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We reviewed 78 patients with soft tissue sarcomas to evaluate the difference in treatment results and prognosis between two groups: those who underwent a prompt additional wide resection and those who underwent a wide margin procedure after subsequent local recurrence. Twenty-two patients underwent a prompt additional wide resection within three months after a simple excision (Group A), and 26 underwent a wide margin procedure when there was local recurrence following a simple excision (Group B). Group C was a control group consisting of 30 patients with a planned wide resection after pathological diagnosis following biopsy. The five-year disease-free survival rate in group A was 87.3%, 57.4% in group B, and 80.5% in group C. The patients in group A had a significantly higher survival rate than patients in group B. In summary, even if the initial surgery was unplanned, a subsequent prompt additional wide resection is an appropriate salvage procedure for patients who received an inadequate simple excision. Wide resection of tissues in the compartment or region of the tumor according to a detailed plan based on preoperative imaging studies is the conventional surgical management of soft tissue sarcomas. However, unplanned simple excision may be occasionally performed by a surgeon without specific training and experience in the management of these challenging neoplasms. A patient referred by a surgeon who performed a simple excision of soft tissue sarcoma will visit an orthopedic oncologist. In such circumstances, after a definitive pathologic diagnosis of malignancy, either a prompt additional wide resection or observation with the expectation of a wide margin procedure after local recurrence is chosen as a management strategy. However, only two studies have reported on the outcome of an unplanned simple excision of soft tissue sarcomas (Gherlinzoni, Bacci et al., 1986 Giuliano and Eilber, 1985); a comparative study between the two strategies has not previously been reported. This report evaluates the effect of each strategy on prognosis. Send correspondence to: Dr. Akihiro Sudo, Department of Orthopedic Surgery, Mie University Faculty of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan

USEFULNESS OF A PLANNED ADDITIONAL WIDE RESECTION AFTER AN UNPLANNED SIMPLE EXCISION OF SOFT TISSUE SARCOMAS