Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 May 14:25:244-251.
doi: 10.1016/j.jor.2021.05.022. eCollection 2021 May-Jun.

Re-excision after unplanned excision of soft tissue sarcoma: A systematic review and metanalysis. The rationale of systematic re-excision

Federico Sacchetti  1 , Andac Celasun Alsina  2 , Riccardo Morganti  3 , Matteo Innocenti  4 , Lorenzo Andreani  1 , Francesco Muratori  4 , Guido Scoccianti  4 , Francesca Totti  4 , Domenico Andrea Campanacci  4 , Rodolfo Capanna  1
Affiliations
Review

Re-excision after unplanned excision of soft tissue sarcoma: A systematic review and metanalysis. The rationale of systematic re-excision

Federico Sacchetti et al. J Orthop. .

Abstract

In Soft Tissue Sarcomas (STS) referral centre many patients have already had an incomplete tumour resection. In the majority of specimen, tumoral residual is detected and linked to a worsen prognosis. Systematic surgical re-resection of the scar tissue area is often performed. Some authors suggested to postpone re-resections until a clinically evident local recurrence is detected. A searching strategy was applied to Pubmed-Central and Ovid Medline. Odds ratio (OR) for local recurrence (LR), distant metastasis (MTS) or overall survival (OS) were calculated comparing patients who had tumour residual to people who hadn't. OR of local recurrences, distant metastasis and OS were calculated in planned vs unplanned-excisions groups. OR to develop a metastasis and OS after a local recurrences were calculated. Residual tumour led to an OR for LR of 3,56, OR of MTS was 3,42; OR of decreased OS was 3,42. Having a LR lead to a OR of 1,55 for MTS and to a OR of decreased OS of 2,32. Patients who underwent a re-excision compared to planned surgery did not have an increased OR of LR and had an OR to develop a MTS of 0,56. Our data confirm that there is a strong correlation between local recurrences, distant relapses and overall survival. Although there is a selection bias; this analysis highlights the optimal oncological outcome in patients who underwent re-resection. The rationale for systematic re-resection after unplanned excision of soft tissue sarcomas is very strong and this treatment remains the gold standard of care in these patients.

Keywords: Re-Excisions; Re-resections; Sarcomas; Unplanned excision.

PubMed Disclaimer

Conflict of interest statement

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Figures

Fig. 1
Fig. 1
(a, b, c). Literature Search Strategy.Search flow diagram. Studies included in Metanalysis.
Fig. 1
Fig. 1
(a, b, c). Literature Search Strategy.Search flow diagram. Studies included in Metanalysis.
Fig. 1
Fig. 1
(a, b, c). Literature Search Strategy.Search flow diagram. Studies included in Metanalysis.
Fig. 2
Fig. 2
Forest plot of 5 years local recurrence free survival of re-excision and planned excision groups.
Fig. 3
Fig. 3
Forest plot of 5 years metastasis free survival of re-excision and planned excision groups.
Fig. 4
Fig. 4
Forest plot of metastasis free survival of patients who had local recurrence and who did not have any local recurrence.
Fig. 5
Fig. 5
Forest plot of overall survival of patients who had local recurrence and who did not have any local recurrence.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Tedesco N.S., Henshaw R.M. Unplanned resection of sarcoma. J Am Acad Orthop Surg. 2016;24(3):150–159. doi: 10.5435/JAAOS-D-15-00074. - DOI - PubMed
    1. Corey R.M., Swett K., Ward W.G. Epidemiology and survivorship of soft tissue sarcomas in adults: a national cancer database report. Cancer Med. 2014;3(5):1404–1415. doi: 10.1002/cam4.288. - DOI - PMC - PubMed
    1. Mehren M Von, Randall R.L., Benjamin R.S. Soft tissue sarcoma, version 2.2018: clinical practice guidelines in oncology. JNCCN J Natl Compr Cancer Netw. 2018;16(5):536–563. doi: 10.6004/jnccn.2018.0025. - DOI - PubMed
    1. Eilber F.C., Brennan M.F., Riedel E., Alektiar K.M., Antonescu C.R., Singer S. Prognostic factors for survival in patients with locally recurrent extremity soft tissue sarcomas. Ann Surg Oncol. 2005;12(3):228–236. doi: 10.1245/ASO.2005.03.045. - DOI - PubMed
    1. Giuliano A.E., Eilber F.R. The rationale for planned reoperation after unplanned total excision of soft-tissue sarcomas. J Clin Oncol. 1985;3(10):1344–1348. doi: 10.1200/JCO.1985.3.10.1344. - DOI - PubMed

LinkOut - more resources