XXXX : are we stratifying results appropriately?

@entity1 @entity3 @entity5 @entity2968
BACKGROUND: There is no consensus as to which surgical approach to the treatment of @entity2968 is most appropriate or which @entity1 are at a higher risk for recurrence or @entity3 . QUESTIONS/PURPOSES: Therefore, we asked: (1) Are there subsets of @entity1 who are associated with a more recalcitrant disease course? And (2) are surgeons appropriately stratifying @entity1 by identifying risk factors for increased local recurrence and pulmonary metastases? METHODS: We retrospectively reviewed the records of 230 @entity1 with @entity2968 treated from 1980 to 2010, stratifying them by primary versus recurrent disease and by surgical treatment. From the records, we determined local recurrence, @entity3 , and complications of treatment. The median follow up was 47 months (range, 0.1-312 months). RESULTS: Overall incidence of local recurrence was 10% and pulmonary @entity3 was 2%. When stratified by surgical treatment, the incidence of local recurrence among @entity1 undergoing intralesional curettage (12%) was greater than in those undergoing resection (2%). The incidence of local recurrence among @entity5 , independent of treatment, was 9%, whereas the incidence of local recurrence after treatment of recurrent lesions was 16%. The incidence of pulmonary metastases was similar, regardless of treatment or whether primary or recurrent. CONCLUSIONS: Our observations suggest there are subsets of @entity1 with @entity2968 who are at higher risk of recurrence and should be clinically followed more closely. This should allow surgeons to provide @entity1 with more informed expectations. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
