Evidence map›Paper›PMID 39556178›Full record

ArticleAnnals of surgical oncology2025

Identification of Malignancy in Peritumoral Edema in Soft Tissue Sarcoma: A Novel Targeted Molecular Approach.

Miguel Alfonso V Principe, Nalan Gokgoz, Patrick Prochazka, Victoria S Coward, Sidharth Saini, Sonya MacParland, Rebecca Gladdy, Peter Ferguson, Jay S Wunder, Irene L Andrulis and 5 more

Abstract read
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Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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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

15 authors.

Miguel Alfonso V PrincipeLunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
Nalan GokgozLunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
Patrick ProchazkaLunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
Victoria S CowardLunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
Sidharth SainiDepartment of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Sonya MacParlandDepartment of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
Rebecca GladdyLunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
Peter FergusonMusculoskeletal Oncology Unit, Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada.
Jay S WunderLunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
Irene L AndrulisLunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
Peter ChungDepartment of Radiation Oncology, Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Anthony M GriffinMusculoskeletal Oncology Unit, Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada.
Lawrence M WhiteDepartment of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Brendan C DicksonLunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
Kim M TsoiLunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada. Kim.tsoi@sinaihealth.ca.

Funding

International Skeletal Society Research Seed GrantOntario Molecular Pathology Network Stream 1 Cancer Pathology Translational Research G
6 · The paper itself

Abstract

backgroundPeritumoral edema on staging magnetic resonance imaging (MRI) is associated with higher local recurrence in soft tissue sarcoma (STS). This may relate to the presence of satellite malignant cells that are difficult to distinguish from benign atypia, leading to over- or undertreatment. This study evaluated a novel targeted molecular approach to identify malignancy in STS peritumoral planes as a means to improve personalized care.

methodsIn the targeted molecular approach, whole-exome sequencing was employed to identify tumor-specific variants (TSVs), and peritumoral planes were assayed for malignancy, defined as two or more TSVs/plane, using droplet digital polymerase chain reaction (PCR). Feasibility was evaluated using a retrospective cohort (n = 8) in which planes with cellular atypia were tested. A prospective cohort (n = 8) then assayed all peritumoral planes with radiologic edema.

resultsThe targeted molecular approach identified malignancy in three of eight cases with cellular atypia of unknown significance (37.5%) and five of eight cases with peritumoral edema on staging MRI (62.5%). Peritumoral regions were heterogeneous; in none of the malignant cases did all sampled planes have evidence of tumor. Malignancy was also identified in regions without cellular atypia. Both cases with a local recurrence had molecular evidence of malignancy outside the main mass despite R0 margins.

conclusionThis study describes a novel personalized approach to detect malignancy in peritumoral regions in STS and is the first to identify molecular evidence of tumor outside the main mass. While development of a clinical tool is underway, these findings support the current approach of treating all peritumoral edema as malignant.

Indexed as

Biomarkers, TumorEdemaSarcomaAdultAgedExome SequencingFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedPrognosisProspective StudiesRetrospective StudiesBiomarkers, TumorDroplet digital PCRLocal recurrencePeritumoral edemaSarcomaSatellite malignant cellsTumor-specific variants

Identifiers

PMID39556178

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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.