Results of oncological re-resection of primary soft tissue sarcoma

Background: Soft tissue sarcomas (STS) are frequently resected incompletely or without an adequate margin. In such clinical situations an oncological re-resection (wide or compartmental resection or amputation) is recommended . Here, we evaluate the results of oncological re-resection for STS. Method s: Prospectively gathered data on 67 patients who underwent oncological re- resection after inadequate (intracapsular or marginal) surgery for primary soft tissue sarcomas were analyzed. Results: STS were located in the extrem ities (85 %) and trunk (15 %). Advanced UICC stages (1992, 4(th) edn., 2(nd ) Rev.), IIB-IIIB predominated (66 %). Twenty-five patients received intrao perative radiotherapy. Morbidity of re-resection was 28.4%. Residual tumor was detected in 64% of the specimens and clear margins were obtained in 60 patients (90 %). With a median follow-up of 57 months the overall local con trol in patients with tumor-free resection margins was 88% (UICC IA-IIA 100 %, IIB-IIIB 82%). Patients treated by adjuvant intraoperative radiotherapy for UICC stages IIB-IIIB with clear margins achieved 90% local control. The 5-year overall survival rate was 87% in patients with tumor-free resection margins. Conclusions: These findings support the strategy of oncological r e-resection after previously non-oncological surgery of STS and imply that re-resection is the prerequisite for any effective adjuvant therapy modalit y.