Sarcoma Department, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA.
Radiology Department, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33629, USA.
Ann Surg Oncol. 2021 Jun;28(6):3366-3374. doi: 10.1245/s10434-020-09229-4. Epub 2020 Oct 18.
Resecting non-palpable soft tissue tumors presents a unique challenge, particularly with recurrent disease in which surrounding tissue has been surgically manipulated and often irradiated. SAVI SCOUT is a radar-based localization device that was developed for breast tumor localization and was recently FDA-approved for localization of soft tissue tumors. Application of this technology to soft tissue sarcoma has not been previously reported.
We assembled a single-institution retrospective case series of patients with trunk and extremity sarcomas resected by five sarcoma surgeons using SAVI SCOUT from December 2018 to May 2020. Reflectors were placed preoperatively using image-guidance, and the radar detector was used intraoperatively to localize the target lesion. Clinical variables were abstracted from the electronic medical record including treatment history, pathology, and early oncologic outcomes. Using a focused review, we compared margin status and recurrence rates with previously published cohorts.
Ten SAVI SCOUT-localized sarcoma resections were performed. Eight were for locally recurrent disease, of which seven (83%) had prior radiation. The remaining lesions became non-palpable after neoadjuvant chemotherapy. SAVI SCOUT facilitated resection in all cases with a margin-negative resection rate (77%) comparable to prior cohorts. In this high-risk population with a median follow-up of 14 months, only one patient recurred locally 7.5 months after SAVI SCOUT-localized resection, requiring re-resection.
SAVI SCOUT technology facilitated resection of non-palpable recurrent sarcoma of the trunk and extremities in all ten cases attempted. In a high-risk patient population, the pattern of recurrence has been primarily distant with one instance of local tumor recurrence.
切除触诊不可及的软组织肿瘤具有独特的挑战性，尤其是在疾病复发时，周围组织已接受手术处理且常接受过放疗。SAVI SCOUT 是一种基于雷达的定位设备，最初用于乳房肿瘤定位，最近已获得 FDA 批准用于软组织肿瘤的定位。该技术在软组织肉瘤中的应用尚未见报道。
我们收集了 2018 年 12 月至 2020 年 5 月期间，五位肉瘤外科医生使用 SAVI SCOUT 切除的躯干和四肢肉瘤患者的单中心回顾性病例系列。术前使用影像引导放置反射器，术中使用雷达探测器定位目标病变。从电子病历中提取临床变量，包括治疗史、病理学和早期肿瘤学结果。通过重点回顾，我们将切缘状态和复发率与先前发表的队列进行了比较。
共进行了 10 例 SAVI SCOUT 定位的肉瘤切除术。其中 8 例为局部复发性疾病，其中 7 例（83%）有既往放疗史。其余病变在新辅助化疗后变得触诊不可及。SAVI SCOUT 辅助了所有病例的切除，切缘阴性的切除率（77%）与先前的队列相似。在中位随访 14 个月的高危人群中，仅 1 例患者在 SAVI SCOUT 定位切除后 7.5 个月局部复发，需要再次切除。
SAVI SCOUT 技术成功辅助了 10 例尝试切除的躯干和四肢触诊不可及的复发性肉瘤。在高危患者人群中，复发模式主要为远处转移，仅 1 例出现局部肿瘤复发。
