[Treatment and prognosis of soft tissue sarcoma]

The treatment and prognosis of 121 patients with primary and locally recurrent soft tissue sarcomas of the extremities and trunk were analyzed. The most common histologic type was malignant fibrous histocytoma (32 patients, 26.4%). Ninety-three patients had high grade sarcomas (76.9%) and 28 had low grade sarcomas (23.1%). Adjuvant radiotherapy and chemotherapy were applied to 37 and 41 patients respectively. In 28 patients who had local recurrence after surgery, the 5-year local control rate was 72.3%. The overall 5-year survival rate was 59.9% for all patients, and 59.1% for 96 patients with locally recurrent lesions. The independent risk factors affecting the overall survival included high grade, tumor of upper extremity, perioperative blood transfusion, and tumor size of > or = 10 cm. We conclude that (1) wide excision is the most accepted operative procedure for treatment of soft tissue sarcoma of the extremity and trunk unless the lesions are locally advanced (In the advanced cases amputation should be performed); (2) in patients with local recurrence only, there is an almost same rate of long-term salvage as that in patients with primary tumors; (3) avoiding unnecessary perioperative blood transfusion may improve survival; and (4) further investigation of more effective regimen of adjuvant radiotherapy and chemotherapy needs to be taken.