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. 2023 Mar:9:e2200047.
doi: 10.1200/GO.22.00047.

Radiotherapy and Limb-Sparing Surgery in the Management of Localized Soft Tissue Sarcomas: Tertiary Care Center Experience From Pakistan

Syed M Raza  1 , Adeel Riaz  1 , Muhammad A Mansha  1 , Samir Fasih  2 , Umme Kalsoom Awan  2 , Kashif Siddiqui  3 , Ilyas Rafi  4 , Ahmed Shoaib  4 , Muhammad Abu Bakar  5 , Muhammad M Fareed  6
Affiliations

Radiotherapy and Limb-Sparing Surgery in the Management of Localized Soft Tissue Sarcomas: Tertiary Care Center Experience From Pakistan

Syed M Raza et al. JCO Glob Oncol. 2023 Mar.

Abstract

Purpose: When combined with radiotherapy, limb salvage surgery is an alternative to amputation. This study sought to determine the limb-sparing treatment outcomes in patients diagnosed with soft tissue extremity sarcomas treated at our institution.

Materials and methods: All adult patients with extremity soft tissue sarcoma treated with the radical limb salvage strategy at Shaukat Khanum Memorial Cancer Hospital and Research Canter, Lahore, Pakistan, between January 2017 and December 2019 were retrospectively assessed.

Results: A total of 122 patients were included in the study. The mean age was 42 years (range 19-82), and 64 (52.5%) were males. The majority of patients, 65 (53.3%), were diagnosed with stage III and grade III disease according to American Joint Committee on Cancer TNM classification (Eighth edition). The most common surgical modality was wide local excision that was performed in 106 (86.9%) patients. Adjuvant radiation treatment was given in 111 (91%) patients, whereas 11 (9%) patients received neoadjuvant radiation treatment. The mean dose was 58 Gy (range: 46-66 Gy). Eighty-two (67.2%) of the patients were disease-free on post-treatment radiologic scans with disease recurrence observed in 40 (32.8%) patients. The median disease-free survival was 8 months (95% CI, 5.45 to 10.55). Local recurrence and distant metastases developed in 16 (13%) and 24 (20%) patients, respectively.

Conclusion: About two thirds of patients with extremity soft tissue sarcoma were successfully treated with limb salvage strategy, surgery, and radiation therapy. However, high rate of relapse warrants further novel strategies in this patient population.

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/go/authors/author-center.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

No potential conflicts of interest were reported.

Figures

FIG 1
FIG 1
(A) Disease-free survival and (B) overall survival. ESTS, extremity soft tissue sarcomas.
See this image and copyright information in PMC

Comment in

References

    1. Felderhof JM, Creutzberg CL, Putter H, et al. Long-term clinical outcome of patients with soft tissue sarcomas treated with limb-sparing surgery and postoperative radiotherapy. Acta Oncologica. 2013;52:745–752. - PubMed
    1. Herbert SH, Corn BW, Solin LJ, et al. Limb-preserving treatment for soft tissue sarcomas of the extremities: The significance of surgical margins. Cancer. 1993;72:1230–1238. - PubMed
    1. Jacobs AJ, Michels R, Stein J, et al. Improvement in overall survival from extremity soft tissue sarcoma over twenty years. Sarcoma. 2015;2015:279601–279609. - PMC - PubMed
    1. Rosenberg SA, Tepper J, Glatstein E, et al. 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;196:305–315. - PMC - PubMed
    1. Kask G, Barner-Rasmussen I, Repo JP, et al. Functional outcome measurement in patients with lower-extremity soft tissue sarcoma: A systematic literature review. Ann Surg Oncol. 2019;26:4707–4722. - PMC - PubMed