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Record W3159566676 · doi:10.3171/2021.2.focus201091

Feasibility of achieving planned surgical margins in primary spine tumor: a PTRON study

2021· article· en· W3159566676 on OpenAlexaff
Charlotte Dandurand, Charles G. Fisher, Laurence D. Rhines, Stefano Boriani, Raphaële Charest-Morin, Alessandro Gasbarrini, Alessandro Luzzati, Jeremy Reynolds, Feng Wei, Ziya L. Gokaslan, Chetan Bettegowda, Daniel M. Sciubba, Áron Lazáry, Norio Kawahara, Michelle J. Clarke, Y. Raja Rampersaud, Alexander C. Disch, Dean Chou, John H. Shin, Francis J. Hornicek, IIya Laufer, Arjun Sahgal, Nicolas Dea

Bibliographic record

VenueNeurosurgical FOCUS · 2021
Typearticle
Languageen
FieldMedicine
TopicManagement of metastatic bone disease
Canadian institutionsToronto Western HospitalSunnybrook HospitalUniversity of TorontoUniversity of British Columbia
FundersUniversity of Texas MD Anderson Cancer CenterPeking University Third HospitalUniversity of California, San FranciscoPeking UniversityIstituto Ortopedico Rizzoli di BolognaOxford University Hospitals NHS Foundation TrustKanazawa Medical UniversityMassachusetts General HospitalTechnische Universität DresdenUCLA Health SystemAO FoundationUniversity of OxfordJohns Hopkins University
KeywordsMedicineUnivariate analysisSurgical marginSurgeryMargin (machine learning)General surgeryMultivariate analysisResection

Abstract

fetched live from OpenAlex

OBJECTIVE: Oncological resection of primary spine tumors is associated with lower recurrence rates. However, even in the most experienced hands, the execution of a meticulously drafted plan sometimes fails. The objectives of this study were to determine how successful surgical teams are at achieving planned surgical margins and how successful surgeons are in intraoperatively assessing tumor margins. The secondary objective was to identify factors associated with successful execution of planned resection. METHODS: The Primary Tumor Research and Outcomes Network (PTRON) is a multicenter international prospective registry for the management of primary tumors of the spine. Using this registry, the authors compared 1) the planned surgical margin and 2) the intraoperative assessment of the margin by the surgeon with the postoperative assessment of the margin by the pathologist. Univariate analysis was used to assess whether factors such as histology, size, location, previous radiotherapy, and revision surgery were associated with successful execution of the planned margins. RESULTS: Three hundred patients were included. The surgical plan was successfully achieved in 224 (74.7%) patients. The surgeon correctly assessed the intraoperative margins, as reported in the final assessment by the pathologist, in 239 (79.7%) patients. On univariate analysis, no factor had a statistically significant influence on successful achievement of planned margins. CONCLUSIONS: In high-volume cancer centers around the world, planned surgical margins can be achieved in approximately 75% of cases. The morbidity of the proposed intervention must be balanced with the expected success rate in order to optimize patient management and surgical decision-making.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.052
Threshold uncertainty score0.884

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.032
GPT teacher head0.311
Teacher spread0.279 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations9
Published2021
Admission routes1
Has abstractyes

Explore more

Same venueNeurosurgical FOCUSSame topicManagement of metastatic bone diseaseFrench-language works237,207