Groin soft tissue tumors--a challenge for local control and reconstruction: a prospective cohort analysis.
OBJECTIVE
Groin soft tissue tumors are associated with high local recurrence rates of 16-48% and postoperative complications in 40-68%. Neoadjuvant chemoradiation and aggressive reconstructive techniques were utilized to improve local control and complication rates in this challenging area.


METHODS
Nine patients in this prospective series were treated with neoadjuvant chemoradiation (30 mg IV doxorubicin x 3d followed by 300 cGy/d x 10d) followed by surgery and two patients received radiation (5,000 cGy with tissue spacer) followed by surgery for tumors with a pelvic/retroperitoneal component. Surgery included resection plus reconstruction of the abdominal wall, myocutaneous flaps for large defects, and vascular reconstruction as necessary.


RESULTS
The 11 consecutive patients presented with Stage I (30%), II (40%), or III (30%) disease. Four patients (36%) were operated on for possible incarcerated hernia prior to referral and two (18%) presented with recurrent tumors. Pathology included 10 sarcomas and 1 desmoid tumor; tumor grade was low (30%), moderate (40%), or high (30%). Local control (mean follow-up 55 months; minimum follow-up 36 months) and limb salvage rate was 100%. Minor wound complications not requiring re-operation occurred in three patients, lymphedema in two, and there were no postoperative hernias.


CONCLUSIONS
Preoperative therapy provides excellent local control of groin soft tissue tumors. Current surgical techniques allow extensive resection with limb salvage, dependable primary wound healing and long-term integrity of the abdominal wall.
Mack
L A
LA
Department of Surgery/Oncology, University of Calgary, Calgary, Alberta, Canada.
Temple
Walley J
WJ
DeHaas
W G
WG
Schachar
N
N
Morris
D G
DG
Kurien
E
E
D034861:Abdominal Wall / Q000601:surgery; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006119:Groin; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D019651:Plastic Surgery Procedures / Q000379:methods*; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D013524:Surgical Flaps
D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin