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Completely resected recurrent soft tissue sarcoma: primary anatomic site governs outcomes
Alexander Stojadinovic1, Alice Yeh, Murray F Brennan
1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Journal of the American College of Surgeons
|April 13, 2002
Summary
Primary tumor site significantly impacts outcomes for recurrent soft tissue sarcoma (STS) after resection. Retroperitoneal (RP) recurrences carry a higher mortality risk than extremity-trunk recurrences.
Area of Science:
- Oncology
- Surgical Oncology
- Sarcoma Research
Background:
- Investigating the natural history of locally recurrent soft tissue sarcoma (STS).
- Understanding the influence of primary tumor site on outcomes after complete resection.
- Focusing on STS recurrence without distant metastasis.
Purpose of the Study:
- To define the natural history of locally recurrent soft tissue sarcoma.
- To determine the influence of primary anatomic site on outcomes.
- To analyze factors affecting survival after recurrence.
Main Methods:
- Retrospective selection of 290 patients with local recurrence (LR) after primary STS resection.
- Analysis of 239 patients who underwent complete resection of their first LR.
- Kaplan-Meier survival estimates and Cox proportional hazards modeling for extremity-trunk and retroperitoneal (RP) sites.
Main Results:
- Primary tumor site and margin status independently predicted local control.
- Extremity-trunk site and high tumor grade predicted distant relapse.
- RP recurrence increased mortality risk (1.4x), with 5-year survival of 57% vs. 70% for extremity-trunk.
- High tumor grade was a strong predictor of mortality.
Conclusions:
- Anatomic site is a key determinant of local control and survival in recurrent STS.
- Distant relapse dictates outcomes for extremity-trunk STS.
- Local recurrence is the primary driver of mortality in RP STS.