Results of resection of forearm soft tissue sarcoma

Abstract

Purpose: Soft tissue sarcomas (STS) of the forearm are rare. We aim to assess their oncological and functional outcomes.

Methods: We retrospectively evaluated 34 patients who underwent surgical excision for forearm STS at our institution between 1993 and 2020. We analyzed postoperative Musculoskeletal Tumor Society rating scale (MSTS) and local recurrence-free survival (LRFS), metastasis-free survival, and overall survival (OS) rates. The significance of the following variables was determined: age, sex, histology, tumor size, Fédération Nationale des Centres de Lutte contre le Cancer grade, American Joint Committee on Cancer stage, surgical margin, unplanned excision, metastases upon initial presentation, receipt of chemotherapy, and radiotherapy (RT).

Results: The postoperative median MSTS score was 28. Bone resection or major nerve palsy was the only factor that influenced MSTS scores. The median MSTS scores in patients with or without bone resection or major nerve palsy were 24 and 29, respectively (P < 0.001). The 5-year LRFS rates was 87%. Univariate analysis revealed that the histological diagnosis of myxofibrosarcoma was the only factor that influenced LRFS (P = 0.047). The 5-year MFS rates was 71%. In univariate analysis, no factors were associated with MFS. The 5-year OS rates was 79%. Age was the only factor that influenced OS (P = 0.01).

Conclusion: In the treatment of forearm STS, reconstruction of the skin and tendon can compensate for function, while bone resection and major nerve disturbance cannot. Careful follow-up is important, especially in patients with myxofibrosarcoma, due to its likelihood of local recurrence.

Keywords: Forearm; Function; Prognosis; Soft tissue sarcomas.

Fig. 1

This Kaplan–Meier curve shows local recurrence-free survival (LRFS). The 3- and 5-year LRFS rates are 91% and 87%, respectively

Fig. 2

This figure shows local recurrence-free survival (LRFS) in patients with myxofibrosarcoma and others. The 5-year LRFS rates are 70% and 95% in patients with myxofibrosarcoma and others, respectively

Fig. 3

This Kaplan–Meier curve shows metastasis-free survival (MFS). The 3- and 5-year MFS rates are 71% and 71%, respectively

Fig. 4

This Kaplan–Meier curve shows overall survival (OS). The 3- and 5-year OS rates are 85% and 79%, respectively

Fig. 5

This figure shows overall survival (OS) in patients ≥ 65 years and those with < 65 years. The 5-year OS rates are 63% and 94% in patients ≥ 65 years and < 65 years, respectively