Outcomes of re-excision after unplanned excisions of soft-tissue sarcomas

Background and Objectives Unplanned excisions of soft‐tissue sarcomas of the extremities occur commonly. Our goal was to evaluate the presence of residual disease, the treatment outcomes as they relate to local and distant recurrence and 5‐year survival, and the limb functional outcomes in patients with unplanned sarcoma excision who were treated with re‐excision and adjuvant therapy. Methods Between 1993 and 1999, 42 patients presented to our institution after unplanned excision of soft‐tissue sarcomas. Of those 42 patients, 38 without gross residual disease or metastatic lesions formed the basis of this review. All 38 patients underwent revision wide excision; most (31) also received adjuvant therapy (radiation and/or chemotherapy). Clinical data were obtained from analysis of patient records and radiographic studies. Univariate analysis was performed with logistical regression, and multivariate analysis was performed with Cox modeling. Results The overall 5‐year survival rate was 91.3% and the disease‐free 5‐year survival rate was 82.2%. Univariate analysis showed that stage‐III disease (American Joint Committee on Cancer classification of soft‐tissue sarcomas), lesions below the fascia, a histologic high‐grade, and the development of organ metastasis were statistically significant factors for mortality. Stage‐III disease also was significant for mortality on multivariate analysis. Only stage‐III disease was significant for the development of local recurrence. Eighty‐four percent of the patients had good to excellent functional outcomes. Conclusions Re‐excision with adjuvant therapy proved to be a safe and effective method for treating the disease and preserving limb function. J. Surg. Oncol. 2005;91:153–158. © 2005 Wiley‐Liss, Inc.