Oncological outcome, functional results and costs after unplanned excision of musculoskeletal soft tissue sarcoma.

Autor: Morattel B; Service of Orthopedics and Traumatology, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 4, 1011, Lausanne, Switzerland. Electronic address: morattelb@gmail.com., Mustaki L; Service of Orthopedics and Traumatology, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 4, 1011, Lausanne, Switzerland., Montemurro M; Medical Oncology Department, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland., Letovanec I; Institute of Pathology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland., Durham AD; Radiation Oncology Department, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland., Becce F; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland., Omoumi P; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland., di Summa PG; Department of Plastic and Reconstructive Surgery, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland., Matter M; Departments of Surgery and Oncology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland., Rüdiger HA; Orthopedic Department, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland., Cherix S; Service of Orthopedics and Traumatology, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 4, 1011, Lausanne, Switzerland.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2020 May; Vol. 46 (5), pp. 898-904. Date of Electronic Publication: 2020 Jan 30.
DOI: 10.1016/j.ejso.2020.01.025
Abstrakt: Background: Treatment of soft tissue sarcomas (STS) should only be initiated once the diagnosis is fully established. Resection of tumors of unknown nature should be avoided. Nevertheless, specialized centers continue to face numbers of unplanned excisions (UPE) in STS.
Aim: To compare oncologic and functional outcomes, number of surgeries, length of hospital stay and treatment costs of UPE versus planned excision (PE) in STS.
Method: A retrospective single tertiary center study was performed on 201 patients. Survival, local and distant recurrence rates were compared between PE (n = 137) and UPE (n = 64). In a subgroup analysis of 60 patients, functional outcome (MSTS and TESS scores), and socio-economic impact (number of surgeries, length of hospital stay and treatment costs) in "functional planned excision" (fPE) group (n = 30) and "functional unplanned excision" (fUPE) group (n = 29) were compared.
Results: There was no significant difference in oncological outcome between PE and UPE. In the subgroup analysis, we found a non-significant difference in functional outcome. Patients in the fUPE had significantly more surgeries (3.5 vs. 1.4; p < 0.00001) and costs of their management was 64% higher than fPE (p = 0.048). Hospital stay was longer after fUPE but not statistically significant (18.3 days vs. 11.8 days; p = 0.13).
Conclusion: Even though oncological and functional outcomes are comparable after PE and UPE of STS, the number of surgeries, length of hospital stay and treatment costs were higher in patients with UPE. Our data underscore the importance of specialized STS treatment centers including multidisciplinary management.
(Copyright © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
Databáze: MEDLINE
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