Primary excision compared with re-excision of extremity soft tissue sarcomas--is anything new? | Department of Physical Medicine and Rehabilitation

Alamanda VK, Crosby SN, Archer KR, Song Y, Schwartz HS, Holt GE. Primary excision compared with re-excision of extremity soft tissue sarcomas--is anything new? Journal of surgical oncology. 2012 Jun 1;105(105). 662-7. PMID: 22213171 [PubMed]

Abstract

Background

Soft tissue sarcomas (STS) are rare and are commonly excised outside of a sarcoma center without appropriate preoperative planning. Studies have shown varying results in survival and outcome when comparing patients undergoing re-excision to patients undergoing a single, planned excision.

Methods

This retrospective study evaluated 278 patients treated for STS of the extremities between January 2000 and July 2006. One hundred seventy-two patients had a primary excision while 106 patients had a sarcoma re-excised. Survival curves for disease-free survival, metastasis-free survival, and local recurrence-free survival were calculated using competing risk analysis for both groups.

Results

After adjusting for high-risk variables, our results indicate that re-excision is a proxy for smaller, low-grade tumors which tend to have a better survival profile. Death due to sarcoma and distant metastases were correlated with high-grade and large tumors. The presence of positive microscopic margins was the strongest predictor of local recurrence (P 0.05).

Conclusions

There were no differences in death, metastases, or local recurrence between the two groups after adjusting for high-risk variables. Survival advantages previously reported with STS re-excision serve as proxy for tumors that have a better survival profile.