Hanasilo Carlos E H, Casadei Marcelo S, Auletta Leandro, Amstalden Eliane M I, Matte Silvia R F, Etchebehere Mauricio
Faculdade de Ciências Médicas, Orthopedics, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Pathology, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Clinics (Sao Paulo). 2014 Sep;69(9):579-84. doi: 10.6061/clinics/2014(09)01.
Unplanned excision of soft tissue sarcomas is common because benign soft tissue lesions are very frequent. This study evaluated the impact of unplanned resections on overall survival, local recurrence and distant metastasis in patients with soft tissue sarcomas of the extremities.
In total, 52 patients who were diagnosed with soft tissue sarcomas between May 2001 and March 2011 were analyzed in a retrospective study. Of these patients, 29 (55.8%) had not undergone previous treatment and the remaining 23 (44.2%) patients had undergone prior resection of the tumor without oncological planning. All subsequent surgical procedures were performed at the same cancer referral center. The follow-up ranged from 6 to 122 months, with a mean of 39.89 months. Age, lesion size and depth, histological grade, surgical margins, overall survival, local and distant recurrence and adjuvant therapies were compared.
Residual disease was observed in 91.3% of the re-resected specimens in the unplanned excision group, which exhibited greater numbers of superficial lesions, low histological grades and contaminated surgical margins compared with the re-resected specimens in the planned excision group. No differences were observed in local recurrence and 5-year overall survival between the groups, but distant metastases were significantly associated with planned excision after adjustment for the variables.
There was no difference between patients undergoing unplanned excision and planned excision regarding local recurrence and overall survival. The planned excision group had a higher risk of distant metastasis, whereas there was a high rate of residual cancer in the unplanned excision group.
由于良性软组织病变非常常见，软组织肉瘤的非计划性切除很普遍。本研究评估了非计划性切除对肢体软组织肉瘤患者总生存、局部复发和远处转移的影响。
对2001年5月至2011年3月期间诊断为软组织肉瘤的52例患者进行回顾性研究。其中，29例（55.8%）此前未接受过治疗，其余23例（44.2%）患者此前接受过肿瘤切除但未进行肿瘤学规划。所有后续手术均在同一癌症转诊中心进行。随访时间为6至122个月，平均39.89个月。比较了年龄、病变大小和深度、组织学分级、手术切缘、总生存、局部和远处复发以及辅助治疗情况。
非计划性切除组再次切除标本中91.3%观察到残留病灶，与计划性切除组再次切除标本相比，该组浅表病变数量更多、组织学分级低且手术切缘受污染。两组间局部复发和5年总生存未见差异，但在对变量进行校正后，远处转移与计划性切除显著相关。
非计划性切除和计划性切除的患者在局部复发和总生存方面无差异。计划性切除组远处转移风险较高，而非计划性切除组残留癌发生率较高。
