Evidence map›Paper›PMID 39279240›Full record

ArticleCancer medicine2024

The impact of margins and re-resection in pediatric synovial sarcoma.

Andres F Espinoza, Priya B Shetty, Jillian C Jacobson, Hannah Todd, Kelley Harrell, Alfred F Trappey, John Doski, Eumenia C Castro, Nicole I Montgomery, M Fatih Okcu and 3 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Andres F EspinozaTexas Children's Surgical Oncology Program and Liver Tumor Program, Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA.ORCID 0000-0001-8716-3125
Priya B ShettyDepartment of Pediatric Hematology and Oncology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Jillian C JacobsonDivision of Pediatric Surgery, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas, USA.
Hannah ToddTexas Children's Surgical Oncology Program and Liver Tumor Program, Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA.
Kelley HarrellDivision of Pediatric Surgery, University of Texas San Antonio, San Antonio, Texas, USA.
Alfred F TrappeyDivision of Pediatric Surgery, University of Texas San Antonio, San Antonio, Texas, USA.
John DoskiDivision of Pediatric Surgery, University of Texas San Antonio, San Antonio, Texas, USA.
Eumenia C CastroDepartment of Pathology and Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Nicole I MontgomeryDepartment of Orthopedics, Baylor College of Medicine, Texas Children's Hospital and Cancer Center, Houston, Texas, USA.
M Fatih OkcuDepartment of Pediatric Hematology and Oncology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Rajkumar VenkatramaniDepartment of Pediatric Hematology and Oncology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Dai H ChungDivision of Pediatric Surgery, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas, USA.
Sanjeev A VasudevanTexas Children's Surgical Oncology Program and Liver Tumor Program, Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA.

Funding

Cancer Prevention and Research Institute of Texas RP210037Macy Easom Cancer Research Foundation
6 · The paper itself

Abstract

introductionSynovial sarcoma is one of the most common soft tissue sarcomas in children. Guidelines regarding the adequate extent of resection margins and the role of re-resection are lacking. We sought to evaluate the adequate resection margin and the role of re-resection in predicting outcomes in children with synovial sarcomas.

methodsA cohort of 36 patients less than 18 years of age at diagnosis who were treated for localized synovial sarcoma at three tertiary pediatric hospitals between January 2004 and December 2020 were included in this study. Patient and tumor demographics, treatment information, and margin status after surgical resection were collected from the medical record. Clinical, treatment, and surgical characteristics, as well as outcomes including hazard ratios (HRs), event-free survival (EFS), and overall survival (OS) were compared by resection margins group and re-resection status.

resultsPatients in the R1 resection group were significantly more likely to relapse or die compared to patients in the R0 resection group. However, there was no significant difference in EFS (HR 0.52, p = 0.54) or OS (HR 1.56, p = 0.719) in R0 patients with less than 5 mm margins compared to R0 patients with more than 5 mm margins. Patients with R1 on initial or re-resection had significantly worse OS than patients who had R0 resection on initial or re-resection (HR = 10.12, p = 0.005).

conclusionThis study re-affirms that R0 resection is an independent prognostic predictor of better OS/EFS in pediatric synovial sarcoma. Second, our study extends this finding to report negative margins on initial resection or re-resection is associated with better OS/EFS than positive margins on initial resection or re-resection. Lastly, we found that there is no difference in outcomes associated with re-resection or <5 mm margins for R0 patients, indicating that re-resection and <5 mm margins are acceptable if microscopic disease is removed.

Indexed as

Margins of ExcisionSarcoma, SynovialAdolescentChildChild, PreschoolFemaleHumansMaleNeoplasm Recurrence, LocalPrognosisReoperationRetrospective Studiesmarginspediatricre‐resectionsynovial sarcoma

Identifiers

PMID39279240
PMCPMC11403124

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.