Long-term outcomes in extremity soft tissue sarcoma after a pathologically negative re-resection and without radiotherapy Journal Article
| Authors: | Cahlon, O.; Spierer, M.; Brennan, M. F.; Singer, S.; Alektiar, K. M. |
| Article Title: | Long-term outcomes in extremity soft tissue sarcoma after a pathologically negative re-resection and without radiotherapy |
| Abstract: | BACKGROUND. The purpose was to define the rate of local recurrence (LR) and identify prognostic factors for LR in patients with extremity soft-tissue sarcoma (STS) treated with limb-sparing surgery and a pathologically negative re-resection specimen without radiotherapy (RT). METHODS. A review of the prospective sarcoma database identified 200 patients with primary, nonmetastatic, extremity STS treated with limb-sparing surgery between June 1982 and December 2002 who had a pathologically confirmed negative re-resection. None of the patients had adjuvant RT. Univariate and multivariate analyses were performed to determine clinicopathologic factors associated with LR. RESULTS. With a median follow-up of 82 months the 5-year actuarial LR rate was 9%. Factors associated with higher LR rates on univariate and multivariate analysis were older age, stage III presentation, and histology. The 5-year LR rate was 5% for those <50 compared with 15% for those ≥50 (P = .001). For patients with stage III the LR rate was 26% versus 7% for those with stage I/II (P < .001). On multivariate analysis only age ≥50 (relative risk [RR] 3.3; P = .02) and stage III disease (RR 3.4; P = .01) remained significant predictors for LR. When the cohort of patients was divided into 3 groups based on the number of risk factors present, the 5-year LRs were as follows: no risk factors (stage I/II and <50 years old) 4%, 1 risk factor (stage III or ≥50) 12%, and 2 risk factors (stage III and ≥50) 31% (P <.01). CONCLUSIONS. Patients with a pathologically negative re-excision represent a heterogeneous group. Whereas the overall rate of local recurrence at 5 years was 9% for the entire cohort, patients with older age and/or stage III disease had a higher rate of LR. Therefore, treatment decisions especially with regard to adjuvant RT should be individualized and not be based solely on the finding of a negative reresection. © 2008 American Cancer Society. |
| Keywords: | adolescent; adult; cancer survival; controlled study; human tissue; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; cancer surgery; surgical technique; survival rate; major clinical study; histopathology; cancer recurrence; adjuvant therapy; cancer radiotherapy; disease free survival; radiotherapy, adjuvant; disease association; neoplasm recurrence, local; radiotherapy; age factors; pathology; risk factor; age; sarcoma; feasibility study; limb; feasibility studies; tumor recurrence; reoperation; limb tumor; soft tissue sarcoma; extremities; cancer relapse; outcomes; extremity; re-resection |
| Journal Title: | Cancer |
| Volume: | 112 |
| Issue: | 12 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2008-06-15 |
| Start Page: | 2774 |
| End Page: | 2779 |
| Language: | English |
| DOI: | 10.1002/cncr.23493 |
| PUBMED: | 18429001 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 5" - "Export Date: 17 November 2011" - "CODEN: CANCA" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work