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Soft tissue sarcomas of the lower extremity: surgical treatment and outcome
- Source :
- European Journal of Surgical Oncology. 26:679-685
- Publication Year :
- 2000
- Publisher :
- Elsevier BV, 2000.
-
Abstract
- Aims The aims of this retrospective follow-up study were to evaluate the justification for limb-saving multi-disciplinary treatment of soft tissue sarcomas (STS) and to report the results achieved by our treatment protocol. Local control was studied, with emphasis on tumour depth, operation margin and need for post-operative radiotherapy. Methods We examined 130 patients with STS in the lower limb referred to the multi-disciplinary group of Helsinki University Central Hospital. For the survival analysis 106 patients with local disease remained. The goal of treatment was to preserve a functional limb. Wide excision was attempted. If the margin was less than 2.5 cm, post-operative radiotherapy (RT) was delivered to all except 20 patients. Results Ninety-two per cent of the patients were treated by limb salvage. The success rate of free flaps was 16 out of 18. The 5-year disease-specific overall survival was 76%, metastasis-free survival 72% and local control 79%. Prognostic factors for local recurrence were extracompartmental site and large size; for development of metastases high grade, extracompartmental site and large size; for decreased disease-specific overall survival high grade, large size and advanced age. Local control of intramuscular tumours ( n =6) was 100%, subcutaneous tumours ( n =38) 94% and tumours penetrating the deep or muscle fascia and those locating extracompartmentally ( n =62) 67%. Conclusions Limb salvage in patients with STS is possible with an acceptable outcome by selective combination of treatment modalities. Modern plastic surgical methods with free tissue transfers are successful and often needed. Subcutaneous and intramuscular tumours have good local control. The outcome is poorest for tumours penetrating the deep or muscle fascia and for those located extracompartmentally, and patients with such tumours might be a target for adjuvant therapy. Treatment should be coordinated by multidisciplinary teams.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Soft Tissue Neoplasms
Disease-Free Survival
Surgical Flaps
Adjuvant therapy
medicine
Humans
Combined Modality Therapy
Survival analysis
Aged
Retrospective Studies
Leg
business.industry
Soft tissue
Sarcoma
Retrospective cohort study
General Medicine
Middle Aged
Plastic Surgery Procedures
medicine.disease
Survival Analysis
Surgery
Radiation therapy
Plastic surgery
Treatment Outcome
Oncology
Surgical Procedures, Operative
Female
Radiotherapy, Adjuvant
business
Subjects
Details
- ISSN :
- 07487983
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- European Journal of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....7be79a01a0f6cc41bb9ccf52af66a6e8