What Are Risk Factors for Local Recurrence of Deep High-grade Soft-tissue Sarcomas?

Abstract

Background Patients with local recurrence of soft-tissue sarcomas have a poor overall survival. High-grade, softtissue sarcomas in deep locations may have a poorer prognosis regarding local recurrence than low-grade sarcomas or those located superficially. Although previous reports evaluated tumors at various depths, it is unclear what factors influence recurrence of deep, high-grade sarcomas. Questions/purposes We therefore determined whether possible risk factors (tumor size, location, histologic subtype, unplanned excision, local recurrence at presentation, metastasis at diagnosis, surgical procedure, surgical margin, and adjuvant treatments) influenced local recurrence of deep, high-grade, soft-tissue sarcomas. Patients and Methods We retrospectively reviewed 433 patients with deep, high-grade, soft-tissue sarcomas surgically treated between 1985 and 2005. For each patient, we reviewed tumor size, location, histologic subtype, unplanned excision, local recurrence at presentation, metastasis at diagnosis, surgical procedure, surgical margin, and adjuvant treatments and determined the effect of each prognostic variable on local recurrence. The minimum followup was 1 month (median, 51 months; range, 1-305 months).

Prediction of Soft Tissue Sarcoma from Clinical Characteristics and Laboratory Data

“…Therefore, soft tissue sarcomas are sometimes misdiagnosed, resulting in unplanned resections or diagnostic delays. Although reports on the relationship between the additional wide excision after unplanned excision and local recurrence of soft tissue sarcomas are controversial [8][9][10][11], unplanned excision is generally considered to be associated with an increased risk of local recurrence and the needed for additional and more extensive surgery [2]. A delay in diagnosing a sarcoma will inevitably lead to tumor enlargement and large tumor size is a very poor prognostic factor [12].…”

How Long Should We Follow Patients With Soft Tissue Sarcomas?

“…After treatment of primary soft tissue sarcomas, 11% to 14% of patients develop local recurrence and 18% to 50% of patients develop metastases [3,8,12,15,16,19,23]. Local recurrence may require additional surgery, radiotherapy, or even amputation.…”

Optimization of the Therapeutic Approach to Patients with Sarcoma: Delphi Consensus

“…After the treatment of the primary STS, 11-14% of patients develop local recurrences and between 18% and 50% end up developing metastases [45,68]. e 2018 guidelines published by the US National Comprehensive Cancer Network (NCCN) [9] recommends local follow-up of patients with high-grade STS every 3-6 months during the first 2-3 years, every 6 months until the fifth year, and annually from the sixth year onwards.…”