Diagnostic Accuracy of Imaging Study and the Impact of Clinical Risk Factors on the Presence of Residual Tumor Following Unplanned Excision of Soft Tissue Sarcomas

Eunsun Oh; Sung Wook Seo; Jeonghwan Jeong

doi:10.4055/jkoa.2019.54.2.150

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Oh, Seo, and Jeong: Diagnostic Accuracy of Imaging Study and the Impact of Clinical Risk Factors on the Presence of Residual Tumor Following Unplanned Excision of Soft Tissue Sarcomas

Original Article

Journal of the Korean Orthopaedic Association 2019; 54(2): 150-156.

Published online: 30 April 2019

DOI: https://doi.org/10.4055/jkoa.2019.54.2.150

Diagnostic Accuracy of Imaging Study and the Impact of Clinical Risk Factors on the Presence of Residual Tumor Following Unplanned Excision of Soft Tissue Sarcomas

Eunsun Oh, M.D.^*, Sung Wook Seo, M.D.

, Jeonghwan Jeong, M.D.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

^*Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea.

Correspondence to: Sung Wook Seo, M.D. epartment of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. TEL: +82-2-3410-1229, FAX: +82-2-3410-0061, sungwseo@skku.edu

Received 10 April 2018 Revised 4 June 2018 Accepted 29 June 2018

The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study examined the diagnostic accuracy of an imaging study to find the factors that affect the presence of residual tumors after an unplanned excision of sarcomas.

Materials and Methods

Ninety-eight patients, who underwent a re-excision after unplanned surgery between January 2008 and December 2014, were enrolled in this study. Magnetic resonance imaging (MRI) was performed before reoperation in all patients. Positron emission tomography (PET)-computed tomography was performed on 54 patients. A wide re-excision and histology diagnosis were performed in all cases. The clinical variables were evaluated using univariate logistic regression and multivariate logistic regression.

Results

The presence of a deep-seated tumor increases the risk of remnant tumors (odds ratio: 3.21, p=0.02, 95% confidence interval: 1.25–8.30). The sensitivity for detecting residual tumors is high in MRI (sensitivity 0.79).

Conclusion

Deep-seated tumors have a significantly higher risk of remnant tumors. Because the negative predictive value of MRI and PET scans is very low, reoperation should be performed regardless of a negative result.

Keywords: sarcoma, soft tissue, unplanned excision, neoplasm, residual, re-excision

Figures and Tables

Table 1

Patient and Tumor Characteristics

Values are presented as median (range) or number (%). ^*International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3). N/A: not applicable.

Table 2

Univariate and Multivariate Logistic Regression of Clinical Risk Factors

OR, odds ratio; CI, confidence interval.

Table 3

Comparison of the Parameters between MRI and PET-CT

MRI, magnetic resonance interval; PET-CT, positron emission tomography-computed tomography; PPV, positive predictive value; PPV, negative predictive value.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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ORCID iDs: Sung Wook Seo
https://orcid.org/0000-0001-9048-0367
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