[Systemic therapy and hyperthermia for locally advanced soft tissue sarcoma]

Prognostic significance of p16INK4a alteration in soft tissue sarcomas: A meta-analysis

PURPOSE

Numerous studies have investigated the role of p16^INK4a alteration in patients with soft tissue sarcomas (STSs) yielding inconsistent and inconclusive results. Hence, we conducted a meta-analysis to precisely assess its prognostic value.

MATERIALS AND METHODS

Electronic literature databases such as PubMed, EMBASE, Web of Science were searched, and five studies with a total of 536 patients were eligible for this meta-analysis. Pooled hazard ratio (HR) with 95% confidence interval (95% CI) of overall survival (OS) was used to assess the prognostic role of p16^INK4a alteration.

RESULTS

Overall, the pooled HR for all five eligible studies evaluating decreased p16^INK4a expression on OS was 1.47 (95% CI: 1.14-1.90); sensitivity analysis suggested that the pooled HR was stable and omitting a single study did not change the significance of the pooled HR. There is no evidence of publication bias in the meta-analysis.

CONCLUSIONS

In conclusion, this meta-analysis showed that decreased p16^INK4a expression is associated with lower OS rate in patients with STS, and it is an effective biomarker of prognosis.

Soft Tissue Coverage of the Lower Limb following Oncological Surgery

The treatment of lower limb tumors has been shifted by advancements in adjuvant treatment protocols and microsurgical reconstruction from limb amputation to limb salvage. Standard approaches include oncological surgery by a multidisciplinary team in terms of limb sparing followed by soft tissue reconstruction and adjuvant therapy when indicated. For the development of a comprehensive surgical plan, the identity of the tumor should first be determined by histology after biopsy. Then the surgical goal and comprehensive treatment concept should be developed by a multidisciplinary tumor board and combined with soft tissue reconstruction. In this article, plastic surgical reconstruction options for soft coverage of the lower extremity following oncological surgery will be described along with the five clinical cases.