Patterns of disease relapse in primary extremity soft-tissue sarcoma

Area of Science:

• Orthopedic Oncology
• Surgical Pathology
• Cancer Epidemiology

Background:

• Extremity soft-tissue sarcomas encompass diverse histological subtypes.
• Characterizing relapse patterns is crucial for managing these rare tumors.

Purpose of the Study:

• To analyze disease relapse patterns in patients with primary extremity soft-tissue sarcoma.
• To investigate the prognostic impact of histological subtype on survival outcomes.

Main Methods:

• Retrospective analysis of 556 patients undergoing resection at a single institution (2004-2014).
• Evaluation of local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-specific survival (DSS).
• Multivariable analysis to determine independent prognostic factors.

Main Results:

• Undifferentiated pleomorphic sarcoma showed the poorest outcomes (5-year DMFS 56.8%, DSS 60.1%).
• Histological subtype significantly impacted DMFS and DSS (P < 0.001), but not LRFS (P = 0.222).
• Lungs were the most common site of metastasis (80.5%), but extrapulmonary metastases were more frequent in myxoid liposarcoma.

Conclusions:

• Histological subtype is not an independent prognostic factor for LRFS, DMFS, or DSS.
• The site of first metastasis significantly varies by histological subtype.
• Findings highlight the importance of considering subtype-specific metastatic patterns in treatment strategies.