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Multifocal extremity sarcoma: an uncommon and controversial entity
S L Blair1, J J Lewis, D Leung
1Department of Surgery, Memorial-Sloan Kettering Cancer Center, New York, New York 10021, USA.
Annals of Surgical Oncology
|April 3, 1998
Summary
Diagnosing multifocal extremity sarcoma is challenging. Regardless of whether it is truly multifocal or metastatic, outcomes are similar, suggesting treatment as metastatic disease.
Area of Science:
- Oncology
- Surgical Pathology
- Cancer Metastasis
Background:
- Extremity sarcomas commonly metastasize to the lungs.
- Distinguishing multifocal disease from metastasis in non-lung sites is clinically challenging.
Purpose of the Study:
- To investigate the characteristics and outcomes of patients with apparent multifocal extremity sarcoma.
- To determine if multifocal disease should be treated differently from metastatic disease.
Main Methods:
- Retrospective review of 1423 patients with extremity sarcoma (1982-1996).
- Analysis of patient demographics, tumor characteristics, recurrence, metastasis, and survival.
- Statistical analysis using Fischer exact test, chi-squared, Kaplan-Meier, and log-rank tests.
Main Results:
- Sixteen patients (1%) presented with multifocal disease; no demographic or tumor differences were noted compared to unifocal disease.
- Patients with multifocal disease had higher rates of lung metastasis (63% vs. 21%) and similar 5-year survival to those with lung metastasis.
- High rates of local recurrence (50%) and distant metastasis (80%) were observed in the multifocal group.
Conclusions:
- The distinction between true multifocal disease and metastasis in extremity sarcoma remains unclear.
- The clinical outcome for patients with multifocal disease is comparable to those with metastatic disease.
- Management guidelines should consider multifocal extremity sarcoma as metastatic disease for treatment planning.
