High Risk of Early Local Recurrence After Unplanned Excision of Soft Tissue Sarcoma in Patients Followed Without Immediate Additional Wide Excision

Unplanned excision (UE) of soft tissue sarcoma (STS) carries a high risk of local recurrence; additional wide excision is generally recommended. Some patients cannot undergo early re-excision because of patient preference, delayed referral, or an undefined extent of resection, and are observed instead. We retrospectively reviewed 32 patients with STS who had undergone UE at previous hospitals, who first visited our institution between 1997 and 2024, and in whom immediate additional wide excision could not be performed. Recurrence-free survival (RFS) was estimated using the Kaplan–Meier method. Local recurrence was detected in 22 of 32 patients (68.8%) over a median follow-up of 65.3 months, with 63.6% of recurrences occurring within 12 months. The 1-, 3-, and 5-year RFS rates were 56.2%, 32.5%, and 32.5% (median, 1.26 years). Recurrence also developed in 3 of 6 grade 1 tumors. In sensitivity analyses excluding patients referred only after recurrence (n = 20) and restricted to referral within 90 days (n = 22), recurrence still developed in 50.0% and 59.1%. The 5-year overall survival rate was 96.0%. UE of STS carries a high risk of early local recurrence, even in low-grade tumors; additional wide excision should therefore be recommended whenever feasible.