BACKGROUND: Over the past three decades, several studies have reported worse outcomes with unplanned resection for malignant soft tissue tumors. However, the impact of these studies on preventing unnecessary unplanned resection remains unknown. METHODS: In a retrospective survey on the treatment of soft tissue sarcomas, we compared cases of unplanned resection with cases of planned resection in terms of the properties of unplanned resection and the oncological and functional outcomes. For the unplanned resection cases, an additional wide resection was performed. RESULTS: Of 92 cases, unplanned resection was performed in 24 (26 %). Small or subcutaneous tumors were significantly more frequently subjected to unplanned resection. In 17 of 24 unplanned resection cases, residual tumors (70.8 %) were noted. Plastic surgery was more frequently needed for unplanned resection cases. There was no significant difference between the unplanned resection and control cases with regard to oncological outcome. However, as to local recurrence and overall survival, the events occurred only in the cases with residual tumors in the additional wide resection specimen in the unplanned resection group. There was no significant difference in functional evaluation, except for emotional acceptance, which had a better score in the unplanned resection group. CONCLUSIONS: Despite repeated cautions regarding unplanned resection in terms of its inadequate procedure which contradicts the principles of soft tissue sarcoma treatment, unplanned resections are still frequently performed. Perhaps the small size and subcutaneous location of the sarcomas in the unplanned resection group did not evoke the probability of malignancy for the surgeons who initially managed them. Even though an additional wide resection was performed, a residual tumor would lead to a worse outcome. An effective awareness program to avoid unnecessary unplanned resections for soft tissue sarcoma should be considered.
BACKGROUND: Over the past three decades, several studies have reported worse outcomes with unplanned resection for malignant soft tissue tumors. However, the impact of these studies on preventing unnecessary unplanned resection remains unknown. METHODS: In a retrospective survey on the treatment of soft tissue sarcomas, we compared cases of unplanned resection with cases of planned resection in terms of the properties of unplanned resection and the oncological and functional outcomes. For the unplanned resection cases, an additional wide resection was performed. RESULTS: Of 92 cases, unplanned resection was performed in 24 (26 %). Small or subcutaneous tumors were significantly more frequently subjected to unplanned resection. In 17 of 24 unplanned resection cases, residual tumors (70.8 %) were noted. Plastic surgery was more frequently needed for unplanned resection cases. There was no significant difference between the unplanned resection and control cases with regard to oncological outcome. However, as to local recurrence and overall survival, the events occurred only in the cases with residual tumors in the additional wide resection specimen in the unplanned resection group. There was no significant difference in functional evaluation, except for emotional acceptance, which had a better score in the unplanned resection group. CONCLUSIONS: Despite repeated cautions regarding unplanned resection in terms of its inadequate procedure which contradicts the principles of soft tissue sarcoma treatment, unplanned resections are still frequently performed. Perhaps the small size and subcutaneous location of the sarcomas in the unplanned resection group did not evoke the probability of malignancy for the surgeons who initially managed them. Even though an additional wide resection was performed, a residual tumor would lead to a worse outcome. An effective awareness program to avoid unnecessary unplanned resections for soft tissue sarcoma should be considered.
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
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Authors: Hina Saeed; David M King; Candice A Johnstone; John A Charlson; Donald A Hackbarth; John C Neilson; Manpreet Bedi Journal: Int J Surg Oncol Date: 2016-10-10
Authors: Maria Anna Smolle; Dimosthenis Andreou; Per-Ulf Tunn; Joanna Szkandera; Bernadette Liegl-Atzwanger; Andreas Leithner Journal: EFORT Open Rev Date: 2017-10-17
Authors: Maria Anna Smolle; Per-Ulf Tunn; Elisabeth Goldenitsch; Florian Posch; Joanna Szkandera; Marko Bergovec; Bernadette Liegl-Atzwanger; Andreas Leithner Journal: Ann Surg Oncol Date: 2017-01-20 Impact factor: 5.344
Authors: J-Y Blay; C Honoré; E Stoeckle; P Meeus; M Jafari; F Gouin; P Anract; G Ferron; A Rochwerger; M Ropars; S Carrere; F Marchal; F Sirveaux; A Di Marco; L R Le Nail; J Guiramand; G Vaz; J-C Machiavello; O Marco; S Causeret; P Gimbergues; F Fiorenza; L Chaigneau; F Guillemin; J-M Guilloit; F Dujardin; J-P Spano; J-C Ruzic; A Michot; P Soibinet; E Bompas; C Chevreau; F Duffaud; M Rios; C Perrin; N Firmin; F Bertucci; C Le Pechoux; F Le Loarer; O Collard; M Karanian-Philippe; M Brahmi; A Dufresne; A Dupré; F Ducimetière; A Giraud; D Pérol; M Toulmonde; I Ray-Coquard; A Italiano; A Le Cesne; N Penel; S Bonvalot Journal: Ann Oncol Date: 2019-07-01 Impact factor: 32.976
Authors: J-Y Blay; P Soibinet; N Penel; E Bompas; F Duffaud; E Stoeckle; O Mir; J Adam; C Chevreau; S Bonvalot; M Rios; P Kerbrat; D Cupissol; P Anract; F Gouin; J-E Kurtz; C Lebbe; N Isambert; F Bertucci; M Toumonde; A Thyss; S Piperno-Neumann; P Dubray-Longeras; P Meeus; F Ducimetière; A Giraud; J-M Coindre; I Ray-Coquard; A Italiano; A Le Cesne Journal: Ann Oncol Date: 2017-11-01 Impact factor: 32.976