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Title: Anatomical factors in adult extremity soft tissue sarcoma
Author: Gerrand, C. H.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2005
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This thesis examines the influence of anatomical factors in adult extremity soft tissue sarcoma. Four studies address different aspects of this question by reviewing data relating to patients treated at the Musculoskeletal Oncology Unit at the Mount Sinai Hospital, Toronto, Canada. The anatomical relationships of a tumour may mean that it is resected with a positive surgical margin. The first study looks at the clinical scenarios in which positive surgical margins occur and tests a classification of positive surgical margins. The second study examines differences in presentation, treatment and outcomes between soft tissue sarcomas in the upper and lower extremities. The third paper examines the relationship between the anatomical location of lower extremity soft tissue sarcoma and functional outcome measured by Musculoskeletal Tumour Society (MSTS (1993)) and Toronto Extremity Salvage Score (TESS) evaluations. It shows that treatment of superficial tumours does not lead to significant changes in functional scores. Treatment of deep tumours, however, leads to significant reductions in functional scores. Aggregated functional scores do not appear to vary with anatomical location, but the items that comprise the aggregated scores do. The final paper examines whether or not the preservation of anatomical structures leads to better functional scores by comparing scores after the planned marginal excision or “shelling out” of a low grade tumour with those seen after wider resection of a high grade tumour. Planned marginal excision is associated with significant reductions in functional scores. These novel, clinically relevant, studies confirm the importance of anatomical location in determining presentation, treatment and outcomes in extremity soft tissue sarcoma.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available