Association of local recurrence with subsequent survival in extremity soft tissue sarcoma Journal Article
| Authors: | Lewis, J. J.; Leung, D.; Heslin, M.; Woodruff, J. M.; Brennan, M. F. |
| Article Title: | Association of local recurrence with subsequent survival in extremity soft tissue sarcoma |
| Abstract: | Purpose: The aim of this study was to analyze local recurrence in a large cohort of prospectively followed patients with primary extremity soft tissue sarcoma. In particular, we analyzed the correlation of local recurrence with subsequent metastasis and disease-specific survival. Patients and Methods: Patients who underwent treatment for primary extremity soft tissue sarcoma from July 1982 through July 1995 at Memorial Sloan-Kettering Cancer Center were the subject of this study. Local recurrence, distant metastasis, and disease-specific survival were used as end points of the study. The influence of local recurrence on subsequent distant metastasis and disease-specific survival were examined using the Cox proportional hazards model. Results: We treated 911 patients, of whom 297 (33%) developed recurrent disease. Local recurrence occurred in 116 patients (13%), metastasis in 167 (18%), and synchronous local recurrence and metastasis in 13 (2%). Of 116 patients who developed local recurrence, 38 subsequently developed metastasis and 34 died of disease. Metastasis after local recurrence was predicted in patients with initial high-grade (P = .005; risk = 3.5) or deep (P = .02; risk = 2.9) tumors. Tumor mortality after local recurrence was predicted in patients with initial high-grade (P = .007; risk = 3.7) or large (> 5 cm; P = .01; risk = 3.2) primary tumors. Discussion: These findings suggest that there is a strong association of local recurrence with the development of subsequent metastasis and tumor mortality, and that local recurrence is a poor prognostic factor. It would seem prudent to consider patients who develop local recurrence and have high-grade tumors as being at high risk for systemic disease and therefore eligible for investigational adjuvant systemic therapy. |
| Keywords: | adult; cancer survival; disease-free survival; middle aged; major clinical study; cancer recurrence; prospective study; prospective studies; metastasis; neoplasm recurrence, local; proportional hazards models; cancer mortality; risk; sarcoma; limb tumor; soft tissue sarcoma; soft tissue neoplasms; leg; arm; humans; human; male; female; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 15 |
| Issue: | 2 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 1997-02-01 |
| Start Page: | 646 |
| End Page: | 652 |
| Language: | English |
| PUBMED: | 9053489 |
| PROVIDER: | scopus |
| DOI: | 10.1200/JCO.1997.15.2.646 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 17 March 2017 -- Source: Scopus |
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