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  1. Article: [Ⅱ. Clinical Relevance of Comprehensive Genomic Profiling for Advanced Sarcomas].

    Ogura, Koichi / Ikegami, Masachika / Kawai, Akira

    Gan to kagaku ryoho. Cancer & chemotherapy

    2024  Volume 51, Issue 3, Page(s) 259–262

    MeSH term(s) Humans ; Clinical Relevance ; Sarcoma/genetics ; Gene Expression Profiling ; Genomics
    Language Japanese
    Publishing date 2024-03-15
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 604842-0
    ISSN 0385-0684
    ISSN 0385-0684
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    Zs.B 2573: Show issues Location:
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  2. Article ; Online: Infection of surgery for bone and soft tissue sarcoma with biological reconstruction: Data from the Japanese nationwide bone tumor registry.

    Morii, Takeshi / Ogura, Koichi / Sato, Kenji / Kawai, Akira

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association

    2024  

    Abstract: Background: Although biological reconstruction (such as recycled autograft, vascularized autograft, allograft, or bone transport) is possible for bone defects after malignant bone or soft tissue tumor resection, a high incidence of postoperative ... ...

    Abstract Background: Although biological reconstruction (such as recycled autograft, vascularized autograft, allograft, or bone transport) is possible for bone defects after malignant bone or soft tissue tumor resection, a high incidence of postoperative complications, including infection, poses a problem. The difficulty in accumulating cases has resulted in a lack of reliable etiological information, such as the incidence and risk factors of postoperative infections.
    Methods: We conducted a retrospective study on the nationwide registry data. The primary endpoint was the need for additional surgical intervention for infection control. The overall incidence of postoperative infection and the related risk factors were analyzed.
    Results: We included 707 malignant bone and soft tissue tumors with biological reconstruction, including recycled autograft, vascularized autograft, allograft, bone transport, and combinations of these. The incidence of postoperative infection was 10.8%. Patients reconstructed by pedicled autograft showed a higher incidence of infection, while cases involving the combination of recycled and pedicled autograft or allograft showed a lower incidence. Independent risk factors for infection included age over 17, tumor diameter over 10 cm, the tumor located on the trunk or being high grade, reconstruction by pedicled autograft, and delayed wound healing.
    Conclusion: Infection incidence was comparable to those in previous reports. Several conventional and novel risk factors were extracted by administering nationwide registry data. Data from the nationwide registry was informative for analyzing the incidence of postoperative infection in biological reconstruction with malignant bone and soft tissue tumor resection.
    Language English
    Publishing date 2024-05-16
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1314243-4
    ISSN 1436-2023 ; 0949-2658
    ISSN (online) 1436-2023
    ISSN 0949-2658
    DOI 10.1016/j.jos.2024.04.006
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    Zs.A 4484: Show issues Location:
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  3. Article ; Online: Incidence and risk of infection in malignant soft tissue tumor resection: Data from the nationwide soft tissue tumor registry.

    Morii, Takeshi / Sato, Kenji / Ogura, Koichi / Kawai, Akira

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association

    2023  

    Abstract: Background: Postoperative infection is a devastating complication in limb salvage surgery for malignant soft tissue tumors. The low absolute case numbers of these rare cancers represent a bottleneck for data collection and analysis. The administration ... ...

    Abstract Background: Postoperative infection is a devastating complication in limb salvage surgery for malignant soft tissue tumors. The low absolute case numbers of these rare cancers represent a bottleneck for data collection and analysis. The administration of nationwide registry data is a practical option for the accumulation of cases.
    Methods: Data on malignant soft tissue tumor resection were extracted from the Bone and Soft Tissue Tumor Registry in Japan. The incidence of postoperative infection and its risk factors were analyzed.
    Results: A total of 14,460 cases were included. The incidence of infection was 2.6%. Significant risks for infection were male sex, lower extremity or trunk location, tumor diameter of over 10 cm, trans-compartmental invasion, high grade, autologous bone graft, myocutaneous flap, vascular reconstruction, reconstruction by prosthesis, postoperative radiotherapy, and delayed wound healing.
    Conclusions: The incidence was lower than those in the previous studies, perhaps because of less frequent radiotherapy application. Some of the significant risk factors represented local invasiveness of the tumor, suggesting the importance of the preservation of soft tissue for infection prevention. The administration of nationwide registry data was informative for the analysis of infection in malignant soft tissue tumor resection.
    Language English
    Publishing date 2023-08-18
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1314243-4
    ISSN 1436-2023 ; 0949-2658
    ISSN (online) 1436-2023
    ISSN 0949-2658
    DOI 10.1016/j.jos.2023.08.002
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  4. Article ; Online: Incidence and risk of surgical site infection/periprosthetic joint infection in tumor endoprosthesis-data from the nationwide bone tumor registry in Japan.

    Morii, Takeshi / Ogura, Koichi / Sato, Kenji / Kawai, Akira

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association

    2023  

    Abstract: Background: Surgical site infection (SSI)/periprosthetic joint infection (PJI) is a devastating complication in limb salvage surgery with endoprosthesis reconstruction for malignant bone tumors. The main bottleneck for data collection and analysis for ... ...

    Abstract Background: Surgical site infection (SSI)/periprosthetic joint infection (PJI) is a devastating complication in limb salvage surgery with endoprosthesis reconstruction for malignant bone tumors. The main bottleneck for data collection and analysis for the status of SSI/PJI in tumor endoprosthesis is the low absolute case numbers of this rare cancer. The accumulation of many cases is possible by administrating nationwide registry data.
    Methods: The data on malignant bone tumor resection with tumor endoprosthesis reconstruction were extracted from the Bone and Soft Tissue Tumor Registry in Japan. The primary endpoint was defined as the need for additional surgical intervention for infection control. The incidence of postoperative infection and its risk factors were analyzed.
    Results: A total of 1342 cases were included. The incidence of SSI/PJI was 8.2%. The incidence of SSI/PJI in the proximal femur, distal femur, proximal tibia, and pelvis were 4.9%, 7.4%, 12.6%, and 41.2%, respectively. Location in the pelvis or proximal tibia, tumor grade, indication of myocutaneous flaps, and delayed wound healing proved to be independent risks for SSI/PJI, whereas age, sex, previous surgery, tumor size, surgical margin, application of chemotherapy and radiotherapy were not significant.
    Conclusions: The incidence was equal to those in previous studies. The result reconfirmed the high incidence of SSI/PJI in pelvis and proximal tibia cases and cases with delayed wound healing. Novel risk factors such as tumor grade and application of myocutaneous flaps were marked. The administration of nationwide registry data was informative for the analysis of SSI/PJI in tumor endoprosthesis.
    Language English
    Publishing date 2023-07-06
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1314243-4
    ISSN 1436-2023 ; 0949-2658
    ISSN (online) 1436-2023
    ISSN 0949-2658
    DOI 10.1016/j.jos.2023.06.008
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  5. Article ; Online: Geographic Access to High-Volume Care Providers and Survival in Patients with Bone Sarcomas: Nationwide Patterns in the United States.

    Fujiwara, Tomohiro / Ogura, Koichi / Alaqeel, Motaz / Healey, John H

    The Journal of bone and joint surgery. American volume

    2022  Volume 104, Issue 16, Page(s) 1426–1437

    Abstract: Background: Clinical practice guidelines recommend centralized care for patients with bone sarcoma. However, the relationship between the distance that patients travel to obtain care, institutional treatment volume, and survival is unknown.: Methods: ...

    Abstract Background: Clinical practice guidelines recommend centralized care for patients with bone sarcoma. However, the relationship between the distance that patients travel to obtain care, institutional treatment volume, and survival is unknown.
    Methods: We used the National Cancer Database to examine associations between travel distance and survival among 8,432 patients with bone sarcoma diagnosed from 2004 to 2015. Associations were identified using multivariable Cox regression analyses that controlled for sociodemographic, clinical, and hospital-level factors; subgroup analyses stratified patients by histological diagnosis, tumor stage, and pediatric or adult status.
    Results: Mortality risk was lower among patients who traveled ≥50 miles (≥80.5 km) than among patients who traveled ≤10 miles (≤16.1 km) (hazard ratio [HR], 0.69 [95% confidence interval (CI), 0.63 to 0.76]). Among hospital-level factors, facility volume independently affected survival: mortality risk was lower among patients at high-volume facilities (≥20 cases per year) than at low-volume facilities (≤5 cases per year), with an HR of 0.72 (95% CI, 0.66 to 0.80). The proportion of patients who received care at high-volume facilities varied by distance traveled (p < 0.001); it was highest among patients who traveled ≥50 miles (53%) and lower among those who traveled 11 to 49 miles (17.7 to 78.9 km) (32%) or ≤10 miles (18%). Patients who traveled ≥50 miles to a high-volume facility had a lower risk of mortality (HR, 0.65 [95% CI, 0.56 to 0.77]) than those who traveled ≤10 miles to a low-volume facility. In subgroup analyses, this association was evident among patients with all 3 major histological subtypes; those with stage-I, II, and IV tumors; and adults.
    Conclusions: This national study showed that greater travel burden was associated with higher survival rates in adults, a finding attributable to patients traveling to receive care at high-volume facilities. Despite the burdens associated with travel, modification of referral pathways to specialized centers may improve survival for patients with bone sarcoma.
    Level of evidence: Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.
    MeSH term(s) Adult ; Bone Neoplasms/therapy ; Child ; Health Services Accessibility ; Humans ; Proportional Hazards Models ; Sarcoma ; Survival Rate ; Travel ; United States
    Language English
    Publishing date 2022-06-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.21.01140
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.MO 464: Show issues

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  6. Article ; Online: Greater travel distance to specialized facilities is associated with higher survival for patients with soft-tissue sarcoma: US nationwide patterns.

    Fujiwara, Tomohiro / Ogura, Koichi / Healey, John

    PloS one

    2021  Volume 16, Issue 6, Page(s) e0252381

    Abstract: Purpose: The survival impact of geographic access to specialized care remains unknown in patients with soft-tissue sarcomas (STS). This study aimed to clarify the association between the patient travel distance and survival outcome and investigate the ... ...

    Abstract Purpose: The survival impact of geographic access to specialized care remains unknown in patients with soft-tissue sarcomas (STS). This study aimed to clarify the association between the patient travel distance and survival outcome and investigate the factors lying behind it.
    Methods: A total of 34 528 patients with STS registered in the National Cancer Data Base, diagnosed from 2004-2016, were investigated.
    Results: Tumor stage correlated with travel distance: patients with metastatic disease stayed closer to home. However, the type of facility showed greatest variation: 37.0%, 51.0%, 73.5%, and 75.9% of patients with ≤10 miles, 10.1-50 miles, 50.1-100 miles, and >100 miles, respectively (P<0.001), had a sarcoma care at academic/research centers. On a multivariable analysis, reduced mortality risk was associated with longer (versus short) travel distance (>100 miles: HR = 0.877; P = 0.001) and management at academic/research (versus non-academic/research) centers (HR = 0.857; P<0.001). The greatest divergence was seen in patients traveling very long distance (>100 miles) to an academic/research center, with a 26.9% survival benefit (HR = 0.731; P<0.001), compared with those traveling short distance (≤10 miles; 95.4% living in metropolitan area) to a non-academic/research center. There was no significant correlation between travel distance and survival in patients who had care at academic/research centers, whereas a survival benefit of management at academic/research centers was observed in every group of travel distance, regardless of tumor stage.
    Conclusions: This national study demonstrated that increased travel distance was associated with superior survival, attributable to a higher proportion of patients receiving sarcoma care at distant academic/research centers. These data support centralized care for STS. Overcoming referral and travel barriers may enable more patients to be treated at specialized centers and may further improve survival rates for patients with STS, even when it imposes an increased travel burden.
    MeSH term(s) Data Management/methods ; Female ; Health Services Accessibility ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sarcoma/mortality ; Soft Tissue Neoplasms/mortality ; Survival Rate ; Time Factors ; Travel
    Language English
    Publishing date 2021-06-04
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0252381
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  7. Article ; Online: Patients with an increased time to treatment initiation have a poorer overall survival after definitive surgery for localized high-grade soft-tissue sarcoma in the extremity or trunk : report from the National Cancer Database.

    Ogura, Koichi / Fujiwara, Tomohiro / Healey, John H

    The bone & joint journal

    2021  Volume 103-B, Issue 6, Page(s) 1142–1149

    Abstract: Aims: Time to treatment initiation (TTI) is generally defined as the time from the histological diagnosis of malignancy to the initiation of first definitive treatment. There is no consensus on the impact of TTI on the overall survival in patients with ... ...

    Abstract Aims: Time to treatment initiation (TTI) is generally defined as the time from the histological diagnosis of malignancy to the initiation of first definitive treatment. There is no consensus on the impact of TTI on the overall survival in patients with a soft-tissue sarcoma. The purpose of this study was to determine if an increased TTI is associated with overall survival in patients with a soft-tissue sarcoma, and to identify the factors associated with a prolonged TTI.
    Methods: We identified 23,786 patients from the National Cancer Database who had undergone definitive surgery between 2004 and 2015 for a localized high-grade soft-tissue sarcoma of the limbs or trunk. A Cox proportional hazards model was used to examine the relationship between a number of factors and overall survival. We calculated the incidence rate ratio (IRR) using negative binomial regression models to identify the factors that affected TTI.
    Results: Patients in whom the time to treatment initiation was prolonged had poorer overall survival than those with a TTI of 0 to 30 days. These were: 31 to 60 days (hazard ratio (HR) 1.08, p = 0.011); 61 to 90 days (HR 1.11, p = 0.044); and 91 days (HR 1.22; p = 0.003). The restricted cubic spline showed that the hazard ratio increased substantially with a TTI longer than 50 days. Non-academic centres (vs academic centres; IRR ranging from 0.64 to 0.86; p < 0.001) had a shorter TTI. Those insured by Medicaid (vs private insurance; IRR 1.34), were uninsured (vs private insurance; IRR 1.17), or underwent a transition in care (IRR 1.62) had a longer TTI.
    Conclusion: A time to treatment initiation of more than 30 days after diagnosis was independently associated with poorer survival. The hazard ratio showed linear increase, especially if the TTI was more than 50 days. We recommend starting treatment within 30 days of diagnosis to achieve the highest likelihood of cure for localized high-grade soft-tissue sarcomas in the limbs and trunk, even when a patient needs to be referred to a specialist centre. Cite this article:
    MeSH term(s) Aged ; Extremities ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Registries ; Retrospective Studies ; Sarcoma/mortality ; Sarcoma/pathology ; Sarcoma/surgery ; Survival Rate ; Thorax ; Time-to-Treatment ; United States/epidemiology
    Language English
    Publishing date 2021-05-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2697156-2
    ISSN 2049-4408 ; 2049-4394
    ISSN (online) 2049-4408
    ISSN 2049-4394
    DOI 10.1302/0301-620X.103B6.BJJ-2020-2087.R1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6989: Show issues Location:
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  8. Article ; Online: Histological diagnostic discrepancy and its clinical impact in bone and soft tissue tumors referred to a sarcoma center.

    Kawai, Akira / Yoshida, Akihiko / Shimoi, Tatsunori / Kobayashi, Eisuke / Yonemori, Kan / Ogura, Koichi / Iwata, Shintaro / Toshirou, Nishida

    Cancer science

    2024  

    Abstract: Histological diagnosis of sarcomas (malignant bone and soft tissue tumors) is challenging due to their rarity, morphological diversity, and constantly evolving diagnostic criteria. In this study, we aimed to assess the concordance in histological ... ...

    Abstract Histological diagnosis of sarcomas (malignant bone and soft tissue tumors) is challenging due to their rarity, morphological diversity, and constantly evolving diagnostic criteria. In this study, we aimed to assess the concordance in histological diagnosis of bone and soft tissue tumors between referring hospitals and a tertiary sarcoma center and analyzed the clinical impact of the diagnostic alteration. We analyzed 628 consecutively accessioned specimens from 624 patients who visited a specialized sarcoma center for treatment. The diagnoses at referring hospitals and those at the sarcoma center were compared and classified into four categories: agreed, disagreed, specified, and de-specified. Of the 628 specimens, the diagnoses agreed in 403 (64.2%) specimens, whereas some changes were made in 225 (35.8%) specimens: disagreed in 153 (24.3%), specified in 52 (8.3%), and de-specified in 20 (3.2%) cases. The benign/intermediate/malignant judgment changed for 92 cases (14.6%). The diagnostic change resulted in patient management modification in 91 cases (14.5%), including surgical and medical treatment changes. The main inferred reason for the diagnostic discrepancies was a different interpretation of morphological findings of the tumor, which accounted for 48.9% of the cases. This was followed by the unavailability of specialized immunohistochemical antibodies and the unavailability of genetic analysis. In summary, our study clarified the actual clinical impact of diagnostic discrepancy in bone and soft tissue tumors. This may underscore the value of pathology consultation, facilitating access to specialized diagnostic tools, and continued education. These measures are expected to improve diagnostic precision and ultimately benefit patients.
    Language English
    Publishing date 2024-05-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2115647-5
    ISSN 1349-7006 ; 1349-7006
    ISSN (online) 1349-7006
    ISSN 1349-7006
    DOI 10.1111/cas.16211
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  9. Article ; Online: Soft tissue sarcoma in adolescent and young adult patients: a retrospective study using a nationwide bone and soft tissue tumor registry in Japan.

    Fukushima, Takashi / Ogura, Koichi / Akiyama, Toru / Takeshita, Katsushi / Kawai, Akira

    Japanese journal of clinical oncology

    2021  Volume 51, Issue 7, Page(s) 1080–1087

    Abstract: Objective: The relationship between the adolescent and young adult age groups and poor overall survival in soft tissue sarcoma and the risk factors for poor outcomes in adolescent and young adult patients with soft tissue sarcoma were analyzed.: ... ...

    Abstract Objective: The relationship between the adolescent and young adult age groups and poor overall survival in soft tissue sarcoma and the risk factors for poor outcomes in adolescent and young adult patients with soft tissue sarcoma were analyzed.
    Methods: The medical records of 7759 Japanese patients diagnosed with soft tissue sarcoma from 2006-13 were accessed from the Bone and Soft Tissue Tumor registry. The epidemiological features of adolescent and young adult patients were compared with those of other age groups. The cancer survival rates were calculated using the Kaplan-Meier method. The prognostic factors for cancer survival were analyzed with the Cox proportional hazards models. The primary endpoint for prognosis was tumor-related death.
    Results: There were 210 children, 1467 adolescent and young adults, 2771 adults and 3311 elderly among the 7759 patients identified with soft tissue sarcoma. Compared with other age groups, the proportions of myxoid/round cell liposarcoma, synovial sarcoma, malignant peripheral nerve sheath tumor, primitive neuroectodermal tumor and rhabdomyosarcoma in adolescent and young adult patients were the highest, but none was significantly more prevalent in adolescent and young adult patients. On multivariate analysis, age was not a prognostic factor for poor cancer survival among adolescent and young adult patients with soft tissue sarcoma. The cancer survival rates of adolescent and young adult patients with malignant peripheral nerve sheath tumor were poorer than those of the other age groups; however, adolescent and young adult age was not a prognostic factor on multivariate analysis in malignant peripheral nerve sheath tumor patients.
    Conclusions: Our study is the first to investigate soft tissue sarcoma in adolescent and young adult patients using the nationwide Bone and Soft Tissue Tumor registry. Adolescent and young adult age is not a prognostic factor for poor cancer survival among those with soft tissue sarcoma in Japan.
    MeSH term(s) Adolescent ; Aged ; Female ; Humans ; Japan/epidemiology ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prognosis ; Registries ; Retrospective Studies ; Sarcoma/epidemiology ; Soft Tissue Neoplasms/epidemiology ; Young Adult
    Language English
    Publishing date 2021-03-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 190978-2
    ISSN 1465-3621 ; 0368-2811
    ISSN (online) 1465-3621
    ISSN 0368-2811
    DOI 10.1093/jjco/hyab044
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  10. Article ; Online: A vessel sealing system can help reduce the risk of postoperative complications after tumour resection in the medial thigh.

    Toda, Yu / Iwata, Shintaro / Kobayashi, Eisuke / Ogura, Koichi / Osaki, Shuhei / Fukushima, Suguru / Mawatari, Masaaki / Kawai, Akira

    Bone & joint open

    2023  Volume 4, Issue 6, Page(s) 442–446

    Abstract: Aims: The risk of postoperative complications after resection of soft-tissue sarcoma in the medial thigh is higher than in other locations. This study investigated whether a vessel sealing system (VSS) could help reduce the risk of postoperative ... ...

    Abstract Aims: The risk of postoperative complications after resection of soft-tissue sarcoma in the medial thigh is higher than in other locations. This study investigated whether a vessel sealing system (VSS) could help reduce the risk of postoperative complications after wide resection of soft-tissue sarcoma in the medial thigh.
    Methods: Of 285 patients who underwent wide resection for soft-tissue sarcoma between 2014 and 2021 at our institution, 78 patients with tumours in the medial thigh were extracted from our database. Information on clinicopathological characteristics, preoperative treatment, surgical treatment (use of VSS, blood loss volume, operating time), and postoperative course (complications, postoperative haemoglobin changes, total drainage volume, and drainage and hospitalization durations) were obtained from medical records. We statistically compared clinical outcomes between patients whose surgery did or did not use VSS (VSS and non-VSS groups, respectively).
    Results: There were 24 patients in the VSS group and 54 in the non-VSS group. There were no significant differences between the two groups in terms of clinicopathological background. The total drainage volume in the VSS group was significantly less than that in the non-VSS group (1,176 ml vs 3,114 ml; p = 0.018). Moreover, the drainage and hospitalization durations were significantly shorter in the VSS group compared to the non-VSS group (p = 0.017 and p = 0.024, respectively).
    Conclusion: Our results suggest that use of VSS can help reduce the risk of postoperative complications after wide resection of soft-tissue sarcoma in the medial thigh.
    Language English
    Publishing date 2023-06-12
    Publishing country England
    Document type Journal Article
    ISSN 2633-1462
    ISSN (online) 2633-1462
    DOI 10.1302/2633-1462.46.BJO-2023-0037.R1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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