Radiation Therapy Before Repeat Wide Resection for Unplanned Surgery of Soft Tissue Sarcoma (“Oops” Operation) Results in Improved Disease-Free Survival
Purpose: The main goal of treatment of soft-tissue sarcomas is achieving wide negative margins to improve local control and prevent recurrence. The role of radiation therapy (RT) is well established in sarcomas of the extremities; however, its role in unplanned surgery of soft-tissue sarcoma (when a...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-11-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109422001130 |
| _version_ | 1818516388853055488 |
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| author | Roni Kollender, BScMed Ofer Merimsky, MD Amir Sternheim, MD Yair Gortzak, MD Solomon Dadia, MD Alon Doron, BScMed Ilya Novikov, PhD Yehuda Kollender, MD Viacheslav Soyfer, MD |
| author_facet | Roni Kollender, BScMed Ofer Merimsky, MD Amir Sternheim, MD Yair Gortzak, MD Solomon Dadia, MD Alon Doron, BScMed Ilya Novikov, PhD Yehuda Kollender, MD Viacheslav Soyfer, MD |
| author_sort | Roni Kollender, BScMed |
| collection | DOAJ |
| description | Purpose: The main goal of treatment of soft-tissue sarcomas is achieving wide negative margins to improve local control and prevent recurrence. The role of radiation therapy (RT) is well established in sarcomas of the extremities; however, its role in unplanned surgery of soft-tissue sarcoma (when a mass presumed to be benign is resected and the pathology comes back as sarcoma, usually referred to as an “oops” operation) is inconclusive. This article reports on the effect of RT after an unplanned surgery before the reresection. Methods and Materials: A total of 65 patients who had undergone an unplanned resection of a postoperatively diagnosed soft-tissue sarcoma were treated with RT and/or surgery and retrospectively evaluated for disease progression. Treatment started with RT in 49 cases (75.4%), including 8 cases of no further surgery. A repeat wide resection was performed directly after the initial surgery in 16 patients, followed by RT in 15 of them. Results: The disease recurred in 7 out of 49 patients (14.3%) who received RT first and in 9 out of 16 (56.25%) who underwent reoperation before RT (P = .001). Disease-free progression was higher in cases of low-grade malignancy (P = .049). A clinical diagnosis of lipoma was associated with a better outcome than a diagnosis of nonlipoma (P = .034). The presence of residual tumor at reoperation did not affect disease control. Patient age, time between symptom onset and diagnosis, hospital level of initial diagnosis (tertiary versus nontertiary), anatomic site, tumor size, and margin status at the initial excisional biopsy were not significantly correlated with the outcome. Conclusion: Initiating treatment with RT followed by unplanned “oops” resection of soft-tissue sarcoma before the reresection improved disease-free survival as opposed to vice versa. |
| first_indexed | 2024-12-11T00:41:29Z |
| format | Article |
| id | doaj.art-bf6fc19e631642a480473bb2e4956c5b |
| institution | Directory Open Access Journal |
| issn | 2452-1094 |
| language | English |
| last_indexed | 2024-12-11T00:41:29Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj.art-bf6fc19e631642a480473bb2e4956c5b2022-12-22T01:26:54ZengElsevierAdvances in Radiation Oncology2452-10942022-11-0176101007Radiation Therapy Before Repeat Wide Resection for Unplanned Surgery of Soft Tissue Sarcoma (“Oops” Operation) Results in Improved Disease-Free SurvivalRoni Kollender, BScMed0Ofer Merimsky, MD1Amir Sternheim, MD2Yair Gortzak, MD3Solomon Dadia, MD4Alon Doron, BScMed5Ilya Novikov, PhD6Yehuda Kollender, MD7Viacheslav Soyfer, MD8Department of Radiology and The Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Radiology and The Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Radiology and The Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Radiology and The Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Radiology and The Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Radiology and The Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Radiology and The Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Radiology and The Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelCorresponding author: Viacheslav Soyfer, MD; Department of Radiology and The Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelPurpose: The main goal of treatment of soft-tissue sarcomas is achieving wide negative margins to improve local control and prevent recurrence. The role of radiation therapy (RT) is well established in sarcomas of the extremities; however, its role in unplanned surgery of soft-tissue sarcoma (when a mass presumed to be benign is resected and the pathology comes back as sarcoma, usually referred to as an “oops” operation) is inconclusive. This article reports on the effect of RT after an unplanned surgery before the reresection. Methods and Materials: A total of 65 patients who had undergone an unplanned resection of a postoperatively diagnosed soft-tissue sarcoma were treated with RT and/or surgery and retrospectively evaluated for disease progression. Treatment started with RT in 49 cases (75.4%), including 8 cases of no further surgery. A repeat wide resection was performed directly after the initial surgery in 16 patients, followed by RT in 15 of them. Results: The disease recurred in 7 out of 49 patients (14.3%) who received RT first and in 9 out of 16 (56.25%) who underwent reoperation before RT (P = .001). Disease-free progression was higher in cases of low-grade malignancy (P = .049). A clinical diagnosis of lipoma was associated with a better outcome than a diagnosis of nonlipoma (P = .034). The presence of residual tumor at reoperation did not affect disease control. Patient age, time between symptom onset and diagnosis, hospital level of initial diagnosis (tertiary versus nontertiary), anatomic site, tumor size, and margin status at the initial excisional biopsy were not significantly correlated with the outcome. Conclusion: Initiating treatment with RT followed by unplanned “oops” resection of soft-tissue sarcoma before the reresection improved disease-free survival as opposed to vice versa.http://www.sciencedirect.com/science/article/pii/S2452109422001130 |
| spellingShingle | Roni Kollender, BScMed Ofer Merimsky, MD Amir Sternheim, MD Yair Gortzak, MD Solomon Dadia, MD Alon Doron, BScMed Ilya Novikov, PhD Yehuda Kollender, MD Viacheslav Soyfer, MD Radiation Therapy Before Repeat Wide Resection for Unplanned Surgery of Soft Tissue Sarcoma (“Oops” Operation) Results in Improved Disease-Free Survival Advances in Radiation Oncology |
| title | Radiation Therapy Before Repeat Wide Resection for Unplanned Surgery of Soft Tissue Sarcoma (“Oops” Operation) Results in Improved Disease-Free Survival |
| title_full | Radiation Therapy Before Repeat Wide Resection for Unplanned Surgery of Soft Tissue Sarcoma (“Oops” Operation) Results in Improved Disease-Free Survival |
| title_fullStr | Radiation Therapy Before Repeat Wide Resection for Unplanned Surgery of Soft Tissue Sarcoma (“Oops” Operation) Results in Improved Disease-Free Survival |
| title_full_unstemmed | Radiation Therapy Before Repeat Wide Resection for Unplanned Surgery of Soft Tissue Sarcoma (“Oops” Operation) Results in Improved Disease-Free Survival |
| title_short | Radiation Therapy Before Repeat Wide Resection for Unplanned Surgery of Soft Tissue Sarcoma (“Oops” Operation) Results in Improved Disease-Free Survival |
| title_sort | radiation therapy before repeat wide resection for unplanned surgery of soft tissue sarcoma oops operation results in improved disease free survival |
| url | http://www.sciencedirect.com/science/article/pii/S2452109422001130 |
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