NDLI: Overall survival in patients with re-excision of positive microscopic margins of limb and trunk wall soft tissue sarcoma operated outside of a reference center: a nationwide cohort analysis

Content Provider	Springer Nature : BioMed Central
Author	Gouin, Francois Stoeckle, Eberhard Honoré, Charles Ropars, Mickael Jafari, Mehrdad Mattei, Jean Camille Rochwerger, Alexandre Carrere, Sébastien Waast, Denis Ferron, Gwenaël Machiavello, Jean-Christophe Anract, Philippe Marchal, Frédéric Sirveaux, François Marco, Oren Guiramand, Jérôme Paquette, Brice Di Marco, Antonio Causeret, Sylvain Guilloit, Jean-Marc Soibinet, Pauline Tzanis, Dimitri Gimbergues, Pierre Fiorenza, Fabrice Dujardin, Franck Le Nail, Louis R. Ruzic, Jean-Christophe Chemin-Airiau, Claire Morelle, Magali Meeus, Pierre Karanian, Marie Le Loarer, François Vaz, Gualter Blay, Jean-Yves
Abstract	Background This French nationwide NETSARC exhaustive prospective cohort aims to explore the impact of systematic re-excision (RE) as adjuvant care on overall survival (OS), local recurrence free survival (LRFS), and local and distant control (RFS) in patients with soft tissue sarcoma (STS) with positive microscopic margins (R1) after initial resection performed outside of a reference center. Methods Eligible patients had experienced STS surgery outside a reference center from 2010 to 2017, and had R1 margins after initial surgery. Characteristics and treatment comparisons used chi-square for categorical variables and Kruskall-Wallis test for continuous data. Survival distributions were compared in patients reexcised (RE) or not (No-RE) using a log-rank test. A Cox proportional hazard model was used for subgroup analysis. Results A total of 1,284 patients had experienced initial STS surgery outside NETSARC with R1 margins, including 1,029 patients with second operation documented. Among the latter, 698 patients experienced re-excision, and 331 were not re-excised. Characteristics were significantly different regarding patient age, tumor site, tumor size, tumor depth, and histotype in the population of patients re-excised (RE) or not (No-RE). The study identified RE as an independent favorable factor for OS (HR 0.36, 95%CI 0.23–0.56, p<0.0001), for LRFS (HR 0.45, 95%CI 0.36–0.56, p<0.0001), and for RFS (HR 0.35, 95%CI 0.26–0.46, p<0.0001). Conclusion This large nationwide series shows that RE improved overall survival in patients with STS of extremities and trunk wall, with prior R1 resection performed outside of a reference center. RE as part of adjuvant care should be systematically considered. Level of evidence II
Related Links	https://bmccancer.biomedcentral.com/counter/pdf/10.1186/s12885-022-10121-5.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	14712407
DOI	10.1186/s12885-022-10121-5
Journal	BMC Cancer
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2022-10-03
Access Restriction	Open
Subject Keyword	Cancer Research Oncology Surgical Oncology Health Promotion and Disease Prevention Biomedicine Medicine Public Health Soft tissue sarcoma Surgery Relapse Reference center Multidisciplinary tumor board resection margins Survival Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology Genetics
Journal Impact Factor	3.4/2023
5-Year Journal Impact Factor	3.8/2023

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