Titre du document / Document title
Soft tissue sarcomas of the groin : Diagnosis, management, and prognosis
Auteur(s) / Author(s)
BROOKS Ari D. (1) ;
BOWNE Wilbur B. (1) ;
DELGADO Ruby (2) ;
LEUNG Denis H. Y. (3) ;
WOODRUFF James (2) ;
LEWIS Jonathan J. (1) ;
BRENNAN Murray F. (1) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, ETATS-UNIS
(2) Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, ETATS-UNIS
(3) Department of Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, ETATS-UNIS
Résumé / Abstract
BACKGROUND: Soft tissue sarcomas (STS) of the groin may present a difficult problem because of misdiagnosis as groin hernia and proximity to major neurovascular structures. We evaluated our management and survival in a large cohort of patients. STUDY DESIGN: Patients treated between July 1, 1982 and July 1, 1998 with primary or recurrent STS of the groin were included. Groin sarcomas were defined as those tumors within 5 cm of the inguinal crease. Patient, tumor, clinical, and survival data were analyzed using a log rank test and Cox regression. RESULTS: We treated and followed 88 patients with STS of the groin. The median age was 52 years (range 16 to 86 years) and 55 patients (63%) were male. Disease-specific survival was 72% at 5 years. Tumors tended to be larger than 5 cm (52%), deep (72%), and high-grade (60%). Unfavorable prognostic factors for disease-specific survival were high grade (p < 0.001), neurovascular invasion (p < 0.001), positive margin (p < 0.01), deep depth (p < 0.01), and selection for adjuvant therapy (p < 0.005). Multivariate analysis indicated age greater than 50 years (p < 0.05), high grade (p < 0.001), neurovascular invasion (p < 0.001), and positive microscopic margins (p < 0.001). Fourteen patients (16%) were diagnosed with STS at hernia operation then went on to a definitive operation with no impact on survival. Seventeen patients (19%) had involvement of a major vessel or nerve, and 5 of these ultimately required amputations, 3 for local recurrence. CONCLUSIONS: High grade, neurovascular invasion, and positive microscopic margins are associated with poor outcomes. The biology of these tumors is similar to other extremity STS, and similar principles of management apply. Even with neurovascular involvement, most patients with primary groin STS do not require amputation.
Revue / Journal Title
Journal of the American College of Surgeons
ISSN
1072-7515
Source / Source
2001, vol. 193, n
o2, pp. 130-136 (19 ref.)
Langue / Language
Anglais
Editeur / Publisher
Elsevier, New York, NY, ETATS-UNIS
(1994)
(Revue)
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Localisation / Location
INIST-CNRS, Cote INIST : 6004, 35400009906026.0030
Nº notice refdoc (ud4) : 1103149
