Sarcoma of the buttock: a trend toward limb-saving resection

A retrospective comparison was made between soft tissue sarcomas of the buttock treated during two consecutive periods at one institution: (1) 1966-1978, during which almost all tumors were treated by radical buttectomy with limb preservation, often in conjunction with radiation therapy, and (2) 1934-1966, as previously reported by Wanebo et al, in which treatment by hemipelvectomy was frequently offered. Desmoid tumors were excluded. The five-year survival rates after curative treatment were almost identical, 40% vs 39%, respectively. Distant metastases were the main cause of death. Very high local recurrence rates were recorded after therapy: 45% vs 39% for the respective periods. Local recurrences seemed prone to occur with large, deeply fixed sarcomas, particularly when inadequate or no radiation therapy had been utilized. These observations point to the need for innovative methods to prevent local tumor recurrence and a trial of adjuvant chemotherapy if long-term cure with limb preservation is to be achieved.