Resumen
The quality of resection after unplanned excision of soft tissue sarcoma (STS) performed outside of a reference center or at second resection potentially impacts local and metastatic recurrence and survival. The French cohort NETSARC prospectively collected data from patients with unplanned excision outside reference centers from 2010 to 2019 and reported survival in patients reexcised (RE) or not (No-RE). Patients who would most benefit from RE need to be identified. A total of 2371 patients had unplanned excision for STS outside reference centers, including 1692 patients with no multidisciplinary board review (RE: 913; No-RE: 779). Discrepancies in RE/No-RE subgroups were observed regarding age, tumor site, size, depth, grade and histotype. R0 final resection associated with better MFS; R1 initial resection showed better MFS than R0 initial resection. The study identified RE as an independent favorable factor for MFS (HR 0.7, 95% CI 0.53?0.93; p = 0.013). All subgroups except patients > 70 years, and patients with large tumors (>10 cm) showed better MFS with RE. RE in patients with STS of limb or trunk after macroscopic complete resection out of NETSARC reference center, and also in R0 resections to improve LRFS and MFS. Systematic RE should not be advocated for patients = 70 years, or tumor size = 10 cm.