Clinical Treatment Outcomes Of Soft Tissue Sarcoma After Unplanned Excision

Objective:To explore the re-excision and its treatment of soft tissue sarcoma (STS) patients who have performed unplanned excision.Methods:The criteria for selecting cases:(1) time, from January2005to December2011,who were treated in Qilu Hospital orthopedic departmentof Shandong University;(2) Those underwent unplanned excision for soft tissue tumors, including as benign tumors or inflammatory lesion,removal biopsy,lack of preoperative MRI and assessment of surgerical margin,without considerationof surgerical margin;(3)Pathologicaldiagnosises were soft tissue sarcomasbythe department of pathology of our hospital;(4)Underwent secondary excision in our hospital.53cases were chosen,of which9patients were lost (17%).We obtained complete followup data of44cases,25males and19females,with the ratio of1.3:1. Average age was44years(14-74years).The followup was3-82months(mean55months). Locations of the tumors were the lower extremity (23),upper extremity (10), and trunk (11).All patients were divided into two groups according to whether recurrence or not before reexcision.We determined whether recurrence, metastasis, and survival differed between the two groups. Statistical analysis was performed using SPSS Version16.0.Results:There were17cases without recurrence of soft tissue sarcoma before reexcision(group A),and27cases with recurrence of soft tissue sarcoma before reexcision (group B).The ratio of recurrence in group A was11.8%,and48.1%in group B,and P=0.021<0.05, with significant difference.While the ratio of metastasis in group A was5.9%,and29.6%in group B, and P=0.121>0.05,with no significant difference. Kaplan-Meier Univariate was used for overall survival in all cases of soft tissue sarcoma before and after re-excision. Respectively, there was no significant difference in both of these. Cox proportional hazard model multivariate analysis was used for overall survival,and no significant difference.1-year,3-year and5-year overall survival of sot tissue sarcoma were83%,79%and79%.The5-year disease-free survival was86.3%±9.2%in group A and40.3%±10.1%in group B,with a significant difference (P=0.003<0.05).Conclusion:It’squite common for the patients of soft tissue sarcoma who underwent unplanned excision.These patients were in a highratio of local recurrence.They should be performed reexcision before recurrence in time. Reexcision before recurrencecan effectively reduce the rate of recurrence and improve disease-free survival.Local recurrenceof soft tissue sarcoma did not have ameasurable impact on metastasis and overall survival,but could significantly reduce the disease-free survival.