Local Recurrence in Adult Soft-Tissue Sarcoma

Brennan, Murray F.; Hilaris, B.S.; Shiu, Man H.; Lane, Joseph M.; Magill, Gordon B.; Friedrich, Claudia; Hajdu, Steven I.

doi:10.1001/archsurg.1987.01400230075014

Cited by 178 publications

(32 citation statements)

References 13 publications

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“…They reported a 20% rate of local recurrence in the limb salvage group and none in the amputation group, but the higher rate of local recurrence in the limb salvage group was not significant since the number of patients available for comparison was small and the study likely underpowered for that question. A similar consideration of lack of statistical power apply to the study by Brennan et al [3] showing, despite lower rates of local recurrence in patients who underwent surgical resection with adjuvant brachytherapy, the overall survival was not different from that in patients who received surgical resection alone.…”

Section: Discussionmentioning

confidence: 91%

“…However, there was no difference in overall survival. Brennan et al [3] showed, despite lower rates of local recurrence in patients who underwent surgical resection with adjuvant brachytherapy, the overall survival was not different from patients who received surgical resection alone. In contrast, several other studies have recognized local recurrence as a major factor associated with decreased overall survival [10,21,23].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors believe a negative microscopic surgical margin enhances local disease control but does not measurably improve overall survival [3,4,28]. In contrast, recent reports argued surgical excision with negative margins not only improves local control but also enhances overall survival [9,23,27].…”

Section: Introductionmentioning

confidence: 99%

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

Novais

Demiralp

Alderete

et al. 2010

Clinical Orthopaedics &Amp; Related Research

140

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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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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Novais

Demiralp

Alderete

et al. 2010

Clinical Orthopaedics &Amp; Related Research

140

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“…Several published studies of surgery and postoperative radiotherapy report local recurrence rates between 10% and 28% (8,23,(49)(50)(51)(52)(53)(54). The series from the MD Anderson Cancer Center is one of the first and largest, involving 300 patients (7).…”

Section: Rudiofherupy and Surgerymentioning

confidence: 99%

“…Postoperative brachytherupy was addressed by Brennan and associates in a randomized prospective study of 117 patients with soft tissue sarcomas localized to the extremities and the trunk wall (54). Fifty-two patients were randomized to brachytherapy and the remainder received no brachytherapy.…”

Section: Rudiofherupy and Surgerymentioning

confidence: 99%

Soft Tissue Sarcomas

Alvegård¹

1996

Acta Oncologica

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Prognostic Factors in Primary Retroperitoneal Soft-Tissue Sarcomas

Bevilacqua

Rogatko²,

Hajdu³

et al. 1991

Arch Surg

139

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We analyzed independent treatment variables (age, sex, signs and symptoms, site, size, histopathologic findings, grade, and clinical presentation) and treatment-dependent variables (resectability, type of operation, surgical margins, surgical boundaries, microscopic margins, adjuvant radiotherapy, and adjuvant chemotherapy) in 80 patients with primary retroperitoneal soft-tissue sarcomas admitted from 1982 through 1988. Both univariate and multivariate analysis of survival and disease-free survival were performed. The major factor in survival outcome was the ability to completely resect the lesion. When the 62 patients who underwent complete resection were examined, the only independent prognostic factor for both survival and disease-free survival was grade. We conclude that completeness of resection and grade of the lesion are primary determinants of survival. Once all tumor is macroscopically removed, no advantage could be demonstrated by more extensive surgical resection or current adjuvant therapy.

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Local Recurrence in Adult Soft-Tissue Sarcoma

Cited by 178 publications

References 13 publications

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

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

Soft Tissue Sarcomas

Prognostic Factors in Primary Retroperitoneal Soft-Tissue Sarcomas

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