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The impact of re‐excision on survival after unplanned resection in extremity soft tissue sarcomas
Author(s) -
ATALAY Can,
ÇETIN Bahadir,
ZARALI Ozan,
ALTINOK Mehmet
Publication year - 2005
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/j.1743-7563.2005.00013.x
Subject(s) - medicine , surgery , soft tissue , surgical margin , radiation therapy , multivariate analysis , adjuvant radiotherapy , resection margin , overall survival , surgical resection , soft tissue sarcoma , resection
Background: Patients with extremity soft tissue sarcomas are frequently treated with unplanned resections outside the specialized centers. Those patients treated with unplanned resections are evaluated for possible prognostic factors affecting disease‐free and overall survival. Methods: Patients were grouped after an unplanned resection as having: positive surgical margins; negative surgical margins treated with re‐excision; or no further surgery. Patients’ age, gender, tumor location, size, grade, group according to the surgical margin status and surgical treatment, adjuvant radio‐ and chemotherapy were evaluated as possible prognostic factors. Results: Seventy‐three patients were eligible for the study. Twenty‐seven patients (37%) had re‐excision due to positive surgical margins, 28 patients (38.3%) had surgery although the initial margins were negative and 18 patients (24.7%) with negative margins received no more surgery. The median disease‐free and overall survival were 35 and 52 months while 5‐year disease‐free and overall survival were 39% and 65%, respectively. In multivariate analysis, low tumor grade ( P = 0.005) and adjuvant radiotherapy ( P = 0.002) were the independent prognostic factors prolonging disease‐free survival and only the groups formed according to surgical margins and re‐excision had an independent effect on overall survival (OS) ( P = 0.029). Conclusion: This study has indicated that a re‐excision in case of negative margins may decrease OS. In clinical practice, a re‐excision after unplanned resections should be performed in patients with positive margins.