{
  "abstract": "Background: Sex-associated differences in early surgical care may occur within individual sarcoma entities. We examined recorded tumor characteristics, initial resection location, margin status, and re-excision in extremity leiomyosarcoma.\n\nMethods: This exploratory retrospective study included 79 patients with initial resection during 2000–2015 who ultimately received treatment at a tertiary sarcoma center. The primary endpoint was initial R1 versus R0 resection. Analyses used Firth penalized logistic regression and Bayesian marginal standardization; treatment-location, re-excision, and survival analyses were exploratory.\n\nResults: Initial R1 occurred in 34/46 men (73.9%) and 13/29 women (44.8%; absolute difference 29.1 percentage points; P = 0.015). Men more frequently underwent initial outside-center surgery (72.3% vs. 41.4%) and re-excision (82.6% vs. 50.0%). Recorded tumors <5 cm were more frequent in men (64.6% vs. 35.5%). The male-sex odds ratio decreased from 3.41 (95% CI 1.31–9.24) after age and site adjustment to 2.43 (0.82–7.41) after additional size and depth adjustment. The fully standardized difference was 16.6 percentage points (95% credible interval −2.5 to 37.4), compatible with no difference as well as a clinically substantial difference. Among patients with known location and R0/R1 status, R1 occurred after 37/44 outside-center and 9/29 index-center resections. All 47 patients with initial R1 underwent re-excision; definitive R0 was achieved in all 79 patients.\n\nConclusion: Men in this selected, exploratory cohort had higher observed frequencies of outside-center resection, initial R1, and re-excision. Adjustment attenuated the association, with substantial residual uncertainty. These findings do not establish inequity, differential access, biological causation, or mediation and require prospective multicenter validation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Plastic Surgery and Hand Surgery, Burn Center, Sarcoma Center, BG University Hospital Bergmannsheil, Ruhr University Bochum",
    "Clinic for Plastic and Reconstructive Surgery, Agaplesion Diakonieklinikum Hamburg"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Pia Weskamp"
    },
    {
      "affs": [
        0
      ],
      "name": "Sonja Verena Schmidt"
    },
    {
      "affs": [
        0
      ],
      "name": "Marius Drysch"
    },
    {
      "affs": [
        0
      ],
      "name": "Felix Reinkemeier"
    },
    {
      "affs": [
        1
      ],
      "name": "Mehran Dadras"
    },
    {
      "affs": [
        0
      ],
      "name": "Marcus Lehnhardt"
    },
    {
      "affs": [
        0
      ],
      "name": "Flemming Puscz"
    },
    {
      "affs": [
        0
      ],
      "name": "Christoph Wallner"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/534ryg787nd4a.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1980400",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13724375/?tool=EBI",
  "id": "534ryg787nd4a",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1980400/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2740|Sarcoma Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7222976344",
  "pdf_url": "https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1980400/pdf",
  "pmcid": "PMC13724375",
  "pmid": "42973579",
  "published": "2026-10-19",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/534ryg787nd4a.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1980400",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1980400/full"
    },
    {
      "first_seen": "2026-11-03T15:20:50Z",
      "native_id": "PMC:PMC13724375",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13724375"
    },
    {
      "first_seen": "2026-11-04T12:22:57Z",
      "native_id": "PMC13724375",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fonc.2026.1980400"
    },
    {
      "first_seen": "2026-11-04T15:20:48Z",
      "native_id": "MED:42973579",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42973579"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2234-943X",
      "subfield": "oncology"
    }
  ],
  "title": "Sex-associated differences in initial resection location, margin status, and re-excision in extremity leiomyosarcoma: a retrospective tertiary-center cohort study",
  "title_text": "Sex-associated differences in initial resection location, margin status, and re-excision in extremity leiomyosarcoma: a retrospective tertiary-center cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:21:09Z",
  "url": "https://research.draconitic.com/paper/534ryg787nd4a",
  "venue": "Frontiers in Oncology",
  "versions": []
}