ArticleInternational orthopaedics2025
Unplanned resections in extremity soft tissue sarcomas: higher local recurrence, more complications and less chance of limb preservation.
Article in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare, in two groups of patients, the prognosis of unplanned resections of soft tissue sarcomas treated in a specialised centre, in terms of survival, local recurrence and complications.
methodsA retrospective investigation was performed between 2006-2016. A total of 191 patients were included. 147 (77%) were included in the control group (planned reactions) and 44 (23%) corresponded to the study group (unplanned resection). The control group, patients underwent primary limb salvage surgery by the orthopaedic oncology team and the study group those who were initially treated at another center and required a second oncologic surgery to achieve free margins. Overall survival, local recurrence, postoperative complications and prognostic factors were analyzed.
resultsOverall survival at five years was 67% (95% CI: 62-76%). Compared to both groups, there was no significant difference (p = 0.22). The risk of LR at five years was 19.1% (95% CI: 18.89-19.30) for the control group and 35.64% (95% CI: 34.56-36.11) for the control group. for the study group (p = 0.047). Postoperative complications were significantly higher in the study group, 45% versus 21% (p < 0.01). We found a greater number of small tumours in the unplanned resection group.
conclusionsUnplanned resection of extremity soft tissue sarcomas does not affect the overall survival of patients, but has a higher risk of local recurrence, a higher risk of developing postoperative complications and a lower chance of limb preservation. This study underscores the importance of thorough preoperative evaluation, particularly for small (< 5 cm) soft tissue tumours of the limb, and supports referral to specialised centres for optimal management.
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