Local Recurrence of Disease after Unplanned Excisions of High-grade Soft Tissue Sarcomas
- 1 December 2008
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 466 (12), 3093-3100
- https://doi.org/10.1007/s11999-008-0529-4
Abstract
Unplanned excisions of soft tissue sarcomas occur with alarming frequency and result in high rates of residual disease, potentially affecting patient prognosis. To determine if unplanned excisions and residual disease status at tumor bed excision increased local recurrence rates and predicted disease-specific patient survival, we retrospectively reviewed 203 consecutive patients with high-grade soft tissue sarcomas treated operatively and followed for at least 2 years (mean, 4.8 years) or until patient death. Among the 64 patients (32%) who had undergone previous unplanned excisions, six had gross residual disease and 40 of the remaining 58 (69%) had microscopic residual disease in the tumor bed. We observed subsequent local recurrence in nine of the 139 patients (6%) after planned excision compared with 22 patients (34%) after unplanned excision. More patients with unplanned excisions who underwent limb salvage procedures required flap coverage and/or skin grafting with their definitive resection (30% versus 5%). In the unplanned excision cohort, residual disease status at tumor bed excision predicted increased rates of local recurrence and decreased disease-specific survival. Unplanned excisions of high-grade soft tissue sarcomas resulted in increased rates of local recurrence but not disease-specific survival. Residual disease at reexcision predicted the likelihood of local recurrence. Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.Keywords
This publication has 49 references indexed in Scilit:
- Extremity Soft Tissue Sarcoma: Adding to the Prognostic Meaning of Local FailureAnnals of Surgical Oncology, 2007
- Outcomes of re-excision after unplanned excisions of soft-tissue sarcomasJournal of Surgical Oncology, 2005
- Survival After Induction Chemotherapy and Surgical Resection for High-Grade Soft Tissue Sarcoma. Is Radiation Necessary?Annals of Surgical Oncology, 2001
- Accuracy of Biopsy Techniques for Limb and Limb Girdle Soft Tissue TumorsAnnals of Surgical Oncology, 2001
- Variable management of soft tissue sarcoma: Regional audit with implications for specialist careBritish Journal of Surgery, 1997
- Local control of soft tissue sarcoma of the extremity: The experience of a multidisciplinary sarcoma group with definitive surgery and radiotherapyEuropean Journal Of Cancer, 1994
- Soft tissue sarcoma should be treated at a tumor center: A comparison of quality of surgery in 375 patientsActa Orthopaedica, 1994
- Localized Operable Soft Tissue Sarcoma of the Upper ExtremityAnnals of Surgery, 1987
- Limb salvage for skeletal and soft tissue sarcomas multidisciplinary preoperative therapyCancer, 1984
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958