• J. Clin. Oncol. · Sep 1999

    Long-term outcome of patients with American Joint Committee on Cancer stage IIB extremity soft tissue sarcomas.

    • J B Fleming, R S Berman, S C Cheng, N P Chen, K K Hunt, B W Feig, P M Respondek, A W Yasko, A Pollack, S R Patel, M A Burgess, N E Papadopoulos, C Plager, G Zagars, R S Benjamin, R E Pollock, and P W Pisters.
    • Sarcoma Center at The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4195, USA.
    • J. Clin. Oncol. 1999 Sep 1; 17 (9): 2772-80.

    PurposeIt has been suggested that patients with small (< 5 cm), high-grade extremity soft tissue sarcomas (STS) have an excellent overall prognosis and, consequently, may not require adjuvant therapies.Patients And MethodsA comprehensive review of all patients with extremity STS treated at a tertiary care cancer hospital over a 9-year period (January 1984 to December 1992) was performed. Prognostic factors, treatment data, and long-term outcome were evaluated in the subset of 111 patients with American Joint Committee on Cancer stage IIB (G3/4, T1a/b) disease.ResultsThe median tumor size was 3.0 cm (range, 0.6 to 4.9 cm), and 55 tumors (50%) were deep in location. All patients underwent surgical resection; 68 (61%) received pre- or postoperative radiotherapy, and 32 (29%) received doxorubicin-based chemotherapy. The median follow-up was 76 months. Forty patients (36%) experienced 59 recurrences. First recurrences occurred at local, regional, and distant sites in 21, five, and 14 patients, respectively. The 5-year actuarial local recurrence-free, distant recurrence-free, disease-free, and overall survival rates were 82%, 83%, 68%, and 83%, respectively. The presence of a microscopically positive surgical margin was an independent adverse prognostic factor for both local recurrence (relative risk [RR] = 3.75; 95% confidence interval [CI], 1.25 to 11.25; P =.02) and disease-free survival (RR = 2.57; 95% CI, 1.33 to 4.98; P =.005).ConclusionEvent-free outcome for this subset of patients with high-grade STS does not seem as favorable as previously reported by other investigators. Patients who undergo maximal surgical resection with microscopically positive margins represent a subset of T1 STS patients who warrant consideration for adjuvant therapies.

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