Local recurrence of soft tissue sarcoma a risk factor for late metastases. 379 patients followed for 0.5-20 years

We performed a retrospective analysis of 379 adult patients treated for soft tissue sarcoma. None had metastasis at the time of diagnosis and all were treated surgically. Patients who developed metastatic disease before the local recurrence were excluded. The 8-year metastasis-free survival rate in the group of 261 patients with local tumor control was 0.72, compared to 0.67 in the 118 patients with local recurrence (P 0.2). Multiple regression analysis showed that high-grade malignancy and large tumor size were risk factors for metastases. Local recurrence was not a risk factor. However, when patients with small and/or low-grade tumors were analyzed separately, local recurrence emerged as a risk factor. In this group of patients, the 8-year survival rate was 0.87 for those with local control and 0.64 for those with local recurrence (P 0.004). Local recurrence appears to be a risk factor for the development of late metastases in patients who otherwise have a low risk of metastases.