title: Comparative study of planned and unplanned excisions for the treatment of soft tissue sarcoma of the extremities.
abstract: OBJECTIVE
  Unplanned excision of soft tissue sarcomas is common because benign soft tissue lesions are very frequent. This study evaluated the impact of unplanned resections on overall survival, local recurrence and distant metastasis in patients with soft tissue sarcomas of the extremities.
  
  
  METHODS
  In total, 52 patients who were diagnosed with soft tissue sarcomas between May 2001 and March 2011 were analyzed in a retrospective study. Of these patients, 29 (55.8%) had not undergone previous treatment and the remaining 23 (44.2%) patients had undergone prior resection of the tumor without oncological planning. All subsequent surgical procedures were performed at the same cancer referral center. The follow-up ranged from 6 to 122 months, with a mean of 39.89 months. Age, lesion size and depth, histological grade, surgical margins, overall survival, local and distant recurrence and adjuvant therapies were compared.
  
  
  RESULTS
  Residual disease was observed in 91.3% of the re-resected specimens in the unplanned excision group, which exhibited greater numbers of superficial lesions, low histological grades and contaminated surgical margins compared with the re-resected specimens in the planned excision group. No differences were observed in local recurrence and 5-year overall survival between the groups, but distant metastases were significantly associated with planned excision after adjustment for the variables.
  
  
  CONCLUSIONS
  There was no difference between patients undergoing unplanned excision and planned excision regarding local recurrence and overall survival. The planned excision group had a higher risk of distant metastasis, whereas there was a high rate of residual cancer in the unplanned excision group.
authors.affiliation: Faculdade de Ciências Médicas, Orthopedics, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Carlos E H
authors.initials: CE
authors.lastname: Hanasilo
authors.affiliation: Faculdade de Ciências Médicas, Orthopedics, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Marcelo S
authors.initials: MS
authors.lastname: Casadei
authors.affiliation: Faculdade de Ciências Médicas, Orthopedics, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Leandro
authors.initials: L
authors.lastname: Auletta
authors.affiliation: Pathology, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Eliane M I
authors.initials: EM
authors.lastname: Amstalden
authors.affiliation: Faculdade de Ciências Médicas, Orthopedics, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Silvia R F
authors.initials: SR
authors.lastname: Matte
authors.affiliation: Faculdade de Ciências Médicas, Orthopedics, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Etchebehere
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005121:Extremities / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D012307:Risk Factors; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult