Does Unplanned Excision of Soft Tissue Sarcomas Affect the Oncological Outcome: A Retrospective Study.

Objectives: Soft tissue sarcoma is commonly misdiagnosed as a benign tumor and excised without appropriate precautions mandatory to deal with malignancy. Referrals after inadequate initial excision account for 19-35% of new patients in sarcoma centers. The objective of this study was to assess the oncological outcome of inappropriately treated soft tissue sarcomas in a retrospective, single-center analysis. Methods: This study included 43 patients who had soft tissue sarcomas in the extremities and were inadequately treated. They were referred to Cairo University Hospitals, Egypt and managed from November 1999 to April 2017. The minimum follow-up period was 1 year after adequate resection. The oncological outcome was assessed regarding the incidence of local recurrence, chest metastasis as well as the overall survivorship. Results: This study included 23 males and 20 females. 19 patients developed local recurrence (44.2%). 17 patients developed chest metastasis (39.5%). The incidence of local recurrence and chest metastasis was significantly affected by the type of the margin. Regarding the overall survival, 14 patients (32.6%) died during the follow up, while 29 patients (67.4%) were still alive by the end of the study. Conclusion: In our study, oncological outcome was significantly affected only by the margin status. Chest metastasis affected overall survival dramatically. Although it is challenging to achieve resection with wide margin, it is mandatory to get good oncological outcome.