Generaal, J.D. (2020) The accuracy and application of preoperative three dimensional virtual surgical planning to determine tumor volume in extremity soft-tissue sarcomas. thesis, Medicine.
Full text available on request.Abstract
Introduction. The indication of reconstruction after extremity soft-tissue sarcoma resection remains subject of debate. This study aims to explore (1) the accuracy of three dimensional virtual surgical planning (3D-VSP) to preoperatively determine tumor volume. (2) The difference of, among others, tumor volume between wound closure types is studied. It is hypothesized that tumor volume is small in patients with skin grafts, whereas it is large in patients with flap reconstructions. Methods. All patients that were treated by surgical resection for an extremity soft-tissue sarcoma between 1 January 2016 and 1 October 2019 were included. Three dimensional models were created with Mimics (Materialise innovation suite) for all patients using the axial T1-weighted contrast-MR-sequence of the diagnostic MR scan. Additional data were gathered from patient records and/or radiotherapy plans. Patients were divided in three groups based on type of closure. Group I consisted of patients with primarily closed tissue defects, group II of patients with skin grafts and group II of patients with flap reconstructions. Results. Eighty-four patients were included for analysis. (1) In 46 pre-operatively irradiated patients, Kendall tau’s b-correlation of gross tumor volume and 3D tumor volume was strong and positive, τb = 0.786, p = ≤0.001. (2) Sixty-four (76.2%) patients were included in group I, 13 (15.5%) in group II and 7 (10.9%) in group III. Preoperative 3D tumor volume was 128.34 [364.60] ml in group I, 22.05 [39.70] ml in group II and 25.04 [148.67] ml in group III (p = ≤0.001). Conclusions. (1) 3D-VSP can accurately be used to determine tumor volume. (2) The group of patients that was treated by flap reconstruction was smaller than expected. In the study population, tumor volume did not influence type of closure. More research is required to determine the indication of reconstruction preoperatively.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Prof. dr. van Leeuwen, MD PhD, B.L. and Glas, MSc, H.H. and Ubbels, MD, J.F. |
| Faculty: | Medical Sciences |
| Date Deposited: | 20 Sep 2023 11:29 |
| Last Modified: | 20 Sep 2023 11:29 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3690 |
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