Clinical outcomes after definitive treatment of soft tissue sarcoma of the hand: A retrospective cohort study of 109 patients Journal Article
| Authors: | Chapman, T. R.; Lavery, J. A.; Nolan, J. E.; Athanasian, E. A. |
| Article Title: | Clinical outcomes after definitive treatment of soft tissue sarcoma of the hand: A retrospective cohort study of 109 patients |
| Abstract: | Purpose: The purpose of this study was to provide updated data on oncologic outcomes following definitive surgical treatment of soft tissue sarcoma of the hand in a cohort of 109 patients, as well as to characterize risk factors for poor oncologic and functional outcomes. Methods: We analyzed data from 109 consecutive patients who had definitive surgical treatment for soft tissue sarcoma of the hand performed between 1996 and 2019 by a single surgeon at a sarcoma center. Primary outcomes included functional outcome (assessed by Musculoskeletal Tumor Society scores), disease-free survival (DFS), and overall survival (OS). We compiled descriptive data and used a multivariable linear model to identify factors associated with functional outcomes. Kaplan-Meier methods were used to estimate 5- and 10-year DFS and OS. Results: Patients had a median age of 36 years at presentation. Median follow-up was 6.1 years among patients alive at the end of follow-up. The median Musculoskeletal Tumor Society score was 29; functional outcome was worse among patients with high-grade tumors or complications. Among the 107 patients who became disease-free, there were four local recurrences (one with metastasis), six distant recurrences, and one death without recurrence. All local recurrences were deep tumors (two myxofibrosarcoma and two myxoinflammatory fibrosarcoma). Estimated 5- and 10-year DFS rates were 89% (95% confidence interval [CI]: 83% to 96%) and 88% (95% CI: 80% to 95%). There were seven deaths, and the estimated 5- and 10-year OS rates were 95% (95% CI: 90% to 100%) and 92% (95% CI: 84% to 100%). Larger tumor size and higher stage at diagnosis were associated with shorter DFS and OS in univariable analyses; low event rates precluded multivariable analysis of survival. Conclusions: Aggressive disease-specific surgical and multidisciplinary treatment can yield long DFS and OS, and good functional outcomes. However, complications and high-grade tumors are associated with worse functional scores. Type of study/level of evidence: Prognostic II. © 2024 American Society for Surgery of the Hand |
| Keywords: | adult; cancer surgery; fracture; major clinical study; overall survival; disease free survival; nuclear magnetic resonance imaging; metastasis; infection; tumor volume; cohort analysis; recurrence; retrospective study; sarcoma; lymphedema; wound healing; death; fibrosarcoma; tumor recurrence; scoring system; soft tissue sarcoma; surgical resection; hematoma; rigidity; hand; fibromyxosarcoma; osteitis; clinical outcome; phantom pain; human; male; female; article; musculoskeletal tumor society score; myxoinflammatory fibrosarcoma; soft tissue sarcoma of the hand; tendon adhesion |
| Journal Title: | Journal of Hand Surgery |
| Volume: | 49 |
| Issue: | 9 |
| ISSN: | 0363-5023 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2024-08-31 |
| Start Page: | 867 |
| End Page: | 874 |
| Language: | English |
| DOI: | 10.1016/j.jhsa.2024.05.003 |
| PUBMED: | 38934989 |
| PROVIDER: | scopus |
| PMCID: | PMC11552399 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Talia R. Chapman -- Source: Scopus |
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