THE INCIDENCE OF LOCAL RECURRENCE FOLLOWING SURGICAL EXCISION OF SOFT TISSUE SARCOMA IN ABERDEEN

Abstract

Introduction: The Scottish Sarcoma network was established in 2004 to optimise the management of sarcoma patients in Scotland. This maintained three units, Aberdeen, Edinburgh and Glasgow, as designated Sarcoma centres. Aberdeen takes referrals from Tayside, Grampian and the Highlands and Islands. Soft tissue tumours are managed with surgical resection +/− radiotherapy. The surgical margin is paramount and thought to predict the risk of local recurrence.

Methods: All patients presenting with a soft tissue sarcoma to the Orthopaedic department in Aberdeen between January 2001 and April 2008 were identified. A retrospective review of the hospital records and histopathology reports was performed. Our aim was to establish the number of recurrences of soft tissue sarcoma within the unit over the 7 year period and relate this to the adequacy of the initial surgical resection margin.

Results: Seventy-six patients were identified, 45 male and 31 female, with a mean age of 56 years. An average of ten patients presented annually (range 5–14). Seven patients (9.2%) presented with local recurrence, 4 with Malignant Fibrous Histiocytoma, 2 with leiomyosarcoma and 1 malignant peripheral nerve sheath tumour.

Five patients with recurrent disease were treated prior to establishment of the sarcoma network. Two patients, before the establishment of the network underwent resection and staging in another unit and the exact time to recurrence is unknown. One patient is currently under investigation for recurrence.

The average time to recurrence was 29.2 months (Range 12–48 months).

Three of the five patients with original pathology available had complete resection with mean margins of 6.25mm (range 5–7.5mm). Two had incomplete excisions carried out by other specialities, only presenting to our unit with recurrent disease.

Discussion: Our recurrence rate of 10.5% is comparable to other centres. Despite adequate resection margins and adjuvant radiotherapy some patients go on to develop recurrent disease. It is unclear why.