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Aims: To evaluate morcellation practices among Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Materials and methods: RANZCOG Fellows were invited to complete an online survey. This anonymous, cross‐sectional survey consisted of 29 questions regarding demographics and morcellation practices. Results: Four hundred and thirty eight (19.04%) of 2300 RANZCOG Fellows responded, and of these 258 (11.22%) completed the entire survey; analysis was undertaken on data from the latter respondents. Respondents were broadly representative of all RANZCOG Fellows regarding gender, age, and location. Of the respondents, 53.10% considered themselves advanced laparoscopic surgeons. Of respondents who had worked as gynaecology consultants prior to 2014, 39.39% used uncontained power morcellation prior to 2014, compared to 17.58% since (a decrease of 44.63%). The most common reasons for utilising uncontained power morcellation less often were the 2014 Food and Drug Administration warnings (40.31%), risk of adverse outcomes (33.72%), and recommendations from colleges such as RANZCOG (27.13%). When undertaking an operation that required specimen extraction, the most common methods used were: employing an open approach from the get‐go (utilised by respondents in 31.01% of such cases); contained manual morcellation (28.90%); and conversion to intra‐operative laparotomy (10.10%). Conclusions: There has been a strong trend away from uncontained power morcellation since 2014, with a 36.00% increase in clinicians who never use uncontained power morcellation, and an 80.65% decrease in clinicians who always use this method of specimen extraction. The most common reason cited for employing uncontained power morcellation less often was the 2014 Food and Drug Administration's warnings. [ABSTRACT FROM AUTHOR]

Preoperative biopsy for retroperitoneal sarcoma (RPS) enables appropriate multidisciplinary treatment planning. A systematic review of literature from 1990 to June 2022 was conducted using the population, intervention, comparison and outcome model to evaluate the local recurrence and overall survival of preoperative biopsy compared to those that had not. Of 3192 studies screened, five retrospective cohort studies were identified. Three reported on biopsy needle tract seeding, with only one study reporting biopsy site recurrence of 2 %. Two found no significant difference in local recurrence and one found higher 5-year local recurrence rates in those who had not been biopsied. Three studies reported overall survival, including one with propensity matching, did not show a difference in overall survival. In conclusion, preoperative core needle biopsy of RPS is not associated with increased local recurrence or adverse survival outcomes. • Systematic review using PICO model to evaluate the association of preoperative biopsy with local recurrence and overall survival in retroperitoneal sarcoma. • No evidence that the preoperative biopsy is not associated with increased local recurrence or adverse survival outcomes. [ABSTRACT FROM AUTHOR]

Our patients, when compared to the pivotal trial, demonstrated more myxoid liposarcoma but less non-myxoid liposarcoma, worse performance status, more previous lines of therapy, and more baseline hepatic impairment. Keywords: Australia; leiomyosarcoma; liposarcoma; real world; Trabectedin EN Australia leiomyosarcoma liposarcoma real world Trabectedin e526 e528 3 09/20/22 20221001 NES 221001 To Editor, Trabectedin is a marine-derived antineoplastic agent with complex mechanisms of action including cytotoxic, immunological, and targeted effects. In 2021, it was approved by the Australian Therapeutics Goods Administration (TGA) for the treatment of patients with unresectable or metastatic liposarcoma or leiomyosarcoma who received a prior anthracycline-containing regimen. [Extracted from the article]

Background and objectives: Leiomyosarcoma of skin (LMS) can be sub‐classified on pathology appearances as Dermal or Subcutaneous. The aim of this study was to provide treatment recommendations for these uncommon tumours. Methods: A retrospective review of all patients with dermal and subcutaneous leiomyosarcoma managed at the Peter MacCallum Cancer Centre, Australia from January 2003 to December 2018 was performed. Eighty‐three patients were identified (64 dermal leiomyosarcoma, 19 subcutaneous leiomyosarcoma). Results: Subcutaneous leiomyosarcoma were larger (median size 14 mm dermal, 49 mm subcutaneous, P = 0.01). No patient with a dermal leiomyosarcoma developed metastatic disease compared to 4 of the 19 subcutaneous leiomyosarcoma (5‐year overall survivals, 98% and 88%, respectively, P = 0.03). The most common site of metastasis was to the lung. No difference in risk of local recurrence was apparent (5‐year recurrence‐free survivals were 85% and 78%, respectively, P = 0.17). Adjuvant radiotherapy was used in 16 (25%) dermal leiomyosarcoma patients and 13 (68%) subcutaneous leiomyosarcoma patients (P < 0.001). Local recurrence was uncommon in both tumour subtypes when patients received definitive surgical excision (minimum histological margins of 10 mm as per institutional protocol) regardless of whether radiotherapy was used. The 5‐year local recurrence‐free survival for dermal leiomyosarcoma treated with radiotherapy was 93% versus 83% without radiotherapy (P = 0.7) and for subcutaneous leiomyosarcoma was 69% and 100%, respectively (P = 0.9). Conclusions: Dermal leiomyosarcoma have an excellent prognosis, particularly after definitive surgical excision with margins of at least 10 mm. Subcutaneous leiomyosarcoma has poorer outcomes and should be managed by wider excision and considered for adjuvant radiotherapy. [ABSTRACT FROM AUTHOR]

Cockatiels (Nymphicus hollandicus) are exotic birds thatoriginated from Australia.Because of their beauty and learning ability, they are one of the most popular pet birds among the Psittaciformes. The objective of this study was to report a case of leiomyosarcoma on the humeral musculature of the left wing of a cockatiel (Nymphicus hollandicus). The animal was admitted to the Wildlife Rehabilitation Center (NURFS-CETAS) of the Universidade Federal de Pelotas withswelling in the humeral region of the left wing. During surgery, the animal died and was transferred to the Laboratório Regional de Diagnóstico, Faculdade de Veterinária (LRD-UFPel). During histopathological evaluation (hematoxylin and eosin routine technique) of the tumor, spindle neoplastic cells were observed, arranged in interlaced bundles amongst degenerate and normal muscle fibers. Using immunohistochemistry, neoplastic cells were positively immunostained for vimentin and alpha smooth muscle actin. Based on of clinical-pathological and immunohistochemical findings, leiomyosarcoma was diagnosed. [ABSTRACT FROM AUTHOR]

Background: Several unanswered questions surround the management of retroperitoneal sarcoma (RPS). Guidelines recommend treatment by a multidisciplinary team at a specialized referral centre. The objective of this study was to describe the management of RPS at an Australian specialist sarcoma centre, comparing outcomes to international standards and analysing for predictors of local failure., Methods: A retrospective review of a prospectively maintained database was performed on patients with RPS treated between 2008 and 2016. A 5-year outcome analyses focussed on patients undergoing curative-intent surgery for primary, non-metastatic RPS., Results: Eighty-eight patients underwent surgery for primary RPS. Five-year overall survival was 66%, 5-year freedom from local recurrence was 65% and 5-year freedom from distant metastasis was 71%. Overall survival was associated with tumour grade (hazard ratio (HR) 6.1, P < 0.001) and histologic organ invasion (HR 5.7, P < 0.001). Variables associated with improved freedom from local recurrence were macroscopically complete resection (HR 0.14, P < 0.001) and neoadjuvant radiotherapy (HR 0.33, P = 0.014). Treatment at a specialist sarcoma centre was associated with a higher rate of preoperative biopsy and neoadjuvant radiotherapy (both with P < 0.001). There was a trend towards improved local control for patients undergoing surgery at a specialist centre (P = 0.055)., Conclusion: This is the largest Australian series of RPS and outcomes are comparable to major international sarcoma centres. Patients treated at a specialist centre had higher rates of preoperative diagnosis and tailored therapy which was associated with improved outcomes. Patients with suspected RPS should be referred to a specialist centre for optimal preoperative evaluation and multidisciplinary management., (© 2018 Royal Australasian College of Surgeons.)