(P 502) SEPARATE RESECTION OF BIOPSY TRACT IN PRIMARY BONE SARCOMA: IMPLICATIONS FOR LOCAL RECURRENCE AND OVERALL SURVIVAL

Objective: Including the biopsy tract with primary resections may limit operative options, potentially contributing to higher morbidity. This study aims to explore whether resecting biopsy tracts separately from the primary wide tumor resection specimen has any effect on local recurrence and overall survival.

Methods: This is a retrospective single-center study from 2014 to 2023. A total of 45 pediatric sarcoma cases were included with diagnoses of osteosarcoma (n=30), Ewing sarcoma (n=11), other primary bone sarcoma (n=4). Of these, the biopsy tract was resected separately from the main specimen in 24 (53%) cases.

Results: We noted a total local recurrence of 6.7% pediatric bone sarcomas. For cases with separate biopsy resection, 4.3% (n=1) demonstrated evidence of disease in the separate biopsy tract specimen. Separate resection of the biopsy tract did not affect the rate of local recurrence (OR 0.88, 95% CI 0.11, 6.77, p=0.90). There was no association between local recurrence and open vs core-needle biopsy (OR 0.28, 95% CI 0.35,2.29, p=0.24). Positive margins in the primary resected specimen (18% of cases) was an independent risk factor for the development of local recurrence.

Conclusion: There was no increased risk of local recurrence in cases where the biopsy tract was resected separately compared to cases where it was resected with the main tumor. Positive margins in the primary resection specimen was the greatest predictor of local recurrence, so optimizing surgical approach and resection strategy to best ensure negative margins is paramount.