Refinement of clinicopathologic staging for localized soft tissue sarcoma of the extremity: a study of 423 adults.

Gaynor, Jeffrey J.; Tan, Charlotte; Casper, Ephraim S.; Collin, Charles; Friedrich, Claudia; Shiu, Man H.; Hajdu, Steven I.; Brennan, Murray F.

doi:10.1200/jco.1992.10.8.1317

Cited by 255 publications

(115 citation statements)

References 79 publications

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“…This concept is also supported by the large difference between patients with and without local recurrence in the interval between primary treatment and metastases. Hence, among patients with small and/or low-grade tumors, local recurrence was a significant risk factor, a finding which is in agreement with a similar study from the Memorial Sloan-Kettering Cancer Center (Gaynor et al 1992).…”

Section: Discussionsupporting

confidence: 80%

Local recurrence of soft tissue sarcoma a risk factor for late metastases: 379 patients followed for 0.5-20 years

Trovik

Bauer

1994

Acta Orthopaedica Scandinavica

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Section: Discussionsupporting

confidence: 80%

Local recurrence of soft tissue sarcoma a risk factor for late metastases: 379 patients followed for 0.5-20 years

Trovik

Bauer

1994

Acta Orthopaedica Scandinavica

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“…Recent independent studies of a large series of soft tissue sarcomas showed that histologic tumour grade, tumour depth and tumour size were independent prognostic factors (Gaynor et al, 1992;Coindre et al, 1996). In the current study, Cox proportional hazard multivariate analysis revealed that histologic grade was the most valuable independent prognostic factor in patients with soft tissue sarcoma.…”

Section: Discussionsupporting

confidence: 51%

“…Recent studies on a large number of soft tissue sarcoma cases have claimed that the grade of the tumour, size of the tumour and tumour depth are independent prognostic factors (Gaynor et al, 1992;Coindre et al, 1996). There is a general consensus that the size of tumour tissue is an important and easily obtainable parameter of tumour growth and that the growth of tumour is largely dependent on neovascularity in solid tumours.…”

mentioning

confidence: 99%

Concentration of vascular endothelial growth factor in the tumour tissue as a prognostic factor of soft tissue sarcomas

et al. 2001

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Previous studies have shown that the prognosis of patients who have tumours with high microvessel density (MVD) is worse than that of patients who have a lower density in a variety of cancers. In this study, we investigated the clinical relevance of neovascularity assessed by MVD and the concentration of vascular endothelial growth factor (VEGF) in the tumour tissue of patients with soft tissue sarcoma in comparison with major clinicohistologic parameters by univariate and multivariate analysis. In 115 patients with soft tissue sarcoma, MVD was measured by counting vessels stained with factor VIII antibody. The concentration of VEGF in the tumour tissue was determined by enzyme-linked immunosorbent assay. These parameters were then compared with disease outcome. The concentration of VEGF in the tumour tissue, but not MVD, was found to be correlated with disease outcome in patients with soft tissue, sarcoma. VEGF concentration in the tumour tissue showed a relationship with the clinical stage and histologic grade of the tumour. There was no significant difference in the levels of tissue VEGF concentration and MVD among soft tissue sarcomas classified according to histologic type. The level of tissue VEGF concentration in patients who had subsequent local recurrence and metastasis were significantly higher than the respective values in patients who did not have such disease outcome. No significant correlation existed between MVD and the concentration of VEGF in the tumour tissue. Univariate analysis showed that a high tissue VEGF concentration was associated with poor overall survival of the patient and a greater probability that local recurrence and metastasis had occurred. Multivariate analysis revealed that the tissue concentration of VEGF is an independent prognostic factor for the disease outcome of patients with soft tissue sarcoma. VEGF concentration in the tumour tissue, but not MVD, is an additional prognostic parameter for disease outcome in patients with soft tissue sarcoma, regardless of histologic type. © 2001 Cancer Research Campaign http://www.bjcancer.com

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“…Several analyses of prognostic factors influencing both local recurrence and overall survival in patients with extremity soft tissue sarcomas show tumor stage, grade, size, depth, and anatomic site are most important for patient survival [6,13,24,26]. Negative surgical margin, low histologic grade, and use of radiotherapy are the most important factors in achieving local disease control [6,8,10,12,23,27,30,33].…”

Section: Introductionmentioning

confidence: 99%

Do Surgical Margin and Local Recurrence Influence Survival in Soft Tissue Sarcomas?

Novais

Demiralp

Alderete

et al. 2010

Clinical Orthopaedics &Amp; Related Research

138

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Background Established prognostic factors influencing survival in soft tissue sarcomas include tumor stage, histopathologic grade, size, depth, and anatomic site. The presence of tumor near or at the margin of resection increases the risk of local recurrence but whether a positive surgical margin or local recurrence affect overall survival is controversial. Questions/purposes We explored the impact of microscopic margin on local recurrence, metastasis, and overall survival in patients with intermediate-to high-grade soft tissue sarcomas of the extremities. We then determined whether local recurrence decreases overall survival. Methods We retrospectively reviewed the medical records of 248 patients who had soft tissue sarcomas of the extremities treated surgically from 1995 to 2008. We estimated survival, local recurrence, and distant metastasis and examined factors potentially influencing these outcomes. The minimum followup was 0.4 years (median, 4.4 years; range, 0.4-13 years). Results The 5-year cumulative incidence of local recurrence was 4.1%. Patients who presented with positive margins or a margin of 2 mm or less had a worse survival than patients who had margins of greater than 2 mm and wide margins (5-year survival, 47% versus 70% and 72%). In addition to surgical margin, developing metastasis, tumor response of less than 90% necrosis, high histopathologic grade, high AJCC stage (Stage III), increasing age, and male gender were associated with decreased overall survival. Local recurrence independently predicted decreased overall survival. Conclusions Microscopic surgical margin and local recurrence after surgical treatment should be included as risk factors predicting decreased overall survival for intermediate-to high-grade soft tissue sarcomas of the extremities. Level of Evidence Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Refinement of clinicopathologic staging for localized soft tissue sarcoma of the extremity: a study of 423 adults.

Cited by 255 publications

References 79 publications

Local recurrence of soft tissue sarcoma a risk factor for late metastases: 379 patients followed for 0.5-20 years

Local recurrence of soft tissue sarcoma a risk factor for late metastases: 379 patients followed for 0.5-20 years

Concentration of vascular endothelial growth factor in the tumour tissue as a prognostic factor of soft tissue sarcomas

Do Surgical Margin and Local Recurrence Influence Survival in Soft Tissue Sarcomas?

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