title: Management of Unplanned Excision for Soft-Tissue Sarcoma With Preoperative Radiotherapy Followed by Definitive Resection.
abstract: The purpose of this study was to review the outcomes after preoperative radiotherapy and definitive surgery for patients who initially had inadvertent excision for sarcoma.
  
  
  
  Treatment records of 44 consecutive patients, who initially underwent unplanned excision of soft-tissue sarcoma between January 2004 and January 2012, were reviewed. All patients had clinically localized disease before treatment and received preoperative external-beam radiotherapy followed by definitive oncologic surgery at our institution.
  
  
  
  The median follow-up was 36 months. Residual tumor after preoperative radiotherapy and wound bed excision was identified in 39% (17/44) of the cases. Kaplan-Meier estimates for 5-year local control, recurrence-free survival, and overall survival are 95% (95% confidence interval [CI], 80-99), 86% (95% CI, 69-94), and 94% (95% CI, 79-99) respectively. Perioperative morbidity occurred in 25% of patients (11/44.) All patients with perioperative wound complications had lower extremity sarcomas.
  
  
  
  Optimal management for unplanned excision of soft-tissue sarcoma is unknown. Our institution has adopted the approach of preoperative radiotherapy, followed by definitive surgery. In our series of 44 patients, local control was excellent at 95%, with perioperative complications seen only in patients with lower extremity sarcomas, suggesting that this is a reasonable approach to manage inadvertently resected sarcoma.
authors.affiliation: Departments of *Radiation Oncology †Laboratory Medicine and Pathology §Orthopedic Surgery, University of Minnesota Affiliated Hospitals ∥Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota ‡Department of Laboratory Medicine and Pathology, Veterans Administration Medical Center, Minneapolis, MN.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Jones
authors.forename: Charles
authors.initials: C
authors.lastname: Shideman
authors.forename: Jianling
authors.initials: J
authors.lastname: Yuan
authors.forename: Kathryn
authors.initials: K
authors.lastname: Dusenbery
authors.forename: J
authors.initials: J
authors.lastname: Carlos Manivel
authors.forename: Christian
authors.initials: C
authors.lastname: Ogilvie
authors.forename: Denis R
authors.initials: DR
authors.lastname: Clohisy
authors.forename: Edward Y
authors.initials: EY
authors.lastname: Cheng
authors.forename: Ryan
authors.initials: R
authors.lastname: Shanley
authors.forename: L
authors.initials: L
authors.lastname: Chinsoo Cho
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D010347:Patient Care Planning; D011300:Preoperative Care / Q000379:methods; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D018570:Risk Assessment; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D012737:Sex Factors; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult