Influence of compartmental involvement on the patterns of morbidity in soft tissue sarcoma of the thigh Journal Article
| Authors: | Rimner, A.; Brennan, M. F.; Zhang, Z.; Singer, S.; Alektiar, K. M. |
| Article Title: | Influence of compartmental involvement on the patterns of morbidity in soft tissue sarcoma of the thigh |
| Abstract: | BACKGROUND: The authors sought to determine whether differences existed in patterns of outcome and morbidity between the 3 thigh compartments after limb-sparing surgery and postoperative radiation therapy (RT). METHODS: A total of 255 patients with primary soft tissue sarcoma (STS) of the thigh were identified in our sarcoma database (1982-2002). More than 80% of tumors were >5 cm, high grade, and deep; 33% had close or positive microscopic resection margins. Adjuvant RT consisted of brachytherapy alone (BRT; 63%), external beam RT alone (EBRT; 31%), or a combination of brachytherapy and EBRT (6%). There were 125 anterior, 58 medial, and 72 posterior lesions. The 3 compartments were balanced as to tumor grade, size, depth, margin status, and RT type. RESULTS: Overall local control (LC) was 89%, distant metastases-free survival (DMFS) was 61%, and overall survival (OS) was 66% at 5 years (median follow-up, 71 months). Overall rates for complications at 5 years were wound reoperation (10%), edema (13%), joint stiffness (12%), nerve damage (8%), and bone fractures (7%). Wound reoperation and edema were significantly higher for medial-compartment tumors (P = .01 and .005, respectively), whereas nerve damage occurred more frequently in posterior-compartment tumors (P < .001). There were no differences among bone fracture, joint stiffness, DMFS, or OS rates between compartments. CONCLUSIONS: Although tumor control was similar for all 3 compartments, more wound reoperation and edema were observed in the medial compartment, and more nerve damage was noted in the posterior compartment. These results may help guide decisions concerning current patients and improve the design of future treatments tailored to compartments. © 2008 American Cancer Society. |
| Keywords: | adolescent; adult; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; cancer surgery; major clinical study; postoperative period; cancer radiotherapy; combined modality therapy; radiotherapy, adjuvant; outcome assessment; follow up; cancer grading; edema; metastasis; radiation; tumor volume; morbidity; sarcoma; thigh; reoperation; soft tissue sarcoma; brachytherapy; nerve injury; surgery; surgical procedures, operative; external beam radiotherapy; fractures, bone; leg edema; leg disease; thigh compartments; joint stiffness; leg fracture |
| Journal Title: | Cancer |
| Volume: | 115 |
| Issue: | 1 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2009-01-01 |
| Start Page: | 149 |
| End Page: | 157 |
| Language: | English |
| DOI: | 10.1002/cncr.23975 |
| PUBMED: | 19090010 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 4" - "Export Date: 30 November 2010" - "CODEN: CANCA" - "Source: Scopus" |
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