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Nonmetastatic Nonrhabdomyosarcoma Soft Tissue Sarcoma
With Dr. Todd Ponsky · hosted by Dr. Todd Ponsky
Cued at 3:26 · stops at 3:41 · press play
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Since there is no outcome difference between planned and unplanned excision, it may be acceptable with low index of suspicion to excise the lesion and perform re-excision if it returns as non-rhabdomyosarcoma.
Re-excision can have high morbidity because it may require taking significantly more tissue.
The study compared outcomes between patients who had unplanned excision of lesions later found to be non-rhabdomyosarcoma followed by re-excision versus patients who had planned workup and excision.
40 patients were referred after having an innocuous lesion removed that came back as non-rhabdomyosarcoma.
5 of the 40 referred patients were deemed impossible to re-excise based on location or other reasons, leaving 35 patients for re-excision.
44 patients had planned excision at the study institution after workup with MRI or incisional biopsy or core biopsy.
23 of the 44 planned excision patients received neoadjuvant therapy, leaving 21 for comparison.
45.7% of patients who underwent re-excision had residual tumor found in the specimen.
There was no difference in disease relapse between planned and unplanned excision groups.
There was no difference in 5-year overall survival between planned and unplanned excision groups.
There was no difference in disease-free survival between planned and unplanned excision groups.
There was no difference in local control rates or local recurrence between planned and unplanned excision groups.
The study authors concluded that patients should have a higher index of suspicion and should be worked up more thoroughly.