Conservative surgery and postoperative radiotherapy in 300 adults with soft-tissue sarcomas.
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.
D000005:Abdomen; D000293:Adolescent; D005121:Extremities; D005354:Fibrosarcoma / Q000601:surgery; D006801:Humans; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009455:Neurofibroma / Q000601:surgery; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*