{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T03:01:46Z","timestamp":1776135706182,"version":"3.50.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Sarcomas are rare cancers originating from mesenchymal tissues, manifesting in diverse anatomical locations, but notably in connective tissue, muscles and the skeleton. Thoracic sarcomas present a unique diagnostic and surgical challenge attributable to their rarity and pathoanatomy. Standard practice currently comprises wide surgical excision, often accompanied by adjuvant chemotherapy and\/or radiotherapy. This approach necessitates a multidisciplinary team, ideally in specialised cancer centres. The Oxford Bone and Soft Tissue Tumour Service is one such centre, and routinely treats such cancers through collaboration between orthopaedic oncology and cardiothoracic surgeons, as well as members of the wider MDT. This study reports the current management and outcomes of primary thoracic sarcoma patients at the Oxford Sarcoma Service over a seven-year period.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>Given the rarity of thoracic sarcomas, and their associated diagnostic and management complexities, our aim is to report on the treatment strategies and outcomes of primary thoracic sarcoma patients treated at the Oxford Sarcoma Service from 2017 to 2023.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Data pertaining to all thoracic sarcoma cases discussed in multidisciplinary meetings at the Oxford tertiary centre from 2017 to 2023 were retrieved from the local electronic database. These were analysed using appropriate statistical tests to determine significance of the various observations made.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 113 identified cases, chondrosarcoma emerged as the most prevalent histological subtype among 22 distinct varieties. 58% of cases exhibited high-grade features. 32 sarcoma-related deaths occurred, with a mean time from diagnosis to death of 23.16 months. A notable association was observed between high-grade sarcomas and mortality (<jats:italic>p<\/jats:italic>\u2009=\u20090.0280). Surgical resection was performed in 77 cases, with 49% of these undergoing surgical resection alone i.e. the patient received no radio- or chemotherapy. Both surgical intervention (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and clear margins (<jats:italic>p<\/jats:italic>\u2009=\u20090.0051) were significantly linked to improved survival. Local recurrence was noted in 28.6% of the 77 surgical cases, and predominantly in the high-grade sarcomas (81.8%). However, no statistical association was found between recurrence and margin status in our data.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Our results indicate that primary resection remains the cornerstone of thoracic sarcoma treatment, representing the single strongest independent factor for survival in treatable cases. Variability in outcomes and overall survival likely stems from factors such as histological diversity, predominance of high-grade sarcomas, and wide age range at diagnosis. Ongoing prospective database update and collaborative efforts across centres would further clarify prognoses and recommendations for specific tumours, based on observational data.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s13019-025-03341-w","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T03:49:15Z","timestamp":1737949755000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management and outcomes of thoracic sarcomas - a collaboration between Orthopaedic Oncology and cardiothoracic surgery: seven-year clinical data from a tertiary referral centre"],"prefix":"10.1186","volume":"20","author":[{"given":"Zaid Ahmed","family":"Shamsi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vlad","family":"Paraoan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Raihanah","family":"Saifuddin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas D A","family":"Cosker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duncan","family":"Whitwell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher L M H","family":"Gibbons","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dionisios","family":"Stavroulias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"DiChiara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"issue":"4","key":"3341_CR1","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1097\/CCO.0000000000001046","volume":"36","author":"MJ Lee","year":"2024","unstructured":"Lee MJ, Chen TW. Sarcoma incidence worldwide: regional differences in histology and molecular subtypes. Curr Opin Oncol. 2024;36(4):276\u201381.","journal-title":"Curr Opin Oncol"},{"key":"3341_CR2","unstructured":"Cancer research UK. 2022, Soft Tissue Sarcoma Statistics, Cancer Research UK."},{"issue":"3","key":"3341_CR3","first-page":"621","volume":"22","author":"GW Gladish","year":"2002","unstructured":"Gladish GW, Sabloff BM, Munden RF, Truong MT, Erasmus JJ, Chasen MH. Prim Thorac Sarcomas RadioGraphics. 2002;22(3):621\u201337.","journal-title":"Prim Thorac Sarcomas RadioGraphics"},{"issue":"6","key":"3341_CR4","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1590\/0100-3984.2015.0165","volume":"49","author":"CHSO Waszczynskyi","year":"2016","unstructured":"Waszczynskyi CHSO, Guimar\u00e3es MD, Franco LFS, Hochhegger B, Marchiori E. Primary undifferentiated sarcoma in the thorax: a rare diagnosis in young patients. Radiologia Brasileira [online]. 2016;49(6):409\u201310.","journal-title":"Radiologia Brasileira [online]"},{"issue":"5","key":"3341_CR5","first-page":"365","volume":"32","author":"P Foran","year":"2011","unstructured":"Foran P, Colleran G, Madewell J, O\u2019Sullivan PJ. Imaging of thoracic sarcomas of the Chest Wall, Pleura, and lung. Seminars in Ultrasound. CT MRI. 2011;32(5):365\u201376.","journal-title":"CT MRI"},{"issue":"3","key":"3341_CR6","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1148\/radiographics.22.3.g02ma17621","volume":"22","author":"GW Gladish","year":"2002","unstructured":"Gladish GW, Sabloff BM, Munden RF, Truong MT, Erasmus JJ, Chasen MH. Primary thoracic sarcomas. Radiographics. 2002;22(3):621\u201337. https:\/\/doi.org\/10.1148\/radiographics.22.3.g02ma17621.","journal-title":"Radiographics"},{"issue":"1","key":"3341_CR7","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1067\/j.cpradiol.2015.06.004","volume":"45","author":"C Jokerst","year":"2016","unstructured":"Jokerst C, McFarland W, Swanson J, Mohammed TL. Thoracic bone tumors every radiologist should know. Curr Probl Diagn Radiol. 2016;45(1):71\u20139.","journal-title":"Curr Probl Diagn Radiol"},{"key":"3341_CR8","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1007\/s13566-015-0236-1","volume":"5","author":"D Rainey","year":"2016","unstructured":"Rainey D, Berriochoa J, Korpak A, Zeng J, Loggers ET, Jones RL, Patel S. Treatment of resectable intrathoracic sarcomas: a single institution experience over twenty years. J Radiation Oncol. 2016;5:169\u201377.","journal-title":"J Radiation Oncol"},{"issue":"6","key":"3341_CR9","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1111\/his.12771","volume":"67","author":"K Thway","year":"2015","unstructured":"Thway K, Jordan S, Fisher C, Nicholson AG. Updates in the approach to intrathoracic sarcomas. Histopathology. 2015;67(6):755\u201370.","journal-title":"Histopathology"},{"issue":"22","key":"3341_CR10","doi-asserted-by":"publisher","first-page":"5334","DOI":"10.3390\/jcm10225334","volume":"10","author":"I van Eck","year":"2021","unstructured":"van Eck I, Den Hollander D, Lidington E, Hentschel L, Eichler M, Salah S, Singer S, Pinto M, Fauske L, Fiore M, Nixon I. Health-related quality of life issues experienced by thoracic and breast sarcoma patients: a rare and understudied group. J Clin Med. 2021;10(22):5334.","journal-title":"J Clin Med"},{"issue":"6","key":"3341_CR11","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1016\/j.cllc.2012.05.003","volume":"13","author":"MG Levra","year":"2012","unstructured":"Levra MG, Novello S, Scagliotti GV, Papotti M, Le Cesne A. Primary pleuropulmonary sarcoma: a rare disease entity. Clin Lung Cancer. 2012;13(6):399\u2013407.","journal-title":"Clin Lung Cancer"},{"issue":"3","key":"3341_CR12","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1200\/JCO.1996.14.3.859","volume":"14","author":"PW Pisters","year":"1996","unstructured":"Pisters PW, Harrison LB, Leung DH, Woodruff JM, Casper ES, Brennan MF. Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol. 1996;14(3):859\u201368.","journal-title":"J Clin Oncol"},{"issue":"1","key":"3341_CR13","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1200\/JCO.1998.16.1.197","volume":"16","author":"JC Yang","year":"1998","unstructured":"Yang JC, Chang AE, Baker AR, Sindelar WF, Danforth DN, Topalian SL, DeLaney T, Glatstein E, Steinberg SM, Merino MJ, Rosenberg SA. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol. 1998;16(1):197\u2013203.","journal-title":"J Clin Oncol"},{"key":"3341_CR14","first-page":"2350157","volume":"2019","author":"TR Soerensen","year":"2019","unstructured":"Soerensen TR, Raedkjaer M, J\u00f8rgensen PH, Hoejsgaard A, Safwat A, Baad-Hansen T. Soft tissue sarcomas of the thoracic wall: more prone to higher mortality, and local Recurrence-A single Institution Long-Term follow-up study. Int J Surg Oncol. 2019;2019:2350157.","journal-title":"Int J Surg Oncol"},{"issue":"3","key":"3341_CR15","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1002\/jso.25979","volume":"122","author":"S Collaud","year":"2020","unstructured":"Collaud S, Stork T, Schildhaus H-U, P\u00f6ttgen C, Pl\u00f6nes T, Valdivia D, et al. Multimodality treatment including surgery for primary pulmonary sarcoma: size does matter. J Surg Oncol. 2020;122(3):506\u201314.","journal-title":"J Surg Oncol"},{"issue":"1","key":"3341_CR16","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1097\/SAP.0000000000001901","volume":"83","author":"H Kuwahara","year":"2019","unstructured":"Kuwahara H, Salo J, Nevala R, Tukiainen E, Single-Institution. Multidisciplinary experience of soft tissue sarcomas in the Chest Wall. Ann Plast Surg. 2019;83(1):82\u20138.","journal-title":"Ann Plast Surg"},{"issue":"5","key":"3341_CR17","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1016\/j.suc.2016.05.005","volume":"96","author":"JYC Hui","year":"2016","unstructured":"Hui JYC. Epidemiology and etiology of Sarcomas. Surg Clin North Am. 2016;96(5):901\u201314.","journal-title":"Surg Clin North Am"},{"issue":"6","key":"3341_CR18","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1007\/s00264-014-2304-3","volume":"38","author":"J Friesenbichler","year":"2014","unstructured":"Friesenbichler J, Leithner A, Maurer-Ertl W, Szkandera J, Sadoghi P, Frings A, et al. Surgical therapy of primary malignant bone tumours and soft tissue sarcomas of the chest wall: a two-institutional experience. Int Orthop. 2014;38(6):1235\u201340.","journal-title":"Int Orthop"},{"issue":"1","key":"3341_CR19","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1067\/mtc.2001.111381","volume":"121","author":"GL Walsh","year":"2001","unstructured":"Walsh GL, Davis BM, Swisher SG, Vaporciyan AA, Smythe WR, Willis-Merriman K, et al. A single-institutional, multidisciplinary approach to primary sarcomas involving the chest wall requiring full-thickness resections. J Thorac Cardiovasc Surg. 2001;121(1):48\u201360.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"3341_CR20","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s12032-010-9450-2","volume":"28","author":"N Alkis","year":"2011","unstructured":"Alkis N, Muallao\u011flu S, Ko\u00e7er M, Arslan \u00dcY, Durnal\u0131 AG, Tokluo\u011flu S, \u00c7elenko\u011flu G, Paksoy F, Coskun U. Primary adult soft tissue sarcomas: analysis of 294 patients. Med Oncol. 2011;28:391\u20136.","journal-title":"Med Oncol"},{"issue":"5","key":"3341_CR21","doi-asserted-by":"publisher","first-page":"699","DOI":"10.5858\/2000-124-0699-LOTPC","volume":"124","author":"NT Okby","year":"2000","unstructured":"Okby NT, Travis WD. Liposarcoma of the pleural cavity: clinical and pathologic features of 4 cases with a review of the literature. Arch Pathol Lab Med. 2000;124(5):699\u2013703.","journal-title":"Arch Pathol Lab Med"},{"issue":"3","key":"3341_CR22","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1002\/cncr.23592","volume":"113","author":"N Pervaiz","year":"2008","unstructured":"Pervaiz N, Colterjohn N, Farrokhyar F, Tozer R, Figueredo A, Ghert M. A systematic meta-analysis of randomized controlled trials of adjuvant chemotherapy for localized resectable soft-tissue sarcoma. Cancer. 2008;113(3):573\u201381.","journal-title":"Cancer"},{"issue":"3","key":"3341_CR23","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1245\/s10434-017-6081-2","volume":"25","author":"M Albertsmeier","year":"2018","unstructured":"Albertsmeier M, Rauch A, Roeder F, Hasenh\u00fctl S, Pratschke S, Kirschneck M, et al. External Beam Radiation Therapy for Resectable Soft tissue sarcoma: a systematic review and Meta-analysis. Ann Surg Oncol. 2018;25(3):754\u201367.","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"3341_CR24","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.athoracsur.2018.03.068","volume":"106","author":"KE Engelhardt","year":"2018","unstructured":"Engelhardt KE, DeCamp MM, Yang AD, Bilimoria KY, Odell DD. Treatment approaches and outcomes for primary Mediastinal Sarcoma: analysis of 976 patients. Ann Thorac Surg. 2018;106(2):333\u20139.","journal-title":"Ann Thorac Surg"},{"issue":"2","key":"3341_CR25","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1097\/JTO.0b013e318277401f","volume":"8","author":"MB Spraker","year":"2013","unstructured":"Spraker MB, Bair E, Bair R, Connell PP, Mahmood U, Koshy M. An analysis of patient characteristics and clinical outcomes in primary pulmonary sarcoma. J Thorac Oncol. 2013;8(2):147\u201351.","journal-title":"J Thorac Oncol"},{"issue":"1","key":"3341_CR26","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.jtcvs.2020.03.179","volume":"162","author":"LA Robinson","year":"2021","unstructured":"Robinson LA, Babacan NA, Tanvetyanon T, Henderson-Jackson E, Bui MM, Druta M. Results of treating primary pulmonary sarcomas and pulmonary carcinosarcomas. J Thorac Cardiovasc Surg. 2021;162(1):274\u201384.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"3","key":"3341_CR27","first-page":"162","volume":"15","author":"J Go\u0142ota","year":"2018","unstructured":"Go\u0142ota J, Osowiecka K, Or\u0142owski T. Primary pulmonary sarcoma \u2013 long-term treatment outcomes and prognostic factors. Kardiochirurgia i Torakochirurgia Polska\/Polish J Thorac Cardiovasc Surg. 2018;15(3):162\u20139.","journal-title":"Kardiochirurgia i Torakochirurgia Polska\/Polish J Thorac Cardiovasc Surg"},{"issue":"1","key":"3341_CR28","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.jtcvs.2019.12.109","volume":"162","author":"K Yin","year":"2021","unstructured":"Yin K, Luo R, Wei Y, Wang F, Zhang Y, Karlson KJ, et al. Survival outcomes in patients with primary cardiac sarcoma in the United States. J Thorac Cardiovasc Surg. 2021;162(1):107\u2013e152.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"3","key":"3341_CR29","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1002\/jso.25162","volume":"118","author":"JB Shewale","year":"2018","unstructured":"Shewale JB, Mitchell KG, Nelson DB, Conley AP, Rice DC, Antonoff MB, et al. Predictors of survival after resection of primary sarcomas of the chest wall\u2014A large, single-institution series. J Surg Oncol. 2018;118(3):518\u201324.","journal-title":"J Surg Oncol"},{"issue":"3","key":"3341_CR30","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1093\/ejcts\/ezv222","volume":"49","author":"H Turbendian","year":"2016","unstructured":"Turbendian H, Seastedt KP, Shavladze N, Port J, Altorki N, Stiles B, et al. Extended resection of sarcomas involving the mediastinum: a 15-year experience\u2020. Eur J Cardiothorac Surg. 2016;49(3):829\u201334.","journal-title":"Eur J Cardiothorac Surg"},{"issue":"7","key":"3341_CR31","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1097\/JTO.0b013e3181a97da3","volume":"4","author":"S Tsukushi","year":"2009","unstructured":"Tsukushi S, Nishida Y, Sugiura H, Nakashima H, Ishiguro N. Soft tissue sarcomas of the chest wall. J Thorac Oncol. 2009;4(7):834\u20137.","journal-title":"J Thorac Oncol"},{"issue":"7","key":"3341_CR32","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1002\/jso.27411","volume":"128","author":"R Stauss","year":"2023","unstructured":"Stauss R, Aigner A, Richter A, Suero E, Altemeier A, Savov P, Ettinger M, Omar M. The prognostic significance of surgical resection margins for local recurrence, distant metastasis, and overall survival in sarcoma. J Surg Oncol. 2023;128(7):1160\u201370.","journal-title":"J Surg Oncol"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-025-03341-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-025-03341-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-025-03341-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T15:35:10Z","timestamp":1737992110000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-025-03341-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,27]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3341"],"URL":"https:\/\/doi.org\/10.1186\/s13019-025-03341-w","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,27]]},"assertion":[{"value":"8 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Approved and registered under Ulysses at Oxford University Hospitals (Number 9455).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All participants provided informed consent for their data to be utilized in research studies.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human Ethics and Consent to participate declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"98"}}