Tomoki Nakamura1, Akira Kawai2, Akihiro Sudo1. 1. Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu-city. 2. Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan.
Abstract
BACKGROUND: The aim of this study was to elucidate the clinical outcomes of patients with STSs who received additional excisions after unplanned excisions (UE) using data from the Bone and Soft Tissue Tumor Registry in Japan. METHODS: We examined 197 patients with STSs who received an additional excision after a UE. Data from 2006 to 2013 were obtained from the BSTT Registry. There were 112 men and 85 women, with a mean age of 54 years. The mean primary tumor size was 4.7 cm. Tumor depth was classified as superficial (n = 132) or deep (n = 65). RESULTS: Residual tumor cells were observed in 115 of 197 (58%) specimens at additional excision. Wide margins were achieved in 190 patients, whereas marginal or intra-lesional margins were made in seven patients. One hundred and five patients (53%) required plastic reconstructions. The 5-year disease-specific survival rate was 97.4%. Local recurrence occurred in 15 patients, and the 5-year local recurrence-free rate was 91%. Residual tumor tissue in re-excision specimens was an independent prognostic factor for local control (P = 0.04). The 5-year local recurrence-free rate was significantly worse in patients with residual tumors than in those without residual tumors. CONCLUSIONS: We suggest that UEs should be avoided because they require additional excisions and, in many cases, subsequent soft tissue reconstruction. Additional excisions that are sufficiently extensive may improve local control, although patients with residual tumor tissue in re-excision specimens should be carefully followed up.
BACKGROUND: The aim of this study was to elucidate the clinical outcomes of patients with STSs who received additional excisions after unplanned excisions (UE) using data from the Bone and Soft Tissue Tumor Registry in Japan. METHODS: We examined 197 patients with STSs who received an additional excision after a UE. Data from 2006 to 2013 were obtained from the BSTT Registry. There were 112 men and 85 women, with a mean age of 54 years. The mean primary tumor size was 4.7 cm. Tumor depth was classified as superficial (n = 132) or deep (n = 65). RESULTS: Residual tumor cells were observed in 115 of 197 (58%) specimens at additional excision. Wide margins were achieved in 190 patients, whereas marginal or intra-lesional margins were made in seven patients. One hundred and five patients (53%) required plastic reconstructions. The 5-year disease-specific survival rate was 97.4%. Local recurrence occurred in 15 patients, and the 5-year local recurrence-free rate was 91%. Residual tumor tissue in re-excision specimens was an independent prognostic factor for local control (P = 0.04). The 5-year local recurrence-free rate was significantly worse in patients with residual tumors than in those without residual tumors. CONCLUSIONS: We suggest that UEs should be avoided because they require additional excisions and, in many cases, subsequent soft tissue reconstruction. Additional excisions that are sufficiently extensive may improve local control, although patients with residual tumor tissue in re-excision specimens should be carefully followed up.