Faculty Collaboration Database

Preoperative Radiation Therapy Followed by Reexcision May Improve Local Control and Progression-Free Survival in Unplanned Excisions of Soft Tissue Sarcomas of the Extremity and Chest-Wall. Int J Surg Oncol 2016;2016:5963167

Date

11/03/2016

Pubmed ID

27803813

Pubmed Central ID

PMC5075633

DOI

10.1155/2016/5963167

Scopus ID

2-s2.0-84993978494 (requires institutional sign-in at Scopus site)   22 Citations

Abstract

Background. The management for unplanned excision (UE) of soft tissue sarcomas (STS) has not been established. In this study, we compare outcomes of UE versus planned excision (PE) and determine an optimal treatment for UE in STS. Methods. From 2000 to 2014 a review was performed on all patients treated with localized STS. Clinical outcomes including local recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS) were evaluated using the Kaplan-Meier estimate. Univariate (UVA) and multivariate (MVA) analyses were performed to determine prognostic variables. For MVA, Cox proportional hazards model was used. Results. 245 patients were included in the analysis. 14% underwent UE. Median follow-up was 2.8 years. The LR rate was 8.6%. The LR rate in UE was 35% versus 4.2% in PE patients (p < 0.0001). 2-year PFS in UE versus PE patients was 4.2 years and 9.3 years, respectively (p = 0.08). Preoperative radiation (RT) (p = 0.01) and use of any RT for UE (p = 0.003) led to improved PFS. On MVA, preoperative RT (p = 0.04) and performance status (p = 0.01) led to improved PFS. Conclusions. UEs led to decreased LC and PFS versus PE in patients with STS. The use of preoperative RT followed by reexcision improved LC and PFS in patients who had UE of their STS.

Author List

Saeed H, King DM, Johnstone CA, Charlson JA, Hackbarth DA, Neilson JC, Bedi M

Authors

Manpreet Bedi MD, MS Professor in the Radiation Oncology department at Medical College of Wisconsin
John A. Charlson MD Associate Professor in the Medicine department at Medical College of Wisconsin
Candice A. Johnstone MD, MPH Professor in the Radiation Oncology department at Medical College of Wisconsin
David M. King MD Chair, Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
John C. Neilson MD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Chemotherapy, Adjuvant
Disease-Free Survival
Extremities
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local
Proportional Hazards Models
Radiotherapy, Adjuvant
Reoperation
Retrospective Studies
Sarcoma
Soft Tissue Neoplasms
Thoracic Wall
Treatment Outcome