Impact of Unplanned Resection and Re-excision of a Soft Tissue Sarcoma on Prognosis
| Autor: | Alberto González Barranquero, Mariam Bajawi Carretero, Jacobo Cabañas Montero, Eduardo Lobo Martínez, Paula Muñoz Muñoz, Antonio Mena Mateos, Alfonso Sanjuanbenito Dehesa, Sara Corral Moreno |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Neoplasm Residual Adolescent Soft Tissue Neoplasms 030230 surgery Malignancy Resection Young Adult 03 medical and health sciences 0302 clinical medicine Humans Medicine Neoplasm Metastasis Re-Excision Aged Neoplasm Staging Retrospective Studies Aged 80 and over Retrospective review business.industry Soft tissue sarcoma Advanced stage General Engineering Soft tissue Sarcoma Middle Aged Prognosis medicine.disease Survival Analysis Surgery Case-Control Studies Female Neoplasm Recurrence Local business |
| Zdroj: | Cirugía Española (English Edition). 98:281-287 |
| ISSN: | 2173-5077 |
| Popis: | Introduction Up to 40% of all initial operations for soft tissue sarcoma (STS) are unplanned, which would leave residual macroscopic tumor in more than 50% of the cases. The effect this has on local recurrence rate, metastases rate and survival has never been fully established, due to the lack of randomized studies. Methods Retrospective review of patients with STS treated in our unit between January 2001-January 2016. We classified them whether they had been treated by initial planned or unplanned operation. Outcomes were compared in both groups globally and stage-matched. Endpoints were local recurrence and distant metastases. Results Twenty-three patients of STS underwent a planned excision and 16 an unplanned excision, 13 of them underwent further re-excision. 40% of patients with planned excision had an advanced stage in regard to the unplanned excision group which presented earlier stages. 77% of patients with unplanned excision had residual tumor identified after surgical re-excision. Local recurrence rate in the unplanned excision group was considerably higher 73.5% vs 43.8%. Metastases rate was lower in planned excision group, 45.5% vs 56.3% (P>.05). The recurrence pattern in the unplanned excision group was unstable, with worse outcomes in earlier stages. Conclusion The unplanned excision of a soft tissue sarcoma may compromise disease local control, with higher rates of local recurrence and metastases, and worse functional outcomes, despite further oncological treatment. We need to recognize the clinical features for malignancy risk in soft tissue lumps for a safe diagnosis to avoid inadequate resections. |
| Databáze: | OpenAIRE |
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