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Long-term outcome of patients with American Joint Committee on Cancer stage IIB extremity soft tissue sarcomas.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 1999 Sep; Vol. 17 (9), pp. 2772-80. - Publication Year :
- 1999
-
Abstract
- Purpose: It 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.<br />Patients and Methods: A 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.<br />Results: The 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).<br />Conclusion: Event-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.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Combined Modality Therapy
Disease-Free Survival
Female
Humans
Male
Middle Aged
Neoplasm, Residual pathology
Neoplasm, Residual surgery
Prognosis
Retrospective Studies
Extremities
Neoplasm Recurrence, Local mortality
Neoplasm Recurrence, Local pathology
Neoplasm Recurrence, Local surgery
Sarcoma mortality
Sarcoma pathology
Sarcoma therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0732-183X
- Volume :
- 17
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 10561352
- Full Text :
- https://doi.org/10.1200/JCO.1999.17.9.2772