{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T02:30:01Z","timestamp":1792549801306,"version":"4.5.0"},"reference-count":34,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T00:00:00Z","timestamp":1715472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: In soft tissue sarcomas, unplanned resections, or so-called Whoops procedures, do occur quite frequently, thus primarily owing to the abundant presence of benign lesions. Whether re-resection reduces local recurrence or improves overall survival remains a topic of ongoing debate. The principle objective of this study was to analyze the outcomes of patients with soft tissue sarcomas of the extremities or trunk wall after an incidental marginal resection by comparing re-resections to individuals who declined the procedure. Methods: A total of 185 patients who underwent unplanned resection were included. These patients were stratified into two groups: Group A (n = 156) underwent re-excision, while Group B (n = 29) was treated conservatively. Depending on the clinical scenario, radio- or chemotherapy was either administered in a neoadjuvant or an adjuvant setting. The presence of residual tumor and metastatic disease was documented. Clinical outcomes, specifically local recurrence (LR), local recurrence-free survival (LRFS) and overall survival (OS), were utilized for evaluation. Results: Group B exhibited significantly larger tumors (p &lt; 0.0001) and a higher mean age than Group A. Among the patients in Group A, 11 (5.9%) had contaminated resection margins (R1), and residual disease (RD) was observed in 93 (59.6%) of the resected specimens. In group B, 10 patients received adjuvant radiotherapy alone, 5 received chemotherapy alone, and 13 underwent a combined approach consisting of both radio- and chemotherapy. In Group A, 8% (n = 12) of the patients developed local recurrence (LR) during the observation period. Conversely, in Group B, this amount was 14% (n = 4) (n.s.). Of the 12 LR in Group A, 10 were found in the subgroup with residual disease. Overall survival and local recurrence-free survival were not significantly different between the groups. A total of 15% (n = 24) of the patients in Group A developed metastatic disease, while 10% (n = 3) in Group B developed metastatic disease (n.s.). Conclusions: Following the reresection of unplanned resected STS, there was no statistically significant difference observed in overall survival or LR compared to patients who did not undergo re-resection. However, within the subgroup of patients with residual disease in the re-resected specimen, the OS was compromised, and the LR rate was higher. Particularly for low-grade lesions, adopting a more conservative approach seems to be justified.<\/jats:p>","DOI":"10.3390\/cancers16101851","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T08:33:03Z","timestamp":1715589183000},"page":"1851","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Unplanned Resections of Soft Tissue Sarcomas\u2014Necessity of Re-Resection?"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2973-764X","authenticated-orcid":false,"given":"Julian","family":"Fromm","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Orthopaedic Oncology, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, D-81377 Munich, Germany"},{"name":"SarKUM, Center of Bone and Soft Tissue Tumors, LMU University Hospital, LMU Munich, D-81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Orthopaedic Oncology, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, D-81377 Munich, Germany"},{"name":"SarKUM, Center of Bone and Soft Tissue Tumors, LMU University Hospital, LMU Munich, D-81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Mentrup","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Orthopaedic Oncology, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, D-81377 Munich, Germany"},{"name":"SarKUM, Center of Bone and Soft Tissue Tumors, LMU University Hospital, LMU Munich, D-81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3708-8264","authenticated-orcid":false,"given":"Lars H.","family":"Lindner","sequence":"additional","affiliation":[{"name":"SarKUM, Center of Bone and Soft Tissue Tumors, LMU University Hospital, LMU Munich, D-81377 Munich, Germany"},{"name":"Department of Medicine III, LMU University Hospital, LMU Munich, D-81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Nachbichler","sequence":"additional","affiliation":[{"name":"SarKUM, Center of Bone and Soft Tissue Tumors, LMU University Hospital, LMU Munich, D-81377 Munich, Germany"},{"name":"Department of Radiation Oncology, LMU University Hospital, LMU Munich, D-81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris Michael","family":"Holzapfel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Orthopaedic Oncology, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, D-81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0964-8386","authenticated-orcid":false,"given":"Sophia Samira","family":"Goller","sequence":"additional","affiliation":[{"name":"SarKUM, Center of Bone and Soft Tissue Tumors, LMU University Hospital, LMU Munich, D-81377 Munich, Germany"},{"name":"Department of Radiology, LMU University Hospital, LMU Munich, D-81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1822-0197","authenticated-orcid":false,"given":"Thomas","family":"Kn\u00f6sel","sequence":"additional","affiliation":[{"name":"SarKUM, Center of Bone and Soft Tissue Tumors, LMU University Hospital, LMU Munich, D-81377 Munich, Germany"},{"name":"Institute of Pathology, LMU Munich, D-81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1347-1173","authenticated-orcid":false,"given":"Hans Roland","family":"D\u00fcrr","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Orthopaedic Oncology, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, D-81377 Munich, Germany"},{"name":"SarKUM, Center of Bone and Soft Tissue Tumors, LMU University Hospital, LMU Munich, D-81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,12]]},"reference":[{"key":"ref_1","unstructured":"Board, E. 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