J Korean Orthop Assoc.  2019 Apr;54(2):150-156. 10.4055/jkoa.2019.54.2.150.

Diagnostic Accuracy of Imaging Study and the Impact of Clinical Risk Factors on the Presence of Residual Tumor Following Unplanned Excision of Soft Tissue Sarcomas

Affiliations
  • 1Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. sungwseo@skku.edu
  • 2Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea.

Abstract

PURPOSE
This study examined the diagnostic accuracy of an imaging study to find the factors that affect the presence of residual tumors after an unplanned excision of sarcomas.
MATERIALS AND METHODS
Ninety-eight patients, who underwent a re-excision after unplanned surgery between January 2008 and December 2014, were enrolled in this study. Magnetic resonance imaging (MRI) was performed before reoperation in all patients. Positron emission tomography (PET)-computed tomography was performed on 54 patients. A wide re-excision and histology diagnosis were performed in all cases. The clinical variables were evaluated using univariate logistic regression and multivariate logistic regression.
RESULTS
The presence of a deep-seated tumor increases the risk of remnant tumors (odds ratio: 3.21, p=0.02, 95% confidence interval: 1.25–8.30). The sensitivity for detecting residual tumors is high in MRI (sensitivity 0.79).
CONCLUSION
Deep-seated tumors have a significantly higher risk of remnant tumors. Because the negative predictive value of MRI and PET scans is very low, reoperation should be performed regardless of a negative result.

Keyword

sarcoma; soft tissue; unplanned excision; neoplasm; residual; re-excision
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