Management of Unplanned Excision for Soft-Tissue Sarcoma with Preoperative Radiotherapy Followed by Definitive Resection

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background and Objectives: The purpose of this study was to review the outcomes after preoperative radiotherapy and definitive surgery for patients who initially had inadvertent excision for sarcoma. Materials and Methods: Treatment records of 44 consecutive patients, who initially underwent unplanned excision of soft-tissue sarcoma between January 2004 and January 2012, were reviewed. All patients had clinically localized disease before treatment and received preoperative external-beam radiotherapy followed by definitive oncologic surgery at our institution. Results: The median follow-up was 36 months. Residual tumor after preoperative radiotherapy and wound bed excision was identified in 39% (17/44) of the cases. Kaplan-Meier estimates for 5-year local control, recurrence-free survival, and overall survival are 95% (95% confidence interval [CI], 80-99), 86% (95% CI, 69-94), and 94% (95% CI, 79-99) respectively. Perioperative morbidity occurred in 25% of patients (11/44.) All patients with perioperative wound complications had lower extremity sarcomas. Conclusions: Optimal management for unplanned excision of soft-tissue sarcoma is unknown. Our institution has adopted the approach of preoperative radiotherapy, followed by definitive surgery. In our series of 44 patients, local control was excellent at 95%, with perioperative complications seen only in patients with lower extremity sarcomas, suggesting that this is a reasonable approach to manage inadvertently resected sarcoma.

Original languageEnglish (US)
Pages (from-to)586-592
Number of pages7
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume39
Issue number6
DOIs
StatePublished - Jan 1 2016

Fingerprint

Sarcoma
Radiotherapy
Confidence Intervals
Lower Extremity
Survival
Wounds and Injuries
Residual Neoplasm
Kaplan-Meier Estimate
Morbidity
Recurrence
Therapeutics

Keywords

  • preoperative radiotherapy
  • sarcoma
  • unplanned excision

Cite this

@article{ca69bcf7860e426f907be308540da239,
title = "Management of Unplanned Excision for Soft-Tissue Sarcoma with Preoperative Radiotherapy Followed by Definitive Resection",
abstract = "Background and Objectives: The purpose of this study was to review the outcomes after preoperative radiotherapy and definitive surgery for patients who initially had inadvertent excision for sarcoma. Materials and Methods: Treatment records of 44 consecutive patients, who initially underwent unplanned excision of soft-tissue sarcoma between January 2004 and January 2012, were reviewed. All patients had clinically localized disease before treatment and received preoperative external-beam radiotherapy followed by definitive oncologic surgery at our institution. Results: The median follow-up was 36 months. Residual tumor after preoperative radiotherapy and wound bed excision was identified in 39{\%} (17/44) of the cases. Kaplan-Meier estimates for 5-year local control, recurrence-free survival, and overall survival are 95{\%} (95{\%} confidence interval [CI], 80-99), 86{\%} (95{\%} CI, 69-94), and 94{\%} (95{\%} CI, 79-99) respectively. Perioperative morbidity occurred in 25{\%} of patients (11/44.) All patients with perioperative wound complications had lower extremity sarcomas. Conclusions: Optimal management for unplanned excision of soft-tissue sarcoma is unknown. Our institution has adopted the approach of preoperative radiotherapy, followed by definitive surgery. In our series of 44 patients, local control was excellent at 95{\%}, with perioperative complications seen only in patients with lower extremity sarcomas, suggesting that this is a reasonable approach to manage inadvertently resected sarcoma.",
keywords = "preoperative radiotherapy, sarcoma, unplanned excision",
author = "Jones, {Daniel A.} and Charles Shideman and Jianling Yuan and Kathryn Dusenbery and {Carlos Manivel}, J. and Christian Ogilvie and Clohisy, {Denis R.} and Cheng, {Edward Y.} and Ryan Shanley and {Chinsoo Cho}, L.",
year = "2016",
month = "1",
day = "1",
doi = "10.1097/COC.0000000000000095",
language = "English (US)",
volume = "39",
pages = "586--592",
journal = "American Journal of Clinical Oncology",
issn = "0277-3732",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Management of Unplanned Excision for Soft-Tissue Sarcoma with Preoperative Radiotherapy Followed by Definitive Resection

AU - Jones, Daniel A.

AU - Shideman, Charles

AU - Yuan, Jianling

AU - Dusenbery, Kathryn

AU - Carlos Manivel, J.

AU - Ogilvie, Christian

AU - Clohisy, Denis R.

AU - Cheng, Edward Y.

AU - Shanley, Ryan

AU - Chinsoo Cho, L.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background and Objectives: The purpose of this study was to review the outcomes after preoperative radiotherapy and definitive surgery for patients who initially had inadvertent excision for sarcoma. Materials and Methods: Treatment records of 44 consecutive patients, who initially underwent unplanned excision of soft-tissue sarcoma between January 2004 and January 2012, were reviewed. All patients had clinically localized disease before treatment and received preoperative external-beam radiotherapy followed by definitive oncologic surgery at our institution. Results: The median follow-up was 36 months. Residual tumor after preoperative radiotherapy and wound bed excision was identified in 39% (17/44) of the cases. Kaplan-Meier estimates for 5-year local control, recurrence-free survival, and overall survival are 95% (95% confidence interval [CI], 80-99), 86% (95% CI, 69-94), and 94% (95% CI, 79-99) respectively. Perioperative morbidity occurred in 25% of patients (11/44.) All patients with perioperative wound complications had lower extremity sarcomas. Conclusions: Optimal management for unplanned excision of soft-tissue sarcoma is unknown. Our institution has adopted the approach of preoperative radiotherapy, followed by definitive surgery. In our series of 44 patients, local control was excellent at 95%, with perioperative complications seen only in patients with lower extremity sarcomas, suggesting that this is a reasonable approach to manage inadvertently resected sarcoma.

AB - Background and Objectives: The purpose of this study was to review the outcomes after preoperative radiotherapy and definitive surgery for patients who initially had inadvertent excision for sarcoma. Materials and Methods: Treatment records of 44 consecutive patients, who initially underwent unplanned excision of soft-tissue sarcoma between January 2004 and January 2012, were reviewed. All patients had clinically localized disease before treatment and received preoperative external-beam radiotherapy followed by definitive oncologic surgery at our institution. Results: The median follow-up was 36 months. Residual tumor after preoperative radiotherapy and wound bed excision was identified in 39% (17/44) of the cases. Kaplan-Meier estimates for 5-year local control, recurrence-free survival, and overall survival are 95% (95% confidence interval [CI], 80-99), 86% (95% CI, 69-94), and 94% (95% CI, 79-99) respectively. Perioperative morbidity occurred in 25% of patients (11/44.) All patients with perioperative wound complications had lower extremity sarcomas. Conclusions: Optimal management for unplanned excision of soft-tissue sarcoma is unknown. Our institution has adopted the approach of preoperative radiotherapy, followed by definitive surgery. In our series of 44 patients, local control was excellent at 95%, with perioperative complications seen only in patients with lower extremity sarcomas, suggesting that this is a reasonable approach to manage inadvertently resected sarcoma.

KW - preoperative radiotherapy

KW - sarcoma

KW - unplanned excision

UR - http://www.scopus.com/inward/record.url?scp=84901385005&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901385005&partnerID=8YFLogxK

U2 - 10.1097/COC.0000000000000095

DO - 10.1097/COC.0000000000000095

M3 - Article

C2 - 24879470

AN - SCOPUS:84901385005

VL - 39

SP - 586

EP - 592

JO - American Journal of Clinical Oncology

JF - American Journal of Clinical Oncology

SN - 0277-3732

IS - 6

ER -