Sakamoto A, Noguchi T, Matsuda S. System describing surgical field extension associated with flap reconstruction after resection of a superficial malignant soft tissue tumor. World J Clin Oncol 2023; 14(11): 471-478 [PMID: 38059186 DOI: 10.5306/wjco.v14.i11.471]
Corresponding Author of This Article
Akio Sakamoto, MD, PhD, Adjunct Professor, Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Kawahara-cho 54, Sakyo-ku, Kyoto 606-8507, Japan. akiosaka@kuhp.kyoto-u.ac.jp
Research Domain of This Article
Orthopedics
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Nov 24, 2023; 14(11): 471-478 Published online Nov 24, 2023. doi: 10.5306/wjco.v14.i11.471
System describing surgical field extension associated with flap reconstruction after resection of a superficial malignant soft tissue tumor
Akio Sakamoto, Takashi Noguchi, Shuichi Matsuda
Akio Sakamoto, Takashi Noguchi, Shuichi Matsuda, Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
Author contributions: Sakamoto A developed the classification and drafted the manuscript; Noguchi T and Matsuda S participated in the study design; All authors read and approved the final manuscript.
Institutional review board statement: Analysis of clinical data accumulation in patients with bone and soft tissue tumors. Retrospective study.
Informed consent statement: The patients represented in this study were informed that the data from the case would be de-identified and used in a journal publication. There is a specific signed document because the analysis used anonymous clinical data that were obtained after each patient had been notified at the Kyoto University home page that the data could be used for a clinical study.
Conflict-of-interest statement: We, the authors, declare no conflicts of interest regarding our manuscript entitled “A system describing surgical field extension associated with flap reconstruction after resection of a malignant soft tissue tumor.”
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Akio Sakamoto, MD, PhD, Adjunct Professor, Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Kawahara-cho 54, Sakyo-ku, Kyoto 606-8507, Japan. akiosaka@kuhp.kyoto-u.ac.jp
Received: August 29, 2023 Peer-review started: August 29, 2023 First decision: September 14, 2023 Revised: September 24, 2023 Accepted: October 13, 2023 Article in press: October 13, 2023 Published online: November 24, 2023 Processing time: 84 Days and 17.6 Hours
ARTICLE HIGHLIGHTS
Research background
Flap reconstruction can extend the surgical field or tumor bed because of flap elevation or dissection of recipient vessels during resection of superficial soft tissue sarcomas. There is currently no method describing extension of the surgical field.
Research motivation
Extension of the surgical field cannot be predicted based on preoperative images for flap reconstruction after superficial soft tissue sarcoma resection. Knowledge of the surgical field extension is important information for evaluation of recurrence images or possible postoperative radiation.
Research objectives
A theoretical CD-grading system was developed consisting of C and D values in the surgical field extension. The C-value represents the flap beyond the nearby large joint and the D-value pertains to a deeper extension.
Research methods
C1/D1 and C0/D0 are positive and negative values, respectively. With a known location, C values are "p" (proximal), "d" (distal), and "b" (in the tumor bed). The description method is as follows: flap type, CxDx [x = 0, 1, p, d or b].
Research results
Classification and possible values are shown in the tables (transpositional fascial flap/propeller, pedicled, and free flaps). Four representative patients with subcutaneous sarcomas who underwent reconstruction using fasciocutaneous flaps are presented.
Research conclusions
The new grading system can give values for tumor bed extension after flap reconstruction following superficial soft tissue sarcoma resection. The description of whether or not the operative field has been extended due to reconstruction is thought to be important information for evaluation of recurrence images.
Research perspectives
Clinical use of assembled clinical data would be necessary and some modification may be required for improvement, especially if the new grading system is modified for any part of bone and soft tissue sarcomas.
