Re-excision after unplanned excision of soft tissue sarcoma: A systematic review and metanalysis. The rationale of systematic re-excision.
Re-Excisions
Re-resections
Sarcomas
Unplanned excision
Journal
Journal of orthopaedics
ISSN: 0972-978X
Titre abrégé: J Orthop
Pays: India
ID NLM: 101233220
Informations de publication
Date de publication:
Historique:
received:
25
02
2021
accepted:
09
05
2021
entrez:
8
6
2021
pubmed:
9
6
2021
medline:
9
6
2021
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 34099954
doi: 10.1016/j.jor.2021.05.022
pii: S0972-978X(21)00130-6
pmc: PMC8165293
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
244-251Informations de copyright
© 2021 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
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.
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