outcome of patients with metastatic disease. Advances in radiotherapy have helped decrease local adverse effects and sustain good local control of the disease. The following report provides an updated view of the diagnosis, treatment, and future perspectives on the management of patients with soft tissue sarcomas.

• Soft tissue sarcomas
• Multidisciplinary treatment
• Surgery
• Radiotherapy
• Chemotherapy
• Targeted therapy
• Update treatment