Influence of Local Recurrence on the Prognosis of Soft-Tissue Sarcomas

Abstract

We have investigated the significance of local recurrence on survival in 173 patients with localised soft-tissue sarcomas of the limbs and of the trunk.The overall survival rates at five and ten years were 75.2% and 68.0%, respectively. After definitive surgery at our hospitals, there was local recurrence in 25 patients (14.5%). After inadequate operations elsewhere, there was a higher incidence of late local recurrence (28.3%), in comparison with those with primary tumours treated by us (9.0%), or patients referred to us immediately after inadequate surgery elsewhere (10.2%). Because of small numbers these differences in the survival rates were not statistically significantly different.Univariate survival analysis showed that local recurrence after definitive surgery (p = 0.006) together with the histological grade (p = 0.0002), the size of the tumour (p = 0.002), its depth in relation to deep fascia (p = 0.003), and the surgical margin (p = 0.0001) were the significant prognostic factors. Local recurrence at the initial presentation did not affect survival. Multivariate analysis showed that local recurrence after definitive surgery also lost its apparent prognostic significance.

Impact of Margin Status and Local Recurrence on Soft-Tissue Sarcoma Outcomes

“…Local recurrence (data not shown) was significantly associated with overall survival irrespective of clinical presentation of recurrence (at the time of initial presentation or following definitive surgery). However, Ueda et al 1 specifically distinguished factors related to presentation of local recurrence in the analysis of the prognostic impact of local disease failure, concluding that neither initially presenting nor post-definitive resection local recurrence significantly influences survival after resection of localized soft-tissue sarcomas in multivariate analysis.…”

Local Recurrence After Initial Multidisciplinary Management of Soft Tissue Sarcoma: Is there a Way Out?

“…This study was conducted within the musculoskeletal oncology units at McGill University Health Centre and Maisonneuve-Rosemont Hospital. [7,10,13,16,25,27,28,30]. Local recurrences resulting from inadequate treatment have reported better prognosis than those occurring after a more comprehensive approach, with 5-year survival figures of 50% and 32%, respectively [1,11,22].…”

Unplanned resection of soft tissue sarcoma

“…Ueda et al 22 found that the local recurrence rate was higher in patients who received unplanned surgery than those who received successful primary wide excision. 23 Fiore et al 14 analyzed 597 consecutive patients with primary STSs. Of the 597 patients, 318 were referred after unplanned surgery and the remaining 279 patients underwent primary resection.…”