Localized extremity soft tissue sarcoma: Improved knowledge with unchanged survival over time Journal Article
| Authors: | Weitz, J.; Antonescu, C. R.; Brennan, M. F. |
| Article Title: | Localized extremity soft tissue sarcoma: Improved knowledge with unchanged survival over time |
| Abstract: | Purpose: The objective of this study was to define whether survival of patients with extremity soft tissue sarcoma (STS), stratified for known risk factors, has improved over the last 20 years. Patients and Methods: From January 1982 to December 2001, 1,706 patients with primary and recurrent STS of the extremities were treated at our institution and were prospectively followed. From this cohort, we selected 1,261 patients who underwent complete macroscopic resection and had one of the following histopathologies: fibrosarcoma, liposarcoma, leiomyosarcoma, malignant fibrous histiocytoma, or synovial sarcoma. Median follow-up was 55 months. Patient, tumor, and treatment factors were analyzed as prognostic factors. Results: The 5-year disease-specific actuarial survival was 79% (78% for patients treated from 1982 to 1986, 79% for patients treated from 1986 to 1991, 79% for patients treated from 1992 to 1996, and 85% for patients treated from 1997 to 2001; P = not significant). For high-risk patients (high-grade, > 10 cm, deep tumors; n = 247), 5-year disease-specific survival was 51% (50% for patients treated from 1982 to 1986, 45% for patients treated from 1986 to 1991, 52% for patients treated from 1992 to 1996, and 61% for patients treated from 1997 to 2001; P = not significant). Tumor depth, size, grade, microscopic margin status, patient age, presentation status (primary tumor versus local recurrence), location (proximal versus distal), and certain histopathologic subtypes were significant prognostic factors for disease-specific survival on multivariate analysis; however, time period of treatment was not. Conclusion: Prognosis of patients with extremity STS, stratified for known risk factors, has not improved over the last 20 years, indicating that current therapy has reached the limits of efficacy. © 2003 by American Society of Clinical Oncology. |
| Keywords: | survival; adult; cancer survival; clinical article; controlled study; treatment outcome; aged; disease-free survival; middle aged; survival analysis; retrospective studies; histopathology; mortality; cancer risk; multimodality cancer therapy; adjuvant therapy; comparative study; disease free survival; chemotherapy, adjuvant; combined modality therapy; radiotherapy, adjuvant; cancer staging; follow up; methodology; follow-up studies; neoplasm staging; metastasis; cohort studies; proportional hazards models; cohort analysis; risk factors; pathology; retrospective study; risk factor; risk assessment; sarcoma; proportional hazards model; fibrosarcoma; limb; probability; adjuvant chemotherapy; soft tissue sarcoma; dermatofibroma; leiomyosarcoma; synovial sarcoma; analysis of variance; soft tissue neoplasms; soft tissue tumor; liposarcoma; leg; orthopedic procedures; orthopedic surgery; lower extremity; arm; upper extremity; humans; human; male; female; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 21 |
| Issue: | 14 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2003-07-15 |
| Start Page: | 2719 |
| End Page: | 2725 |
| Language: | English |
| DOI: | 10.1200/jco.2003.02.026 |
| PUBMED: | 12860950 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
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