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Soft tissue sarcomas: preoperative versus postoperative radiotherapy
E Y Cheng1, K E Dusenbery, M R Winters
1Department of Orthopaedic Surgery, University of Minnesota, Minneapolis.
Journal of Surgical Oncology
|February 1, 1996
Summary
Postoperative radiotherapy is recommended for extremity soft tissue sarcomas. Preoperative radiation did not improve survival or local control but increased wound complications.
Area of Science:
- Oncology
- Surgical Oncology
- Radiation Oncology
Background:
- External beam radiation is a common treatment for soft tissue sarcomas.
- The optimal timing of radiotherapy (preoperative vs. postoperative) in relation to surgery remains a key clinical question.
Purpose of the Study:
- To investigate whether the timing of radiotherapy affects local control, survival, or complication rates in patients with extremity soft tissue sarcoma.
Main Methods:
- Retrospective analysis of 112 patients with primary, nonmetastatic, extremity soft tissue sarcoma treated with surgery and radiation.
- Kaplan-Meier analysis and chi-square tests were used to compare outcomes between preoperative and postoperative radiotherapy groups.
Main Results:
- No significant differences in 5-year relapse-free survival (P=0.12), overall survival (P=0.94), or local control (P=0.41) between preoperative and postoperative radiotherapy.
- Wound complications were significantly higher in the preoperative radiotherapy group (31%) compared to the postoperative group (8%) (P=0.0014).
Conclusions:
- Preoperative radiotherapy does not offer survival or local control benefits for resectable extremity soft tissue sarcomas.
- Postoperative radiotherapy is preferred due to a lower incidence of wound complications, reserving preoperative radiation for unresectable tumors.