Clinical and radiologic features of soft tissue sarcoma in trunk and extremities that underwent unplanned excision

PLoS One. 2024 Dec 5;19(12):e0311300. doi: 10.1371/journal.pone.0311300. eCollection 2024.

Abstract

Background: To identify the clinical and imaging characteristics of soft tissue sarcomas (STS) of the trunk and extremities that undergo unplanned excision.

Methods: This retrospective study evaluated the data of patients with STS in the trunk or extremities between January 2008 and December 2021. Patients were divided into unplanned and planned excision groups based on their initial treatment. The distribution of histologic subtypes was analyzed, and the magnetic resonance imaging features were evaluated. Multivariable logistic regression was performed to identify variables independently associated with unplanned excision.

Results: A total of 305 patients (mean age±standard deviation, 51±16.4 years; 179 males) were analyzed. The most prevalent subtype in the unplanned excision group was myxofibrosarcoma (22.3%). The unplanned excision group had a significantly smaller tumor size (p < 0.001) and more frequent superficial (p < 0.001) locations. Lobulated shape and peritumoral abnormalities were present in 70.0% and 50.0% of the unplanned excision group, respectively. Tumor size (adjusted odds ratio [OR], 0.87 per 1 cm increase; 95% confidence interval [CI], 0.77-0.98; p = 0.025) and superficial location (adjusted OR, 3.48; 95% CI, 1.57-7.72; p = 0.002) were independently associated with unplanned excision.

Conclusion: Myxofibrosarcoma is associated with a high frequency of unplanned excision. A significant number of patients in the unplanned excision group demonstrated a lobulated shape and peritumoral abnormalities. Only small tumor size and superficial location were independently associated with unplanned STS excision.

MeSH terms

  • Adult
  • Aged
  • Extremities* / diagnostic imaging
  • Extremities* / pathology
  • Extremities* / surgery
  • Female
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sarcoma* / diagnostic imaging
  • Sarcoma* / pathology
  • Sarcoma* / surgery
  • Soft Tissue Neoplasms / diagnostic imaging
  • Soft Tissue Neoplasms / pathology
  • Soft Tissue Neoplasms / surgery
  • Torso* / diagnostic imaging
  • Torso* / pathology

Grants and funding

This research was supported by the [Bio&Medical Technology Development Program] of the National Research Foundation (NRF) funded by the Korean government (MSIT) (No. RS-2023-00222838) awarded to JHL. The funder did not play a role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.