Surgical treatment for small round cell sarcoma of the bone

Abstract

Background. The role of surgical intervention for the treatment of small round cell sarcoma of bone, has become important. However, there have been few reports concerning the surgical safety margin for this disease. An appropriate surgical margin should be discussed in relation to the effects of preoperative treatment, local recurrence rate, and prognosis.

Methods. Twenty-eight patients with small round cell sarcoma of the bone were studied. Nineteen patients were stage M0 (of whom 18 were operated) and 9 were stage M1 (of whom 4 were operated). Preoperative treatment was evaluated by histological examination of the surgical specimen. The surgical margin was evaluated as curative, wide, marginal, or intralesional, by methods accepted by the Japanese Orthopedic Association.

Results. (1) Of the 18 operated patients in stage M0, 2 showed local recurrence because of an inappropriate surgical margin or poor response to preoperative treatment. (2) Patients who had a wide margin procedure and who responded to preoperative treatment did not show local recurrence. (3) Patients who had a curative procedure did not show local recurrence regardless of the effect of preoperative treatment. (4) Patients with surgical speciment histologically evaluated as showing over 90% necrosis showed no local recurrences and had favorable prognoses with wide or curative procedures.

Conclusion. The effects of preoperative treatment and surgical margins were important prognostic factors for local control in patients with small round cell sarcoma of the bone.