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Adult Soft Tissue Sarcoma Local Recurrence After Adjuvant Treatment Without Resection of Core Needle Biopsy Tract

  • Symposium: Highlights from the First Combined 2011 Meeting of the Musculoskeletal Tumor Society and Connective Tissue Oncology Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Core needle biopsies of sarcomas allow a diagnosis in a high percentage of patients with few complications. However, it is unclear whether the tract needs to be excised to prevent recurrences.

Questions/purposes

We therefore determined the rates of recurrence and metastases in patients with Stage III extremity sarcomas, who underwent wide local resection without excision of the needle tract and also received adjuvant treatment.

Methods

We retrospectively reviewed 59 adult patients with deep, larger than 5 cm, high-grade soft tissue sarcomas of the upper or lower extremity treated between January 1999 and April 2009. All the patients underwent a core needle biopsy. Resection was performed with wide margins. The biopsy tract was not resected during the definitive surgery. Fifty-seven patients (97%) received preoperative and/or postoperative radiation, whereas 49 patients (83%) received chemotherapy. Local recurrence and distant recurrence rates were determined. The minimum followup was 24 months (median, 56 months; range, 24–122 months).

Results

The local recurrence rate was 9%. Fifteen patients (25%) developed metastasis after diagnosis. Seven of the 59 patients (12%) had microscopic positive margins at resection.

Conclusions

Our data demonstrate no increase in local recurrence rates or rates of metastatic disease compared with previously published studies when resection of the core biopsy tract was not performed.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. H. Lee Moffitt Cancer Center & Research Institute, Sarcoma Program, 12902 Magnolia Drive, Tampa, FL, 33612, USA

    Odion Binitie MD, Shawn Tejiram MD, David Cheong MD & G. Douglas Letson MD

  2. Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA

    Sheila Conway MD & H. Thomas Temple MD

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  1. Odion Binitie MD
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  2. Shawn Tejiram MD
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  3. Sheila Conway MD
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  4. David Cheong MD
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  5. H. Thomas Temple MD
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  6. G. Douglas Letson MD
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Correspondence to Odion Binitie MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA, and the Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA.

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Binitie, O., Tejiram, S., Conway, S. et al. Adult Soft Tissue Sarcoma Local Recurrence After Adjuvant Treatment Without Resection of Core Needle Biopsy Tract. Clin Orthop Relat Res 471, 891–898 (2013). https://doi.org/10.1007/s11999-012-2569-z

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