Does Unplanned Soft Tissue Sarcoma Surgery Have a Negative Effect on Prognosis?


EROL B., Baysal Ö.

JOURNAL OF INVESTIGATIVE SURGERY, cilt.35, sa.1, ss.38-43, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 35 Sayı: 1
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1080/08941939.2020.1813852
  • Dergi Adı: JOURNAL OF INVESTIGATIVE SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EBSCO Legal Collection, EBSCO Legal Source, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.38-43
  • Anahtar Kelimeler: Soft tissue sarcoma, unplanned excision, oncologic outcomes, residual disease, local recurrence, re-excision surgery, RE-EXCISION, RESIDUAL DISEASE, IMPACT, RERESECTION, OUTCOMES
  • Marmara Üniversitesi Adresli: Evet

Özet

Background We aimed to compare the oncological outcomes of patients who underwent re-excision following unplanned surgery and those who underwent planned surgery. Methods Patients who were referred to our hospital after a mass was inappropriately resected and reported to have a malignant pathology with a positive surgical margin, as well as patients diagnosed with malignant soft tissue tumors, and operated on following a multidisciplinary assessment and staging between 2012 and 2018. All patients were followed up at least 6 months. Results Our study included a total of 125 patients. Forty percent (n = 50) underwent unplanned excision and sixty percent (n = 75) underwent planned excision.There was no statistically significant difference in the survival curves between the two groups (p = 0.248). Tumor size was larger, and the rate of deep-localized tumors was higher in patients undergoing planned surgery than in the unplanned surgery group (p = 0.001). The rate of tumors localized in the upper extremities was significantly higher in the unplanned surgery group than in the planned surgery (p = 0.033). MRI examinations could detect residual tumors with an accuracy of 80%. Age (>48 years), tumor size (>8 cm), tumor grade (grade 3), and distant organ metastasis at follow-up, which were among risk factors found to have a significant effect on mortality. Conclusion Patients undergoing re-excision after an inappropriate resection and undergoing planned resection had a similar prognosis. Superficial, upper extremity-localized, and relatively small-size tumors are more prone to inadequate surgical resection. MRI can be used to detect residual tumors at a high rate in patients who have undergone unplanned surgery. Distant organ metastasis is the most important factor affecting survival.