Assessment of Resection Margins in Bone Tumor Surgery.
Limb salvage surgery is now the preferred procedure for bone tumor surgery. To decrease the risk of local recurrence, it is crucial to obtain adequate resection margins. The obtained margins must be evaluated postoperatively because they influence what treatment is given subsequently when margins ar...
| Publicado en: | Sarcoma pp. 1 - 11 |
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| Autores principales: | , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
12/16/2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=147640439&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 147640439 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1357714X 57R jtl: Sarcoma issn: 1357714X maglogo: Y pubinfo: dt: 12/16/2020 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 147640439 147640439 147640439 10.1155/2020/5289547 147640439 ppf: 1 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Assessment of Resection Margins in Bone Tumor Surgery. aug: au: Malherbe, Corentin Crutzen, Bernard Schrooyen, Jean Caruso, Giovanni Lecouvet, Frédéric Detrembleur, Christine Schubert, Thomas Docquier, Pierre-Louis affil: Service de Chirurgie Orthopédique et Traumatologique, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium sug: subj: Bone Neoplasms Surgery Limb Salvage Methods Surgical Margin Evaluation Magnetic Resonance Imaging Methods Histology Methods Human Cancer Patients Prospective Studies Bone Neoplasms Microbiology Bone Neoplasms Pathology Microscopy Multimethod Studies Neoplasm Recurrence, Local Analysis Outcome Assessment ab: Limb salvage surgery is now the preferred procedure for bone tumor surgery. To decrease the risk of local recurrence, it is crucial to obtain adequate resection margins. The obtained margins must be evaluated postoperatively because they influence what treatment is given subsequently when margins are not adequate (e.g., surgical revision and radiotherapy). The study aims to evaluate margin assessment of tumor specimen by MRI compared to conventional histology (to establish the viability of using MRI) and assess the accuracy of a patient-specific instrument when narrow margins were aimed. The resection margins in 12 consecutive patients that were operated on for bone tumor resection were prospectively analyzed using three methods: MRI of the resection specimen, macroscopic evaluation of specimen slices, and microscopic pathological evaluation. The assessments were qualitative (R0, R1, and R2) and quantitative (distance in mm). MRI, macroscopic, and microscopic margins generated similar results for both the qualitative (all resections were R0) and quantitative assessments. The median error in safe margins was 2 mm with a surgical guide (PSI) and 5 mm without a surgical guide. Local recurrences were not detected after a mean follow-up period of 3.7 years (range, 2.1–5 years); however, four patients died during the study. In conclusion, MRI is a valuable tool for assessing safe margins. When specimens are not available for pathological assessment (e.g., extracorporeally irradiated autograft or autoclaved autograft), MRI could be used to evaluate margins. In particular, when tumor volume is high, MRI could also help to focus the pathological examination on areas of concern. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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