PROGNOSIS AFTER UNPLANNED EXCISION FOR STS

van Geel AN, Eggermont AMM, Schmitz PIM (MD University Hospital Rotterdam / Daniel de Hoed Cancer Center, Rotterdam, the Netherlands)

From 1986–1993 86 pts (32.7% of all refered pts) were treated in our hospital after some kind of excisional biopsy for STS elswhere. All pts had a subfascial STS, minimum size of 5 cms of the limbs, girdls or trunk. After referral all pts underwent after CT or MRI definitive radical treatment (including radiotherapy when indicated and chemotherapy _trial). Miminal follow-up was 5 years.

At first presentation 31 pts (36.1%) had complications (hematoma). In 46 pts (53.5%) at CT or MRI residual tumor was seen and found at pathological examiniation in 66 pts (76.7%). In half of the patients definitive treatment was considered to be more complex, resulting in increased morbidity.

In multivariate analysis 4 prognostic factors were identified: age (60 years), complication after unplanned excision, radical treatment and morbidity. It is concluded that only 33/86 pts (26.6%) have a "good"prognosis after unplanned surgery for STS: these patients are younger than 60 years and a second radical treatment without increased morbidity.