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Calculating Tumor Volume Using Three-Dimensional Models in Preoperative Soft-Tissue Sarcoma Surgical Planning: Does
Jasmijn D Generaal1, Haye H Glas2, Jan F Ubbels3
1Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Journal of Clinical Medicine
|December 9, 2023
Summary
Three-dimensional virtual surgical planning for extremity soft-tissue sarcoma (ESTS) showed flap reconstruction patients had smaller tumors. Tumor size did not predict complications, suggesting it doesn't influence reconstruction needs.
Area of Science:
- Oncology
- Surgical Planning
- Medical Imaging
Background:
- Extremity soft-tissue sarcomas (ESTS) often require reconstructive surgery, particularly flap reconstruction in advanced cases.
- Preoperative assessment of tumor volume is crucial for surgical planning and predicting outcomes.
- Three-dimensional (3D) virtual surgical planning offers advanced visualization and measurement capabilities.
Purpose of the Study:
- To evaluate the feasibility of 3D virtual surgical planning in determining the need for reconstructive surgery in ESTS.
- To test the hypothesis that larger tumor volumes correlate with the need for flap reconstruction in ESTS patients.
Main Methods:
- Retrospective analysis of patients treated for ESTS between January 2016 and October 2019.
- Creation of 3D models from diagnostic magnetic resonance scans for tumor volume calculation.
- Comparison of tumor volumes between patients undergoing primary closure versus flap reconstruction and those with/without complications.
Main Results:
- Patients requiring flap reconstruction had significantly smaller mean tumor volumes (29.4 mL) compared to those with primary closure (107.8 mL) (p=0.004).
- No significant difference in tumor volume was observed between patients with complications (76.1 mL) and uncomplicated courses (57.0 mL) (p=0.311).
- Larger tumor volume did not correlate with increased complications following ESTS treatment.
Conclusions:
- Tumor volume does not appear to influence the need for reconstructive surgery in extremity soft-tissue sarcoma.
- Despite its measurement capabilities, 3D virtual surgical planning is not recommended for routine use in multidisciplinary ESTS treatment based on these findings.
- Further research may be needed to identify other factors influencing reconstructive surgery decisions in ESTS.
