title: Local control of soft tissue sarcoma of the extremity: the experience of a multidisciplinary sarcoma group with definitive surgery and radiotherapy.
abstract: Data gathered on 62 patients with soft tissue sarcoma of an extremity, treated in entirety by an experienced multidisciplinary sarcoma group, were analysed. With a philosophy of emphasising attainment of histologically negative margins at carefully planned limb sparing surgery, combined with either pre-operative or postoperative radiation therapy, a crude local control rate of 95% (59 of 62 patients) at a minimum of 24 months follow-up was obtained. Of 9 patients with microscopically positive margins after definitive surgery, 8 had undergone maximal resection compatible with preservation of function. One of these 9 failed locally, indicating that radiation therapy is effective in eradicating microscopic disease in this tumour. The excellent local control obtained with limb-sparing surgery in this series justifies early referral of patients with these uncommon cancers to an experienced multidisciplinary unit. 26 patients (42%) failed systemically at a minimum of 24 months follow-up, and 19 (30.6%) died of their disease, confirming the need for effective systemic therapy in soft tissue sarcoma. Tumours greater than 10 cm in diameter had a greater risk of systemic relapse.
authors.affiliation: Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Canada.
authors.forename: A N
authors.initials: AN
authors.lastname: Wilson
authors.forename: A
authors.initials: A
authors.lastname: Davis
authors.forename: R S
authors.initials: RS
authors.lastname: Bell
authors.forename: B
authors.initials: B
authors.lastname: O'Sullivan
authors.forename: C
authors.initials: C
authors.lastname: Catton
authors.forename: F
authors.initials: F
authors.lastname: Madadi
authors.forename: R
authors.initials: R
authors.lastname: Kandel
authors.forename: V L
authors.initials: VL
authors.lastname: Fornasier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*