Posters— Surgical Treatment of Sarcomas

UNPLANNED EXCISION FOR SOFT TISSUE SARCOMA: IDENTIFICATION OF A SUBGROUP WITH BAD PROGNOSIS

van Geel AN*, Eggermont AMM*, Schmitz PIM*. * Dept. of surgical oncology and statistics, University Hospital Rotterdam / Daniel den Hoed Cancer Center, Rotterdam, The Netherlands

Introduction: Unplanned Excision (U.E.) for Soft Tissue Sarcoma (STS) is a frequent procedure. Unclear is the influence on prognosis.

Material and Methodes: From 1986–1993 86 pts (32.7% of all referred pts) were treated after U.E. of STS elsewhere (subfascial; limbs, girdles and trunk, > 5 CMS). All pts had CT or MRI before definitive treatment; minimal follow-up was 5 years.

Results: 31 Pts (36.1%) had complications (hematoma) after U.E. In 46 pts (53.5%) residual tumor was seen on CT/MRI and found at pathological examination in 66 pts (76.7%). In half of the pts definitive treatment was considered to be more complex, resulting in increased morbidity. Survival Overall Loc. rec. free Dist. rec. free 2 years 86.0 85.8 84.6 5 years 74.3 72.1 70.6

Conclusion: After multivariate analysis a group of pts (35 pts = 40%) with a significant bad prognosis was found: elder than 60 years with a second treatment with increased complexity and morbidity independent of this treatment is radical or not. This group can be considered as a high risk group eligible for adjuvant chemo therapy trials.