Soft tissue sarcomas of the groin: Diagnosis, management, and prognosis Journal Article

Authors: Brooks, A. D.; Bowne, W. B.; Delgado, R.; Leung, D. H. Y.; Woodruff, J.; Lewis, J. J.; Brennan, M. F.
Article Title: Soft tissue sarcomas of the groin: Diagnosis, management, and prognosis
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. © 2001 by the American College of Surgeons.
Keywords: adolescent; adult; cancer survival; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; major clinical study; cancer recurrence; chemotherapy, adjuvant; radiotherapy, adjuvant; neoplasm staging; diagnosis, differential; proportional hazards models; sarcoma; cancer invasion; amputation; soft tissue sarcoma; diagnostic error; hernia, inguinal; inguinal region; groin; humans; prognosis; human; male; female; priority journal; article
Journal Title: Journal of the American College of Surgeons
Volume: 193
Issue: 2
ISSN: 1072-7515
Publisher: Elsevier Science, Inc.  
Date Published: 2001-08-01
Start Page: 130
End Page: 136
Language: English
DOI: 10.1016/s1072-7515(01)00982-6
PUBMED: 11491442
PROVIDER: scopus
Notes: Export Date: 21 May 2015 -- Source: Scopus
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MSK Authors
  1. Murray F Brennan
    782 Brennan
  2. Jonathan J Lewis
    107 Lewis
  3. Ruby Delgado
    26 Delgado
  4. Denis Heng Yan Leung
    114 Leung
  5. Ari D Brooks
    25 Brooks
  6. Wilbur B Bowne
    20 Bowne
  7. James M Woodruff
    138 Woodruff