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Extremity soft-tissue sarcomas selectively treated with surgery alone.
P L Fabrizio1, S L Stafford, D J Pritchard
1Division of Radiation Oncology, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
Summary
Limb-sparing surgery alone offers good outcomes for selected low-grade soft-tissue sarcomas. High-grade tumors require additional treatment, as surgery alone resulted in unacceptable local and distant disease control.
Area of Science:
- Orthopedic Oncology
- Surgical Oncology
- Sarcoma Research
Background:
- Soft-tissue sarcomas (STS) are rare malignancies.
- Limb-sparing surgery is a common treatment modality.
- The role of surgery alone in managing STS requires further investigation.
Purpose of the Study:
- To determine local control (LC), freedom from distant recurrence (FFDR), and overall survival (OS) in patients with extremity STS treated with surgery alone.
- To identify prognostic factors influencing outcomes in these patients.
Main Methods:
- Retrospective review of 34 adult patients with localized extremity STS treated with surgery alone.
- Analysis of actuarial 5-year LC, FFDR, and OS.
- Univariate analysis to identify prognostic factors.
Main Results:
- 5-year LC was 80%, FFDR was 86%, and OS was 82% for all patients.
- Patients with low-grade tumors had significantly better outcomes (p < 0.05).
- Female patients demonstrated significantly better FFDR and OS (p < 0.05).
Conclusions:
- Limb-sparing surgery alone may be appropriate for selected low-grade STS with negative margins, especially if salvage surgery is feasible.
- Surgery alone is insufficient for high-grade STS, with unacceptable rates of local and distant recurrence.
- Further research is needed to optimize treatment strategies for different STS subtypes.