[The influence of residual tumor on local recurrence after unplanned resection of soft tissue sarcoma].
OBJECTIVE
The "unplanned" excision of a soft tissue sarcoma (STS) is defined as its resection without preoperative staging procedures and without aiming at wide resection margins owing to lacking knowledge of the malignancy of the tumor. Aim of this study was to evaluate the influence of such unplanned excisions, in spite of immediate re-excision, upon local recurrence.


METHODS
Results in 110 consecutive patients were analysed. In all of them an unplanned resection of a STS of the limbs or trunk not achieving wide resection margins had been performed prior to referral. End-point of statistical analysis was local relapse. Median follow-up time was 82 months.


RESULTS
Residual tumor was found in 34 specimens of primary re-excisions (31 %). Local recurrence occurred in 14 patients, 23 patients developed distant metastases. Multivariate analysis revealed two significant prognostic factors for local recurrence: residual tumor in the re-excised specimen and occurrence of distant metastases.


CONCLUSIONS
Presence of residual tumor in re-excised specimens is a prognostic factor for local tumor relapse, is the development of distant metastases. Suspicious soft tissue tumors should be excised after oncological regimens, preferably in experienced centers.
Peiper
M
M
Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Universitätsklinikum Eppendorf, Hamburg. matthias.peiper@uni-duesselderf.de
Knoefel
W T
WT
Izbicki
J R
JR
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003951:Diagnostic Errors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D012306:Risk; D012509:Sarcoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*