Evidence map›Paper›PMID 40490638›Full record

ArticleAnnals of surgical oncology2025

Comparison of Local Recurrence Rates Between Wide Resection and Expanded Marginal Excision in Atypical Lipomatous Tumors.

Hitha V Segu, Sanjeev Rampam, Marcos R Gonzalez, Nicholas M Gebhardt, Ivan Chebib, Yin P Hung, Santiago A Lozano-Calderon

Abstract readComparative Study
PubMed Publisher
In one paragraph

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. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

7 authors.

Hitha V SeguDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Sanjeev RampamDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Marcos R GonzalezDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Nicholas M GebhardtDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Ivan ChebibDivision of Bone and Soft Tissue Pathology, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Yin P HungDivision of Bone and Soft Tissue Pathology, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Santiago A Lozano-CalderonDivision of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA. slozanocalderon@mgh.harvard.edu.ORCID http://orcid.org/0000-0002-0681-9004

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtypical lipomatous tumors (ALTs) are lipomatous neoplasms of the trunk and extremities with higher local recurrence rate than lipomas. Although wide resection is no longer routinely performed, there remains considerable variability in the extent of tissue resection during marginal excision.

methodsWe retrospectively identified patients with histologically proven ALT of the trunk or extremities treated with surgery between 1993 and 2021. We compared wide resection, expanded marginal excision, and simple marginal excision. Expanded marginal excision involved the removal of tissue infiltrated by fat, which can include the fascia, epimysium, or even muscle if it was involved.

resultsWe included 105 patients with median follow-up of 5.5 years. Local recurrence occurred in 15 patients (14.3%). Dedifferentiation occurred in 13% of recurrent patients (2/15), and none of these metastasized. Five- and 10-year local recurrence-free survival (LRFS) were 88.6% and 75.6%, respectively, and did not improve with the use of radiation therapy (RT). Five-year LRFS was 100% for both wide resection and expanded marginal excision. When compared with simple marginal excision, expanded marginal excision showed a trend toward higher 5-year LRFS (100% vs. 86.9%, p = 0.2). Risk factors for local recurrence included sclerosing subtype (adjusted odds ratio (aOR) 5.47) and tumors with previous recurrence (aOR 4.92).

conclusionExpanded marginal excision showed noninferior local control rates to wide resection without the additional morbidity of the latter, while suggesting to be superior to simple marginal resection. Future investigations featuring longer follow-up times should compare long-term local control rates by use of RT, type of resection, and ALT subtype. LEVEL OF EVIDENCE: III.

Indexed as

LipomaLiposarcomaMargins of ExcisionNeoplasm Recurrence, LocalAdultAgedAged, 80 and overExtremitiesFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateLocal recurrenceMarginal excisionRadiation surgeryWide resection

Identifiers

PMID40490638

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