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Predictive factors for complete removal in soft tissue sarcomas: A retrospective analysis in a series of 592 cases
Author(s) -
SastreGarau Xavier,
Coindre JeanMichel,
Leroyer Ariane,
Terrier Philippe,
Ollivier Lilianne,
Stöckle Eberhard,
Bonichon Françoise,
Collin Françoise,
Le Doussal Viviane,
Contesso Geneviève,
Vilain MarieOdile,
Jacquemier Jocelyne,
Bui Nguyen Binh
Publication year - 1997
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/(sici)1096-9098(199707)65:3<175::aid-jso6>3.0.co;2-3
Subject(s) - medicine , univariate analysis , multivariate analysis , pathological , univariate , radiation therapy , soft tissue , surgery , retrospective cohort study , chemotherapy , stage (stratigraphy) , multivariate statistics , radiology , oncology , paleontology , statistics , mathematics , biology
Background and Objectives In order to specify the indications for conservative surgery and preoperative therapeutic approaches of soft tissues sarcomas (STS), we looked for the clinico‐pathological parameters associated with the failure to obtain a complete removal (CRm) of the tumor. Methods We retrospectively analyzed a series of 592 cases of primary non‐metastatic STS. Surgery was performed in 495 cases as a primary treatment and in 88 cases after chemo‐ or radiotherapy. Nine patients were treated by chemotherapy‐radiotherapy. In a univariate analysis, 20 parameters were tested for their association with CRm. A multivariate analysis was then used to define the independent parameters linked to the achievement of a CRm. Results In the univariate analysis, 15 parameters were found to be linked to the achievement of a CRm. Three of them proved to be independent in the multivariate analysis: T in the TNM classification, tumor location, and tumor necrosis. By the combination of these risk factors, four groups of patients were defined, with respective rates of CRm of 97% (no factor), 95% (one factor), 70% (two factors), and 48% (three factors). Conclusions The achievement of a CRm after surgery of STS depends not only on the accessibility of the lesion, but also on tumor aggressiveness, a reflection of which is necrosis. The detection of necrosis by imaging procedures may thus help predicting the resectability of tumors and defining the indications for neoadjuvant therapies, likely to broaden the use of conservative surgery. J. Surg. Oncol. 1997;65:175–182. © 1997 Wiley‐Liss, Inc.