TY - JOUR
T1 - Long-term outcome of patients with American Joint Committee on Cancer Stage IIB extremity soft tissue sarcomas
AU - Fleming, Jason B.
AU - Berman, Russell S.
AU - Cheng, Su Chun
AU - Chen, Nancy P.
AU - Hunt, Kelly K.
AU - Feig, Barry W.
AU - Respondek, Paula M.
AU - Yasko, Alan W.
AU - Pollack, Alan
AU - Patel, Shreyaskumar R.
AU - Burgess, Michael A.
AU - Papadopoulos, Nicholas E.
AU - Plager, Carl
AU - Zagars, Gunar
AU - Benjamin, Robert S.
AU - Pollock, Raphael E.
AU - Pisters, Peter W.T.
PY - 1999/9
Y1 - 1999/9
N2 - 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. 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, T1 a/b) disease. 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). 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.
AB - 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. 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, T1 a/b) disease. 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). 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.
UR - http://www.scopus.com/inward/record.url?scp=0032855729&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032855729&partnerID=8YFLogxK
U2 - 10.1200/jco.1999.17.9.2772
DO - 10.1200/jco.1999.17.9.2772
M3 - Article
C2 - 10561352
AN - SCOPUS:0032855729
SN - 0732-183X
VL - 17
SP - 2772
EP - 2780
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 9
ER -