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Novel Approaches in Surgical Evaluation and Management of Soft Tissue Sarcoma and Bone Tumors

This paper discusses innovative intra-operative evaluation techniques to assess local recurrence, focusing on the correlation between radiologic findings and histologic margins. The analysis evaluates biopsy tracts for residual tumors and emphasizes the importance of precise surgical reporting connected to levels of evidence. Additionally, it presents preliminary Phase I findings on a Cathepsin activated tumor imaging probe, which may help tailor therapies to patients with residual cancer while reducing the need for repeat surgeries in those without residuals.

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Novel Approaches in Surgical Evaluation and Management of Soft Tissue Sarcoma and Bone Tumors

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Presentation Transcript

  1. Surgical Papers CTOS 13 • Novel intra-operative evaluation for local recurrence • Radiologic correlation to histologic margins • Evaluation of biopsy tracts for residual tumor • Reporting surgical papers and correlation to level of evidence

  2. Preliminary Analysis of Phase I, First in Human, Cathepsin Activated Tumor Imaging Probe

  3. Preliminary Analysis of Phase I, First in Human, Cathepsin Activated Tumor Imaging Probe • Intensify therapy for patients with residual cancer

  4. Preliminary Analysis of Phase I, First in Human, Cathepsin Activated Tumor Imaging Probe 2) Avoid RT for patients with no residual cancer

  5. Preliminary Analysis of Phase I, First in Human, Cathepsin Activated Tumor Imaging Probe 3) Reduce rates of repeat resection A good surgeon may be wrong but never in doubt A good scientist may be right but is always in doubt

  6. Infiltrative Soft Tissue Sarcoma – Should We Excise Beyond Radiological Infiltration • 41 pts • 46% RIF 49% HIF • Gad stronger correlation • Positive margin correlated local failure • Tumor mass • Infiltrative margin • 9.8% local failure

  7. Infiltrative Soft Tissue Sarcoma – Should We Excise Beyond Radiological Infiltration Skip Lesion SatalliteLesion Reactive Zone

  8. Infiltrative Soft Tissue Sarcoma – Should We Excise Beyond Radiological Infiltration

  9. Infiltrative Soft Tissue Sarcoma – Should We Excise Beyond Radiological Infiltration • Iwato et al

  10. A Review Of Excised Biopsy Tract Histology For Primary Bone Tumors: Is Excision Necessary? • 19% local recurrence with excision of biopsy tract • 9% local recurrence with out excision of biopsy tract

  11. Surgical Management Of Lower Extremity Bone Tumors: Levels of Evidence And Quality Of Reporting

  12. MOFFITT CANCER CENTER

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