Is Soft Tissue Density at the Margin of Abdominal Sarcomas Predictive of Recurrence After Tumor Resection

Adem Şentürk,1 Ahmet Tarik Harmantepe,2 Emre Gonullu,2 Alp Omer Canturk,3 Fuldem Mutlu,4 Onur Taydas4 1Sakarya University Training and Research Hospital, Department of Surgical Oncology, Sakarya, Turkey; 2Sakarya University Training and Research Hospital, Department of Gastroenterology Surgery, Sakarya, Turkey; 3Sakarya University Training and Research Hospital, Department of General Surgery, Sakarya, Turkey; 4Sakarya University Training and Research Hospital, Department of Radiology, Sakarya, TurkeyCorrespondence: Adem Şentürk, Sakarya University Training and Research Hospital, Sakarya, Turkey, Tel +905360290724, Email [email protected]: The prognostic value of negative surgical margins in soft tissue sarcomas in terms of disease course is well known. However, there is a lack of consensus in the literature regarding the impact of preoperative radiological surgical margins on recurrence rates and overall survival The aim of the present study was to determine whether soft tissue density at the margin of abdominal sarcomas using Hounsfield Unit (HU) measurement on CT is associated with recurrence after tumor resection.Material and Methods: Seventeen patients who underwent resectional surgery for abdominal sarcoma between May 2014 and May 2024 were retrospectively analyzed. Patients were compared with their preoperative CT scans for postoperative local recurrence according to soft tissue density at the margins of the sarcomas.Results: Of the 17 patients, nine (52.9%) had recurrence. No significant difference was found for gender in terms of recurrence (p> 0.05). As the median age decreases, recurrence increases significantly. (60 years (23– 70) vs 73 years (44– 79); p= 0.044). Increased preoperative tissue density (width 3 to 5 cm) at sarcoma margin measured by CT was significantly associated with recurrence after tumor resection (with at margin: 3cm; p=0.047, 4cm; p=0.019, 5 cm; p=0.018). The cut-of value of density measured by preoperative CT for soft tissue at sarcoma margin with recurrence was − 98.8 hounsfield Unit (HU), whereas cut-of value of density was − 109.6 hU with a 91.5% sensitivity, 58.9% specificity, 23.2% positive predictive value (PPV), 76.8% negative predictive value (NPV), and 0.83 accuracy, respectively.Conclusion: Study results suggest that the risk of recurrence after tumor resection can be predicted by measuring soft tissue density at the sarcoma margin on preoperative CT scans.There appears to be a linear relationship between increased preoperative soft tissue density at the sarcoma margin and recurrence after tumor resection. This measurement method offers a perspective that reveals a new approach to this subject. Multicenter studies consisted of larger patient populations are needed to reach a definitive conclusion.Keywords: soft tissue sarcoma, recurrence, computerized tomography, Hounsfield Unit