Conservative surgery and postoperative radiotherapy in 300 adults with soft‐tissue sarcomas

• Published in: Cancer 1981-05, Vol.47 (10), p.2391-2397
• Main Authors: Lindberg, Robert D., Martin, Richard G., Romsdahl, Marvin M., Barkley, H. Thomas
• Format: Article
• Language: English
• Subjects: Abdomen; Adolescent; Extremities; Fibrosarcoma - surgery; Humans; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasm Staging; Neurofibroma - surgery; Postoperative Complications; Prognosis; Retrospective Studies; Sarcoma - pathology; Sarcoma - radiotherapy; Sarcoma - surgery; Soft Tissue Neoplasms - pathology; Soft Tissue Neoplasms - radiotherapy; Soft Tissue Neoplasms - surgery
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(19810515)47:10<2391::AID-CNCR2820471012>3.0.CO;2-B

From January 1963 through December 1977, 300 adults with soft‐tissue sarcomas were treated by a conservative surgical excision and postoperative radiotherapy. The absolute two‐ and five‐year disease‐free survival rates are 74% (222/300) and 61.3% (103/168), respectively. The five‐year survival rate varies with: (1) anatomic site, e.g., 69.4% (75/108) for extremity lesions vs. 33% (5/15) for abdominal lesions; (2) histopathologic diagnosis, e.g., 86.4% (19/22) for fibrosarcoma vs. 50% (15/30) for neurofibrosarcoma; and (3) stage of the lesion. The overall local recurrence rate was 22.3% (67/300) and 27% (81/300) of the patients developed distant metastases. The incidence of lymph node metastases as an initial site of spread was only 2.7% (8/300); therefore, elective treatment of the regional lymphatics is not indicated. The 6.5% incidence of significant complications in extremities is low and might be further diminished by careful treatment planning. The combination of conservative surgery and postoperative radiation therapy maintains a functional limb in 84.5% (169/200) of patients with extremity lesions. This rate is comparable to the five‐year survival rate attained with radical surgery.