Local Recurrence and Survival in Soft-tissue Sarcomas

Overview

Journal Ann Surg Oncol

Publisher Springer

Specialty Oncology

Date 1996 May 1

PMID 8726180

Citations 15

Authors

C P Karakousis

C Proimakis

U Rao

A F Velez

D L Driscoll

Affiliations

Soon will be listed here.

Abstract

Background: There is a continuous interest in the literature concerning the management and survival after treatment of local recurrence in sarcomas because it is one of the most common types of recurrence.

Design: We retrospectively reviewed 93 patients treated for local recurrence from soft-tissue sarcoma.

Methods: We evaluated prognostic parameters (grade, tumor size, location) and the effect of treatment on survival.

Results: Resection of all the gross tumor at first visit to our Institute for local recurrence was accomplished in 88 patients (95%). Of the 59 patients with extremity tumors, six (10%) required an amputation. At a mean follow-up of 66 months, further local recurrence was noted in 27%. The estimated 5-year survival rate was 100% for patients with grade I tumors (n = 16), 77% for grade II (n = 31), and 45% for grade III tumors (n = 46) (p = 0.0002). This value was 78% for tumors < or = 5 cm and 57% for those > 5 cm (p = 0.03).

Conclusions: Local recurrence is resectable and limb preservation is possible in the majority of patients. The overall 5-year survival rate was 65%. Survival after treatment of local recurrence is determined mainly by the grade and secondarily by the size of the tumor as for primary sarcomas.

Citing Articles

Rethinking tumor viability as prognostic factor in soft tissue sarcoma.

Montreuil J, Kholodovsky E, Markowitz M, Torralbas Fitz S, Campano D, Erik Geiger J J Orthop. 2025; 68:7-14.

PMID: 39980706 PMC: 11836483. DOI: 10.1016/j.jor.2025.01.030.

Principles of Surgical Treatment of Soft Tissue Sarcomas.

Gonzalez M, Mendez-Guerra C, Goh M, Pretell-Mazzini J Cancers (Basel). 2025; 17(3).

PMID: 39941773 PMC: 11816134. DOI: 10.3390/cancers17030401.

Tumor size and surgical margins are important prognostic factors of synovial sarcoma - A retrospective study.

Sacchetti F, Alsina A, Muratori F, Scoccianti G, Neri E, Kaya H J Orthop. 2023; 42:74-79.

PMID: 37533628 PMC: 10391603. DOI: 10.1016/j.jor.2023.07.002.

Local recurrence management of extremity soft tissue sarcoma.

Serban B, Cretu B, Cursaru A, Nitipir C, Orlov-Slavu C, Cirstoiu C EFORT Open Rev. 2023; 8(8):606-614.

PMID: 37526250 PMC: 10441250. DOI: 10.1530/EOR-23-0095.

Re-excision after unplanned excision of soft tissue sarcoma: A systematic review and metanalysis. The rationale of systematic re-excision.

Sacchetti F, Alsina A, Morganti R, Innocenti M, Andreani L, Muratori F J Orthop. 2021; 25:244-251.

PMID: 34099954 PMC: 8165293. DOI: 10.1016/j.jor.2021.05.022.

References

Shiu M, Castro E, HAJDU S, Fortner J . Surgical treatment of 297 soft tissue sarcomas of the lower extremity. Ann Surg. 1975; 182(5):597-602. PMC: 1344044. DOI: 10.1097/00000658-197511000-00011. View

Brennan M, Casper E, Harrison L, Shiu M, Gaynor J, HAJDU S . The role of multimodality therapy in soft-tissue sarcoma. Ann Surg. 1991; 214(3):328-36; discussion 336-8. PMC: 1358657. DOI: 10.1097/00000658-199109000-00015. View

Potter D, Kinsella T, Glatstein E, Wesley R, White D, Seipp C . High-grade soft tissue sarcomas of the extremities. Cancer. 1986; 58(1):190-205. DOI: 10.1002/1097-0142(19860701)58:1<190::aid-cncr2820580133>3.0.co;2-5. View

Vezeridis M, MOORE R, Karakousis C . Metastatic patterns in soft-tissue sarcomas. Arch Surg. 1983; 118(8):915-8. DOI: 10.1001/archsurg.1983.01390080023007. View

Karakousis C, Emrich L, Rao U, Krishnamsetty R . Feasibility of limb salvage and survival in soft tissue sarcomas. Cancer. 1986; 57(3):484-91. DOI: 10.1002/1097-0142(19860201)57:3<484::aid-cncr2820570314>3.0.co;2-k. View

Mazeron J, Suit H . Lymph nodes as sites of metastases from sarcomas of soft tissue. Cancer. 1987; 60(8):1800-8. DOI: 10.1002/1097-0142(19871015)60:8<1800::aid-cncr2820600822>3.0.co;2-n. View

Potter D, Glenn J, Kinsella T, Glatstein E, Lack E, Restrepo C . Patterns of recurrence in patients with high-grade soft-tissue sarcomas. J Clin Oncol. 1985; 3(3):353-66. DOI: 10.1200/JCO.1985.3.3.353. View

Abbas J, HOLYOKE E, MOORE R, Karakousis C . The surgical treatment and outcome of soft-tissue sarcoma. Arch Surg. 1981; 116(6):765-9. DOI: 10.1001/archsurg.1981.01380180025006. View

Karakousis C, Emrich L, Rao U, Khalil M . Limb salvage in soft tissue sarcomas with selective combination of modalities. Eur J Surg Oncol. 1991; 17(1):71-80. View

10.

Karakousis C, Blumenson L, Canavese G, Rao U . Surgery for disseminated abdominal sarcoma. Am J Surg. 1992; 163(6):560-4. DOI: 10.1016/0002-9610(92)90556-7. View

11.

Eilber F, Guiliano A, Huth J, Mirra J, Morton D . High-grade soft-tissue sarcomas of the extremity: UCLA experience with limb salvage. Prog Clin Biol Res. 1985; 201:59-74. View

12.

Lindberg R, Martin R, Romsdahl M, BARKLEY Jr H . Conservative surgery and postoperative radiotherapy in 300 adults with soft-tissue sarcomas. Cancer. 1981; 47(10):2391-7. DOI: 10.1002/1097-0142(19810515)47:10<2391::aid-cncr2820471012>3.0.co;2-b. View

13.

Giuliano A, Eilber F, Morton D . The management of locally recurrent soft-tissue sarcoma. Ann Surg. 1982; 196(1):87-91. PMC: 1352503. DOI: 10.1097/00000658-198207000-00018. View

14.

Weiss S, ENZINGER F . Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer. 1978; 41(6):2250-66. DOI: 10.1002/1097-0142(197806)41:6<2250::aid-cncr2820410626>3.0.co;2-w. View

15.

Rosenberg S, Tepper J, Glatstein E, Costa J, Baker A, Brennan M . The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. Ann Surg. 1982; 196(3):305-15. PMC: 1352604. DOI: 10.1097/00000658-198209000-00009. View

16.

LAWRENCE Jr W, DONEGAN W, Natarajan N, Mettlin C, Beart R, Winchester D . Adult soft tissue sarcomas. A pattern of care survey of the American College of Surgeons. Ann Surg. 1987; 205(4):349-59. PMC: 1492738. DOI: 10.1097/00000658-198704000-00003. View

17.

Karakousis C, Emrich L, Rao U, Khalil M . Selective combination of modalities in soft tissue sarcomas: limb salvage and survival. Semin Surg Oncol. 1988; 4(1):78-81. DOI: 10.1002/ssu.2980040115. View

18.

Suit H, Mankin H, Wood W, Proppe K . Preoperative, intraoperative, and postoperative radiation in the treatment of primary soft tissue sarcoma. Cancer. 1985; 55(11):2659-67. DOI: 10.1002/1097-0142(19850601)55:11<2659::aid-cncr2820551122>3.0.co;2-q. View