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The Bone & Joint Journal
Vol. 98-B, Issue 12 | Pages 1682 - 1688
1 Dec 2016
Ghazala CG Agni NR Ragbir M Dildey P Lee D Rankin KS Beckingsale TB Gerrand CH

Aims

Myxofibrosarcomas (MFSs) are malignant soft-tissue sarcomas characteristically presenting as painless slowly growing masses in the extremities. Locally infiltrative growth means that the risk of local recurrence is high. We reviewed our experience to make recommendations about resection strategies and the role of the multidisciplinary team in the management of these tumours.

Patients and Methods

Patients with a primary or recurrent MFS who were treated surgically in our unit between 1997 and 2012 were included in the study. Clinical records and imaging were reviewed. A total of 50 patients with a median age of 68.4 years (interquartile range 61.6 to 81.8) were included. There were 35 men; 49 underwent surgery in our unit.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_1 | Pages 113 - 113
1 Jan 2013
Gerrand C Ghazala C Ragbir M
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Background

Myxofibrosarcomas are malignant soft tissue tumours that often present as painless slowly growing masses in the extremities of older males. Locally infiltrative growth means risks of local recurrence is high. Management emphasises negative surgical margins and adjuvant therapy. The aim of this retrospective case series was to review our experience of this tumour, and make recommendations about a minimum resection margin and how best to utilise the expertise of the multidisciplinary team.

Methods

A computerised database identified patients with myxofibrosarcoma surgically treated in our centre between 1997 and 2011. Clinical records were reviewed. Margins were positive if tumour was at or within 1mm of the resection plane.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_1 | Pages 115 - 115
1 Jan 2013
Gerrand C Lipede C Rahman K King I Ragbir M
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Introduction and aims

Solitary fibrous tumours (SFT) are rare soft tissue sarcomas. Challenges in management include the variation in anatomical location and uncertain malignant potential. We retrospectively reviewed our experience with the aim of formulating guidelines on appropriate treatment.

Methods

An electronic database identified patients with SFT presenting between 2003–2011. Clinical records were reviewed.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXX | Pages 27 - 27
1 Jul 2012
Lewis C Gerrand C Barnes D Murray S Milner R Ragbir M
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Introduction

Angiosarcomas are rare aggressive sarcomas of vascular endothelial origin. These tumours have the potential to be multicentric and are associated with high rates of local recurrence, which makes treatment challenging. The gold-standard is that these patients are managed in specialist centres by a multidisciplinary team. We present our experience of managing patients with angiosarcoma in the North of England Bone and Soft Tissue Tumour Service and a review of the literature.

Methods

A prospectively collated electronic database was used to identify patients with angiosarcoma treated between 2000 and 2008, and an analysis performed of demographics, anatomical site, surgical excision and reconstruction, local disease recurrence and metastatic disease.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_I | Pages 64 - 64
1 Mar 2010
Collin T Blackburn A Milner R Gerrand C Ragbir M
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Introduction: The Plastic Surgery challenge in groin sarcoma is often twofold involving restoration of integrity to the lower abdominal wall and provision of durable soft tissue cover for the groin and perineum.

Methods: This is a retrospective review of consecutive patients undergoing groin sarcoma excision with plastic surgery involvement over the last 7 years. The referral patterns of these patients, histological types, margins and details of reconstructions performed were analysed. Information was also gathered regarding adjuvant therapy, recurrences and survival.

Results: Thirteen patients were included in this review. In twelve out of the thirteen patients initial biopsies/explorations were performed by either General Surgeons or Urologists. Ten of these biopsies were incompletely excised. On average 4.4 months elapsed between initial biopsy and referral to the Regional Sarcoma Service.

The most frequently performed reconstruction was a rectus abdominis musculo-cutaneous flap. Six patients developed post operative complications.

Complete/adequate surgical margins were achieved in seven patients. A further five patients had margins designated as “narrow” or “marginal”.

Six patients received post operative radiotherapy based on the multidisciplinary clinic review. Three patients were referred for radiotherapy but did not receive treatment. Five patients developed recurrences and four of these patients died.

Discussion: Groin sarcomas represent a surgical and logistical challenge.

The anatomical topography makes complete surgical excision difficult without available reconstructive techniques and complication rates can be high.

Referral of these patients to the regional sarcoma service is often delayed whilst exploration or biopsy is performed. This delay can persist even after a diagnosis of sarcoma has been made. Communication with colleagues in other centres may be the key to improving this side of management.