Connective Tissue Oncology Society
Download
1 / 34

Connective Tissue Oncology Society 11th Annual Meeting Boca Raton, November 19-21 2005 - PowerPoint PPT Presentation


  • 213 Views
  • Uploaded on

Connective Tissue Oncology Society 11th Annual Meeting Boca Raton, November 19-21 2005 A European project for surgical margins assessment in STS of the extremities and superficial trunk.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Connective Tissue Oncology Society 11th Annual Meeting Boca Raton, November 19-21 2005' - dinos


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

Connective Tissue Oncology Society

11th Annual Meeting

Boca Raton, November 19-21 2005

A European project for surgical margins assessment in STS of the extremities and superficial trunk

Gronchi A, Grimer R, Hoogendoorn PCW, Van Coevorden F, Bauer H, Kindblom LG, Bonvalot S, Coindre JM, Hohenberger P, Wardelman E, Ruka W, Rutkowski P, Collini P, Dei Tos AP



Do we all speak the same language ?

  • R0 = clear margin = Wide ?

  • R1 = tumour at margin = Marginal or intralesional ?

  • R2 = residual macroscopic disease = Intralesional


Do we all speak the same language ?

  • Intralesional

  • Marginal

  • Wide

  • Radical


Japanese orthopaedic surgeons…

Quantify the concept of “barrier”

Joint cartilage = 5cm

Thick barrier = 3cm

Young periosteum

Tendon

Thick fascia (ie fascia lata, presacral fascia)

Thin barrier = 2cm

Adult periosteum

Vascular adventitia

Perineural sheath

Normal muscular fascia

Adherent tumour = – 1cm

Kawaguchi et al 2004, Clin Orthop 419


Japanese orthopedic surgeons…

  • 5 cm. margin = Curative

  • >2 cm margin = Adequately wide

  • <1 cm margin = Inadequately wide

  • “reacting zone” = Marginal

  • Tumour at the margin = Intralesional

Kawaguchi et al 2004, Clin Orthop 419



You have heard medical oncologist claiming

We should DESIST using RECIST at least in GIST

You have heard medical oncoloGIST claiming…

CTOS Barcelona 2003


about surgical margins

You have also heard surgical oncologist and orthopaedic oncologist talking…

Consensus Meeting Trieste 2005






How would you have done it

Much better…

Same…

Other

How would you have done it ?


What would you call it

Wide ?

Inadequately wide ?

Close ?

Marginal ?

What would you call it ?




To have one form for a prospective data base
To have one form for a prospective data base


Details of closer margins

Width

Quality (fascia, muscle, periosteum….)

Details of closer margins


Details of histology

Subtype

Grade

Vascular invasion (Y/N)

Nature of margin (pushing or infiltrative)

Details of histology


Details of adjuvant neoadjuvant treatments

CT

RT

Other

Details of adjuvant/neoadjuvant treatments


Margins depend on

The type of tumour

The grade

The location

Response to neoadjuvant therapies (CT different from RT ?)

The surgeon

The patient

Margins depend on….



Participating groups

EORTC - STBSG

Participating groups

ISG BSG FSG SSG

NWWDT PSG GEIS

+ YOU ?


End point

Local recurrence free survival

Metastasis free survival

Disease specific survival

End Point





ad