Long-term results with resection of radiation-induced soft tissue sarcomas Journal Article
| Authors: | Cha, C.; Antonescu, C. R.; Quan, M. L.; Maru, S.; Brennan, M. F. |
| Article Title: | Long-term results with resection of radiation-induced soft tissue sarcomas |
| Abstract: | Introduction: Radiation therapy is increasingly used as adjuvant treatment of many childhood and adult malignancies. Radiation-induced sarcoma is a well recognized if uncommon event. The objective of this study is to determine the prevalence and long-term outcome for patients who develop radiation-induced sarcomas. Methods: From July 1982 to December 2001, 4884 adult patients with sarcoma were admitted and treated at our institution and recorded in a prospective database. There were 123 (2.5%) patients who had radiation-induced soft tissue sarcomas. Survival was determined by Kaplan-Meier analysis. Patient, tumor, and treatment characteristics were tested for their prognostic significance by log rank and the Cox proportional hazards model. Results: The median interval between radiation and development of sarcoma was 103 (6 to 534) months. In 114 patients with radiation-induced sarcoma who underwent curative resection, the 5-year actuarial survival was 41%, with a median survival of 48 months at a median follow-up of 36 months for survivors. The most common malignancy for which radiation was used was breast cancer (29%), followed by lymphoma (16%) and prostate cancer (15%). Malignant fibrous histiocytoma (23%) was the most common histologic diagnosis, followed by fibrosarcoma (15%) and angiosarcoma (15%). High-grade tumors (n = 85; 79%), age > 60 years (n = 61; 50%), and gross positive resection margin (n = 36; 32%) were predictive of poor sarcoma-specific survival on univariate and multivariate analysis. Conclusions: The increasing utilization of adjuvant radiation therapy, especially for early-stage breast cancer mandates long-term follow-up to detect radiation-induced sarcoma. Surgical resection remains the primary therapy, but 5-year survival remains ∼40%. |
| Keywords: | immunohistochemistry; adult; cancer survival; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; cancer surgery; major clinical study; cancer recurrence; conference paper; cancer radiotherapy; radiation dose; follow up; prospective study; prospective studies; cohort studies; proportional hazards models; radiation injury; data base; risk assessment; sarcoma; biopsy, needle; neoplasms, radiation-induced; cancer size; soft tissue sarcoma; multivariate analysis; analysis of variance; soft tissue neoplasms; orthopedic procedures; humans; prognosis; human; male; female; priority journal |
| Journal Title: | Annals of Surgery |
| Volume: | 239 |
| Issue: | 6 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2004-06-01 |
| Start Page: | 903 |
| End Page: | 910 |
| Language: | English |
| DOI: | 10.1097/01.sla.0000128686.51815.8b |
| PROVIDER: | scopus |
| PMCID: | PMC1356299 |
| PUBMED: | 15166970 |
| DOI/URL: | |
| Notes: | Ann. Surg. -- Cited By (since 1996):70 -- Export Date: 16 June 2014 -- CODEN: ANSUA -- Source: Scopus |
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