Abstract
Introduction: Many soft tissue sarcomas undergo initial inadequate excision (the Whoops! procedure) and are then referred to specialist services. The outcome of 108 such patients is presented.
Method: Records of 108 patients were traced from the prospectively collected database at our institute who had reexcisions of soft tissue sarcomas. We investigated outcome both in terms of local control and overall survival following treatment to assess the significance of an inadequate initial excision.
Results: Over a ten-year time period we was 887 new patients with soft tissue sarcoma of whom 140 patients (11%) presented following previous inadequate excision. Of these, 108 patients underwent re-excision in an attempt to achieve clear margins. 80% tumours were high grade and 40% were deep. After reexcision, 57% patients were found to have residual tumour. 32% patients had close margins after re-excision. Over all survival of patients was 80% at 5 years and local recurrence rate was 10%. Local recurrence of patients with marginal excision was 15% at 5 years but for clear margins was 6.7%. Of 108 patients 22 (20%) had metastasis at 5 years of which 16.6% were in the lung. 81% of metastasis occurred in patients with close margins of reexcisions. Survival of patients with close margins was worse than wide margins (p = 0.0025).
Conclusion: Local recurrence was statistically associated with grade, depth, margins of re excision and presence of residual tumour. Overall survival was influenced by close margins and residual tumour but not by local recurrence. Re-excision of soft tissue sarcoma to clear margins improves survival of the patients at 5 years.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
