Clinical Problems After Initial Unplanned Resection of Sarcoma

Objective Unplanned resection of a sarcoma is often chosen in the early phase by general physicians without any imaging scrutiny. The present study aimed to highlight the clinical problems associated with unplanned resection of sarcomas. Methods Thirty-eight patients who underwent unplanned resectio...

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Bibliographic Details
Published in:Japanese journal of clinical oncology 2008-10, Vol.38 (10), p.701-709
Main Authors: Hoshi, Manabu, Ieguchi, Makoto, Takami, Masatsugu, Aono, Masanari, Taguchi, Susumu, Kuroda, Takaaki, Takaoka, Kunio
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Female
Follow-Up Studies
Hematoma - etiology
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Postoperative Complications
Prognosis
sarcoma
Sarcoma - pathology
Sarcoma - surgery
Soft Tissue Neoplasms - pathology
Soft Tissue Neoplasms - surgery
surgery
Tomography, X-Ray Computed
unplanned resection
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Summary:Objective Unplanned resection of a sarcoma is often chosen in the early phase by general physicians without any imaging scrutiny. The present study aimed to highlight the clinical problems associated with unplanned resection of sarcomas. Methods Thirty-eight patients who underwent unplanned resection of a sarcoma and additional treatment were examined. The definite histological grading was high in 31 patients and low in 7 patients. Results The tumors were located in the depth of the subfascia in 13 patients. The maximal tumor sizes exceeded 5 cm in 16 patients. Preoperative MRI was only performed in six patients. The previous surgical margins were intralesional in 20 patients and marginal in 18 patients. Inappropriate transverse skin incisions were found in 21 patients. Extensive hematoma at the initial surgical site was seen in five patients. Thirty-three patients accepted additional wide resection due to the insufficient removal of malignancy. During an average follow-up of 42.7 months, seven patients died of lung and brain metastases. Conclusions On excision of any soft tissue tumor, surgeons should be aware of the potential risk for erroneous management of malignancy. If not, careless surgery may render the treatment protocol complicated and require excessive additional tissue resection with poor function and prognosis. Appropriate salvage treatment may have a significant role to play after unplanned resection of the sarcoma.
ISSN:0368-2811
1465-3621
DOI:10.1093/jjco/hyn093