The Result of Re-excision Following Unplanned Excision of Soft Tissue Sarcoma of the Extremities

Cho, Wan Hyeong; Song, Won Seok; Park, Jong Hoon; Jeon, Dae Geun; Lee, Soo Yong; Oh, Jung Moon; Kim, Jin Wook

Abstract

PURPOSE
This study examined the effect of a microscopic residual tumor on the survival and recurrence rate by analyzing patients who had undergone a re-excision after an unplanned excision of a soft tissue sarcoma. MATERIALS AND METHODS: From December 1985 to June 2002, 68 unplanned excisions of a soft tissue sarcoma at other institutes were referred to our service. All cases had undergone a re-excision and were re-evaluated for residual tumors. The male to female ratio was the same with an average age of 34.7 years. Staging followed the AJCC classification and there were 3 cases of Ia, 2 Ib, 5 IIa, 34 IIb, 24 III. Twenty six cases underwent surgical treatment only and 42 had added adjuvant therapy. The mean follow-up was 58.9 months. RESULTS: At the final follow up, there were 48 CDF, 9 NED, 3 AWD and 8 DOD. The CDF 5/16 year survival rates were 68.1/61.3%. Eight of the 23 residual tumor positive cases and 6 of the 45 residual tumor negative cases had a local recurrence. The tumor size, residual tumor, interval between the excision and reexcision, and stage were significant factors for a local recurrence. Statistical analysis revealed a local recurrence, metastasis and stage to be significant factors for survival. CONCLUSION: Local recurrence was the only controllable factor for survival. The presence of a residual tumor had an impact on the local recurrence. A re-excision after an unplanned excision may reduce the incidence of a local recurrence.