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. 2014 Mar 18;110(6):1456-64.
doi: 10.1038/bjc.2014.21. Epub 2014 Jan 30.

Long-term outcome after local recurrence of soft tissue sarcoma: a retrospective analysis of factors predictive of survival in 135 patients with locally recurrent soft tissue sarcoma

A Daigeler  1 , I Zmarsly  1 , T Hirsch  1 , O Goertz  1 , H-U Steinau  1 , M Lehnhardt  1 , K Harati  1
Affiliations

Long-term outcome after local recurrence of soft tissue sarcoma: a retrospective analysis of factors predictive of survival in 135 patients with locally recurrent soft tissue sarcoma

A Daigeler et al. Br J Cancer. .

Abstract

Background: The aim of this study was to identify prognostic indicators of survival in patients with locally recurrent soft tissue sarcoma (STS) through a long-term follow-up.

Methods: We retrospectively assessed the relationship between post-recurrence survival (PRS) and potential prognostic factors in 135 patients who had experienced local recurrence, which was suitable for further surgical treatment. The median follow-up time after initial recurrence was 12.3 years (95% confidence interval (CI): 10.4-14.2 years).

Results: The 5-year estimate of the PRS rate was 53.1% (95% CI: 44.3-61.2%) for the entire series. Patients with negative margins after the final surgery experienced improved survival compared with patients with positive margins (5-year survival: 46.7% (35.2-57.5%) vs 35.5% (23.4-47.8%); P=0.01). In a multivariate analysis, the significant prognostic indicators for PRS were histologic grade, tumour site, time to initial recurrence, the number of recurrences and the surgical margin status attained at the last resection.

Conclusions: Complete surgical resection with microscopically clear margins is desirable in patients with locally recurrent STS. However, when achieving clear surgical margins will require major functional impairment of the extremity, a radical surgical approach should be weighed for the patient in each case.

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Figures

Figure 1
Figure 1
Estimated survival curves after primary diagnosis (A) and initial recurrence (B–F) according to the mentioned factors.
Figure 2
Figure 2
Effects of definitive surgical margins on survival after the last resection in: the overall patient population (A), patients with only localised disease (B) and patients with metastases (C) at the time of the last resection.
See this image and copyright information in PMC

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