title: Re-excision after unplanned resection of nonmetastatic nonrhabdomyosarcoma soft tissue sarcoma in children: Comparison with planned excision.
abstract: BACKGROUND
  It is not exceptional to come by children with initial unplanned surgical intervention for nonrhabdomyosarcoma soft tissue sarcomas (NRSTS). The aim of this study was to evaluate the presence of residual disease in these patients after re-excision and compare the treatment outcomes with patients who had planned upfront excision.
  
  
  METHODS
  The data of patients with primary nonmetastatic NRSTS with initially unplanned excision who underwent re-excision between March 2006 and December 2014 were analyzed and the results compared with patients having planned upfront excision in the similar period.
  
  
  RESULTS
  Of the 84 patients, 40 (48%) had an unplanned excision elsewhere; 35 of these patients had a re-excision. Twenty-one of the remaining 44 patients underwent upfront planned excision. A residual tumor was present in 16 (45.7%) patients. There was no significant difference in the local recurrence, distant metastases, or deaths in patients with re-excision or planned excision. The 5-year overall, disease-free survival and local control rates were, respectively, 93.5%, 90.2% and 96.6% for the re-excision group and 84.9%, 65.2% and 88.5% in the planned excision group (p=NS).
  
  
  CONCLUSIONS
  The probability of residual disease following unplanned excision of NRSTS is high. The outcomes following re-excision are similar to that with planned excision.
  Level II evidence.
authors.affiliation: Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Bombay, India. Electronic address: sajidshafiques@hotmail.com.
authors.forename: Sajid S
authors.initials: SS
authors.lastname: Qureshi
authors.affiliation: Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Aruna
authors.initials: A
authors.lastname: Prabhu
authors.affiliation: Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Monica
authors.initials: M
authors.lastname: Bhagat
authors.affiliation: Department of Radiology, Tata Memorial Centre, Bombay, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Kembhavi
authors.affiliation: Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Tushar
authors.initials: T
authors.lastname: Vora
authors.affiliation: Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Girish
authors.initials: G
authors.lastname: Chinnaswamy
authors.affiliation: Department of Pathology, Tata Memorial Centre, Bombay, India.
authors.forename: Mukta
authors.initials: M
authors.lastname: Ramadwar
authors.affiliation: Department of Radiation Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Laskar
authors.affiliation: Department of Biostatistics, Tata Memorial Centre, Bombay, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Talole
mesh_terms: D001706:Biopsy; D002648:Child; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008279:Magnetic Resonance Imaging; D008297:Male; D009362:Neoplasm Metastasis; D018365:Neoplasm, Residual; D049268:Positron-Emission Tomography; D012086:Reoperation; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Nonrhabdomyosarcoma; Pediatric; Re-excision; Soft tissue sarcoma; Unplanned surgery