SLR - February 2012 - Nicholas L. Hugentobler
Reference: Nishimura A, Matsumine A, Asanuma K, Matsubara T, Nakamura T, Uchida A, Kato K, and Sudo A, World J Surg Oncol 9(1):160, 2011.
Scientific Literature Review
Reviewed by: Nicholas L. Hugentobler, DPM
Residency Program: Detroit Medical Center
Podiatric Relevance:
Malignant soft tissue tumors of the foot are extremely rare and thus can be prematurely excised without appropriate preoperative evaluation. This study compares adverse effects between unplanned and planned surgical excisions.
Methods:
This is a retrospective review of clinical records, radiographs, pathology reports, and pathological specimens of 14 consecutive patients with soft tissue sarcoma of the foot among 592 sarcomas from 1973 to 2009. The incidence and clinical outcomes after unplanned (UT, n=5) and planned (PT, n=9) surgical excisions of the foot were compared.
Results:
Synovial sarcoma was the most frequent diagnosis (n=4). The overall 5-year survival rate of the PT and UT groups were 65.6 percent and 60.0 percent, respectively, and the event-free survival rates were 63.5 percent and 40.0 percent, respectively. Event-free and overall survival rates did not significantly differ between the two groups. However, the tumors were significantly larger in the PT group than in the UT group.
Conclusions:
Although in this comparison, the UT group and the PT group did not differ statistically in regards to event-free and overall survival rates, the PT group contained significantly larger tumors. Larger tumors negatively affect the prognosis in patients with soft tissue sarcoma. It is concluded that unplanned resection lead to a relatively worse prognosis and a likelihood of recurrence despite additional resections. The recommendation is that soft tissue tumors of the foot only be excised after appropriate preoperative evaluation regardless of the size of the tumor.