Outcomes of re-excision after unplanned excisions of soft-tissue sarcomas

Mark W. Manoso, Deborah A. Frassica, E. Gene Deune, Frank J. Frassica

Research output: Contribution to journalArticle

Abstract

Background and Objectives: Unplanned excisions of soft-tissue sarcomas of the extremities occur commonly. Our goal was to evaluate the presence of residual disease, the treatment outcomes as they relate to local and distant recurrence and 5-year survival, and the limb functional outcomes in patients with unplanned sarcoma excision who were treated with re-excision and adjuvant therapy. Methods: Between 1993 and 1999, 42 patients presented to our institution after unplanned excision of soft-tissue sarcomas. Of those 42 patients, 38 without gross residual disease or metastatic lesions formed the basis of this review. All 38 patients underwent revision wide excision; most (31) also received adjuvant therapy (radiation and/or chemotherapy). Clinical data were obtained from analysis of patient records and radiographic studies. Univariate analysis was performed with logistical regression, and multivariate analysis was performed with Cox modeling. Results: The overall 5-year survival rate was 91.3% and the disease-free 5-year survival rate was 82.2%. Univariate analysis showed that stage-III disease (American Joint Committee on Cancer classification of soft-tissue sarcomas), lesions below the fascia, a histologic high-grade, and the development of organ metastasis were statistically significant factors for mortality. Stage-III disease also was significant for mortality on multivariate analysis. Only stage-III disease was significant for the development of local recurrence. Eighty-four percent of the patients had good to excellent functional outcomes. Conclusions: Re-excision with adjuvant therapy proved to be a safe and effective method for treating the disease and preserving limb function.

Original languageEnglish (US)
Pages (from-to)153-158
Number of pages6
JournalJournal of Surgical Oncology
Volume91
Issue number3
DOIs
StatePublished - Sep 1 2005

Keywords

  • Predictive factors
  • Recurrence
  • Wide excision

ASJC Scopus subject areas

  • Surgery
  • Oncology

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