SP29
The Significance Of OOPS Lesions
Professor Peter F.M. Choong MBBS MD FRACS FAOrthA
University of Melbourne Department of Surgery, St. Vincent’s Hospital
Department of Orthopaedis, St. Vincent’s Hospital Melbourne
Bone and Soft Tissue Sarcoma Service Peter MacCallum Cancer Centre
pchoong@unime.b.edu.au
Unintended excision of soft tissue sarcomas (STSs) outside expert tumor centers is
common. Often these require wide re-excision to achieve adequate oncologic
margins. This is a retrospective review of 463 consecutive patients with soft tissue
sarcoma who presented to our centre comparing unintended versus planned
excision with the goal of assessing the factors that controlled local recurrence (LR)
and metastasis rate (MR). Two hundered and ninety two patients had their first-time
surgery at our institution, and 171 patients were referred after excision. Mean age of
all patients was 55 years and male gender were more common (254 vs 209).
Tumour size was smaller and location more superficial in those excised outside a
tumour centre. Foot and groin lesions were more commonly excised outside a
centre. Positive margins were more common in lesions excised outside a centre
(102/171 vs 7/292). Despite smaller and more superficial tumours, complication of
non-centre treatment was associated with similar amputation rates as centre
treatment. More patients developed metastases (18/171 vs 16/292) and died of
disease (53/171 vs 66/292) if treated outside a tumour centre. Quality of margins
was associated with local recurrence. Quality of surgical margins was less when
treated outside a tumour centre. The risk of death from disease was 3 times more
common in patients treated outside a tumour centre. Unintended excision of STS
has poorer outcome than planned excision. Therefore, patients with soft tissue
masses should be managed by multidisciplinary team approach at specialized
cancer centers.