Extremity Soft Tissue Sarcoma in a Series of Patients Treated at a Single Institution

Background Core needle biopsies of sarcomas allow a diagnosis in a high percentage of patients with few complications. However, it is unclear whether the tract needs to be excised to prevent recurrences. Questions/purposes We therefore determined the rates of recurrence and metastases in patients with Stage III extremity sarcomas, who underwent wide local resection without excision of the needle tract and also received adjuvant treatment.

Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

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Adult Soft Tissue Sarcoma Local Recurrence After Adjuvant Treatment Without Resection of Core Needle Biopsy Tract

Binitie

Tejiram

Conway

et al. 2013

“…Investigators have attempted to assign quantitative values to various qualitative tissue planes in an effort to determine the appropriate clinical resection guidelines [10][11][12]. Few authors have looked specifically at the relationship between close but negative margins and local recurrence [2,8,14,16,18,19,21]. Evaluation of the literature is complicated by varying inclusion and exclusion criteria and numerous confounders.…”

Section: Introductionmentioning

confidence: 99%

Extremity Soft Tissue Sarcoma Resections: How Wide Do You Need to Be?

King

Hackbarth

Kirkpatrick

2012

Background Sarcomas require a wide margin of resection including a cuff of normal tissue to minimize the risk of local recurrence. The amount of tissue that constitutes a wide margin is unclear in the literature. Questions/purposes We therefore determined whether a close resection margin for soft tissue sarcoma resulted in an increased incidence of locally recurrent disease and whether additional factors, including radiation therapy, outside biopsies, and tumor biology, affected the risk of local recurrence. Methods We retrospectively reviewed 117 patients with soft tissue sarcomas resected with negative margins from 2001 to 2007. Gross specimens were inked and the closest macroscopic margins were sent for microscopic examination. Resection margins were categorized as less than 1 mm, 1-5 mm, or greater than 5 mm. We evaluated additional factors that might influence local recurrence, including radiation therapy, outside biopsies, sarcoma type, grade, and stage at presentation, and development of metastatic disease.

“…Patients who develop a local recurrence from a soft-tissue sarcoma have a poor prognosis [1,7,8]. One study suggests the development of a local recurrence is the most important factor associated with decreased survival, and once patients develop a local recurrence, they are about three times more likely to die from disease compared to patients who do not develop a local recurrence [6].…”

Section: Introductionmentioning

confidence: 99%

What Are Risk Factors for Local Recurrence of Deep High-grade Soft-tissue Sarcomas?

Sawamura

Matsumoto

Shimoji

et al. 2012

Background Patients with local recurrence of soft-tissue sarcomas have a poor overall survival. High-grade, softtissue sarcomas in deep locations may have a poorer prognosis regarding local recurrence than low-grade sarcomas or those located superficially. Although previous reports evaluated tumors at various depths, it is unclear what factors influence recurrence of deep, high-grade sarcomas. Questions/purposes We therefore determined whether possible risk factors (tumor size, location, histologic subtype, unplanned excision, local recurrence at presentation, metastasis at diagnosis, surgical procedure, surgical margin, and adjuvant treatments) influenced local recurrence of deep, high-grade, soft-tissue sarcomas. Patients and Methods We retrospectively reviewed 433 patients with deep, high-grade, soft-tissue sarcomas surgically treated between 1985 and 2005. For each patient, we reviewed tumor size, location, histologic subtype, unplanned excision, local recurrence at presentation, metastasis at diagnosis, surgical procedure, surgical margin, and adjuvant treatments and determined the effect of each prognostic variable on local recurrence. The minimum followup was 1 month (median, 51 months; range, 1-305 months).