Multifactorial analysis of long-term follow-up (more than 5 years) of primary extremity sarcoma Journal Article
| Authors: | Lewis, J. J.; Leung, D.; Casper, E. S.; Woodruff, J.; Hajdu, S. I.; Brennan, M. F. |
| Article Title: | Multifactorial analysis of long-term follow-up (more than 5 years) of primary extremity sarcoma |
| Abstract: | Background: The majority of survival studies in patients with extremity soft tissue sarcoma have focused on early recurrence and mortality. There are few data addressing long-term follow-up and survival. Objective: To analyze survival and recurrence in patients with extremity soft tissue sarcoma who survive for more than 5 years. Methods: Patients who underwent treatment for primary tumors (July 1982 to July 1994) and were followed up for more than 5 years were the subject of study. Disease-specific and disease-free survival were determined actuarially. Significance was evaluated using log-rank testing for univariate analysis and Cox model stepwise regression for multivariate analysis. Results: A total of 495 patients with primary extremity tumors were treated before July 1989 and eligible for 5-year follow-up. Of these, 282 have been followed up for more than 5 years (median follow-up, 84.4 months). Actuarial disease-specific survival of patients who survive for longer than 5 years was 79% ± 7% (±SEM) at 10 years, and of those who were metastasis free at 5 years was 91% ± 4% at 10 years. On univariate analysis, post-5-year disease-specific survival was influenced by positive microscopic margin and initial tumor size of 5 cm or greater. On multivariate analysis, post-5-year disease-specific survival was influenced only by positive margins. Conclusions: Based on these analyses, 21% of patients with primary extremity sarcoma who survive for 5 years will die of disease within 5 years. Even of those who are metastasis free at 5 years, 9% will die of disease within 5 years. In contrast to early mortality, tumor grade has no influence on post-5-year prognosis. Patients with positive microscopic margins are at risk for post-5-year disease-specific mortality and therefore require long-term follow-up and consideration for investigational therapy. |
| Keywords: | adolescent; adult; cancer survival; controlled study; disease-free survival; middle aged; cancer surgery; survival rate; major clinical study; histopathology; cancer recurrence; cancer radiotherapy; recurrence risk; follow up; follow-up studies; cancer grading; metastasis; cancer mortality; time factors; sarcoma; survival time; medical record; limb tumor; soft tissue sarcoma; multivariate analysis; high risk population; soft tissue neoplasms; leg; humans; prognosis; human; male; female; priority journal; article |
| Journal Title: | Archives of Surgery |
| Volume: | 134 |
| Issue: | 2 |
| ISSN: | 0004-0010 |
| Publisher: | American Medical Association |
| Date Published: | 1999-02-01 |
| Start Page: | 190 |
| End Page: | 194 |
| Language: | English |
| DOI: | 10.1001/archsurg.134.2.190 |
| PUBMED: | 10025462 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 16 August 2016 -- Source: Scopus |
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