[Treatment results of soft tissue sarcomas in adults]

An appropriate therapeutical concept for soft tissue sarcomas is unknown particularly since that our knowledge about these neoplasms is considerably incomplete partly resulting from a low incidental rate distributed to many subentities. Children and adolescents were aggressively and multimodally treated. The standard therapy of the adults is an resection as radical as possible followed by adjuvant radiotherapy. The aim of our study was to show the treatment results of our clinic and to investigate survival rates, local tumor control and prognostic factors.

Between 1965 and 1989, a total of 51 male and 49 female were treated for soft tissue sarcoma at the University Hospital of Münster.

The overall five-year survival rate (actuarial survival) was 43.1%. 27% of the patients developed a local recurrence, 45% distant metastases. Lymph node metastases occurred in 4% of the patients. Tumor size was a prognostic factor for the five-year survival rates (T1 = 59.8%, T2 = 44.0%, T3 = 26.0%). The best results were achieved after combined treatment using surgery (wide resection) and postoperative high dose radiotherapy. Compared to wide resection alone, the combined treatment had a significantly higher five-year survival rate (59.7% vs. 26%). There was no significant improvement using adjuvant postoperative chemotherapy.

In our study we could show a remarkable improvement of the five-year survival rate by adjuvant radiotherapy after surgical resection versus surgery alone and demonstrate the importance of radiotherapy in the treatment of soft tissue sarcoma.