Sensitivity, Specificity, and Predictive Values of Tru-Cut® Biopsy in Grading Primary Localized Myxoid Liposarcomas of the Extremities

Biopsy is an essential step in the diagnosis of myxoid liposarcoma (MLs) since the histological grade is a strong determinant of the appropriate treatment in the management of this pathology. The aim of our retrospective study was to investigate the diagnostic accuracy of Tru-cut((R)) biopsy (TCB) and the potential impact on a patient's survival in the case of misdiagnosis. We established that in MLs, diagnosis with TCB might differ from that of surgical specimens, with a histological grade concordance rate of 64% (Kappa 0.30). Neoadjuvant treatments were associated with pathological downgrading with a lower effect of chemotherapy alone compared to neoadjuvant-combined treatments, although such discordance did not modify the prognosis. In the group of patients not treated in neoadjuvant settings, the sensitivity and specificity of TCB were 57% and 100%, respectively. TCB results are useful in leading the clinician in the diagnostic pathway thought; the diagnosis of MLs should be supported by other diagnostic techniques.(1) Background: Histological diagnosis and tumor grading are major prognostic and predictive factors in soft tissue sarcomas (STS), as they dictate the treatment strategies with a direct impact on patient survival. This study aims to investigate the grading accuracy, sensitivity, and specificity of Tru-Cut((R)) biopsy (TCB) in primary localized myxoid liposarcomas (MLs) of the extremities and its impact on patient prognosis. (2) Methods: Patients with ML undergoing TCB and a subsequent tumor resection between 2007 and 2021 were evaluated. Concordance between the preoperative assessment and definitive histology was calculated with a weighted Cohen's kappa coefficient. Sensitivity, specificity, and diagnostic accuracy were calculated. (3) Results: Of 144 biopsies, the histological grade concordance rate was 63% (Kappa 0.2819). Neoadjuvant chemotherapy and/or radiotherapy impacted concordance with a downgrading effect in high-grade tumors. Among forty patients not treated in neoadjuvant settings, the sensitivity of TCB was 57%, the specificity was 100%, and the overall predictive values of positive and negative TCB were 100% and 50%, respectively. Misdiagnosis did not impact overall survival. (4) Conclusions: TCB may underestimate ML grading due to tumor heterogeneity. Neoadjuvant ChT and/or radiotherapy are associated with pathological downgrading; however, discordance in diagnosis does not modify patient prognosis because systemic treatment decision-making also includes other variables

Primary High-Grade Myxoid Liposarcoma of the Extremities: Prognostic Factors and Metastatic Pattern

(1) Background: This retrospective study aimed to analyze the history and treatment outcomes of localized, high-grade MLS of the extremities. (2) Methods: We retrospectively reviewed 82 patients with primary high-grade MLS of the extremities. OS, LRFS, MFS, PRS, and DFS were analyzed. (3) Results: Five-year OS and LRS were 96% (95% CI: 86–98) and 94% (95% CI: 85–98), respectively. Statistical analysis indicated no risk factors for OS and LFRS. MFS was 77% (65–85) at 5-year follow-up. Size (p = 0.0337) was the only risk factor statistically significant for MFS (HR = 0.248, 95% CI: 0.07–0.84). Median PRS after distant metastasis was 34 months (range: 1–127 months). Five-year PRS was 79% (48–93). Overall, the 5-year DFS was 76% (65–85). (4) Conclusions: Patients with MLS were found to have a good prognosis. In high-grade deep-seated tumors, common risk factors for MLS do not correlate with survival. Tumor size appears to be the only predictor of long-term DSF and MSF

Usefulness of Cardiac Magnetic Resonance for Recurrent Pericarditis

Cardiac magnetic resonance (CMR) offers the capability to objectively detect pericarditis by identifying pericardial thickening, edema/inflammation by Short-TI Inversion Recovery-T2 weighted (STIR-T2w) imaging, edema/inflammation or fibrosis by late gadolinium enhancement (LGE), and presence of pericardial effusion. This is especially helpful for the diagnosis of recurrent pericarditis. Aim of the present paper is to assess the diagnostic accuracy of CMR findings as well as their potential prognostic value for the diagnosis of recurrent pericarditis. Multicenter cohort study of consecutive patients with recurrent pericarditis evaluated by CMR. We included 128 consecutive cases (60 males, 47%; mean age 48 ± 14 years). CMR was performed at a mean time of 12 days (95% confidence interval 15 to 21) after the clinical diagnosis. We evaluated the diagnostic accuracy and areas under the receiver operating characteristic (ROC) curve for CMR diagnostic criteria and complications (additional recurrences, cardiac tamponade, and constrictive pericarditis). Areas under the ROC curve were respectively 64% for pericardial thickening, 84% for pericardial edema, 82% for pericardial LGE, and 71% for pericardial effusion. After a mean follow-up of 34 months, recurrences occurred in 52% of patients, tamponade in 6%, and constrictive pericarditis in 11%. Using a multivariable Cox model, elevation of CRP and presence of CMR pericardial thickening were predictors of adverse events, whereas the presence of CMR LGE was associated with a lower risk. The prognostic model for adverse events using gender, age, CRP level, and all CMR variables showed a C-index of 0.84. In conclusion, CMR findings show high diagnostic accuracy and may help identifying patients at higher risk of complications.status: publishe

Ricerca sociale ed emancipazione. Campi, posizionamenti e pratiche

Negli Stati Uniti E.O. Wright ha proposto una scienza sociale ‘emancipativa’ espressamente rivolta a legittimare forme di critica al tardocapitalismo contemporaneo, per comprendere e dare visibilità a forme possibili di contro-organizzazione sociale, e generare così una conoscenza scientifica in grado di sfidare forme emergenti di sfruttamento. In America Latina si moltiplicano nelle università nuove ‘ecologie’ di saperi, cioè percorsi didattici e di ricerca in chiave radicalmente pluridisciplinare legati a istanze poste dai cittadini, secondo pratiche di interazione non dissimili dall’idea di ‘ricerca sociale democratica’ portata avanti a Mumbai da A. Appadurai. Ma anche in Europa, B. de Sousa Santos, L. Boltanski e molti altri provano a tradurre in futuro gli approcci della sociologia critica che caratterizzarono i decenni centrali del ’900 e che già indicavano nei pubblici plurali di cui si compone la società – più che nei circuiti ristretti dei colleghi – gli interlocutori privilegiati per la costruzione del disegno di ricerca e la gestione della vita sociale dei dati prodotti. Oggi tutto ciò avviene, però, con la marcata consapevolezza che occorra promuovere una nuova stagione di ‘risoggettivazione reciproca’ tra ricercatori e attori sociali che passi anche attraverso la capacità immergersi e lasciarsi interpellare dalla dimensione narrativa, esperienziale, esistenziale di processi sociali invisibili, turbolenti, scomodi, difficilmente accessibili, ma in qualche modo emblema profondo dell’attuale complessità