BACKGROUND: We explored the outcome of patients with primary adult soft tissue sarcoma (STS) of the extremities undergoing re-excision after previous unplanned surgery. METHODS: A total of 597 consecutive adult patients with primary extremity STS were treated with conservative surgery at our institution over a 20-year time span. A total of 318 patients were referred after unplanned excisions, and the remaining 279 underwent primary resection at our center. The two groups significantly differed in tumor size and depth. The assessed end points were sarcoma-specific mortality, local recurrence, and distant metastasis. Univariable and multivariable analyses, adjusted for other prognostic factors, were performed in the competing risks framework. RESULTS: The adjusted 10-year cumulative incidences in re-excised and primarily operated patients were, respectively, 18.7% and 16.4% (P = .535) for local relapse, 17.6% and 20.2% (P = .541) for metastasis, and 20.4% and 22.4% (P = .645) for mortality. Among patients who underwent re-excision, evidence of microscopic residual disease on pathologic examination had a significant prognostic effect on multivariable analysis for distant metastases (P = .002). A trend for survival was detected as well. CONCLUSIONS: At a referral center with a liberal policy of re-excisions in adult primary STS of the extremities, the outcome of patients who underwent re-excision was similar to that of patients who had primary resections. Evidence of microscopic residual disease at re-excision was a marker of clinical aggressiveness.
BACKGROUND: We explored the outcome of patients with primary adult soft tissue sarcoma (STS) of the extremities undergoing re-excision after previous unplanned surgery. METHODS: A total of 597 consecutive adult patients with primary extremity STS were treated with conservative surgery at our institution over a 20-year time span. A total of 318 patients were referred after unplanned excisions, and the remaining 279 underwent primary resection at our center. The two groups significantly differed in tumor size and depth. The assessed end points were sarcoma-specific mortality, local recurrence, and distant metastasis. Univariable and multivariable analyses, adjusted for other prognostic factors, were performed in the competing risks framework. RESULTS: The adjusted 10-year cumulative incidences in re-excised and primarily operated patients were, respectively, 18.7% and 16.4% (P = .535) for local relapse, 17.6% and 20.2% (P = .541) for metastasis, and 20.4% and 22.4% (P = .645) for mortality. Among patients who underwent re-excision, evidence of microscopic residual disease on pathologic examination had a significant prognostic effect on multivariable analysis for distant metastases (P = .002). A trend for survival was detected as well. CONCLUSIONS: At a referral center with a liberal policy of re-excisions in adult primary STS of the extremities, the outcome of patients who underwent re-excision was similar to that of patients who had primary resections. Evidence of microscopic residual disease at re-excision was a marker of clinical aggressiveness.
Authors: Javier Martin-Broto; Nadia Hindi; Josefina Cruz; Javier Martinez-Trufero; Claudia Valverde; Luis M De Sande; Angeles Sala; Lorena Bellido; Ana De Juan; Jordi Rubió-Casadevall; Roberto Diaz-Beveridge; Ricardo Cubedo; Oscar Tendero; Diego Salinas; Isidro Gracia; Rafael Ramos; Silvia Baguè; Antonio Gutierrez; José Duran-Moreno; Antonio Lopez-Pousa Journal: Oncologist Date: 2018-11-08
Authors: Sarah B Bateni; Alicia A Gingrich; Sun Y Jeon; Jeffrey S Hoch; Steven W Thorpe; Amanda R Kirane; Richard J Bold; Robert J Canter Journal: J Surg Res Date: 2019-02-27 Impact factor: 2.192
Authors: Lee Wang; Juan Pretell-Mazzini; Darcy A Kerr; Lydia Chelala; Xuan Yang; Jean Jose; Ty K Subhawong Journal: Skeletal Radiol Date: 2017-09-01 Impact factor: 2.199
Authors: Jeung Il Kim; In Sook Lee; You Seon Song; Se Kyoung Park; Kyung-Un Choi; Jong Woon Song Journal: Br J Radiol Date: 2016-07-26 Impact factor: 3.039