title: Soft-tissue sarcomas of the shoulder girdle: factors influencing local recurrence distant metastases, and survival.
abstract: BACKGROUND
  Prognostic factors and the role of radiotherapy have not been well characterized for soft-tissue sarcomas (STS) of the shoulder girdle.
  
  
  METHODS
  The cases of 70 patients with primary shoulder STS were reviewed for the following information: size, grade and histology of tumors, extent of resection, and use of adjuvant radiotherapy. The influence of these factors on local disease-free survival (LDFS), distant disease-free survival (DDFS), and overall survival (OS) rates was analyzed using univariate analysis.
  
  
  RESULTS
  With a median follow-up of 108 months, the overall 5- and 10-year survival rates for patients with shoulder girdle STS were 82% and 80%, respectively, whereas the 5-year disease-free survival rate was 63%. There were 25 (35%) tumor recurrences: 12 (17%) distant and 13 (18%) local regional. Tumors > 5 cm in size were associated with a significantly decreased 5-year OS rate compared with lesions < 5 cm, and high-grade tumors were associated with significantly decreased DDFS and OS rates. Because most of the patients who underwent amputation had large, high-grade tumors, they had significantly decreased 5-year DDFS and OS rates compared with wide local excision. Radiotherapy produced a significant improvement in LDFS rates, particularly in patients with tumors > 5 cm in size.
  
  
  CONCLUSIONS
  The results indicate that both tumor size and grade are important prognostic factors in shoulder girdle STS. Adjuvant radiotherapy should be considered in large tumors to improve the LDFS and to decrease the need for radical ablative surgery.
authors.affiliation: Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Meterissian
authors.forename: J A
authors.initials: JA
authors.lastname: Reilly
authors.forename: A
authors.initials: A
authors.lastname: Murphy
authors.forename: M M
authors.initials: MM
authors.lastname: Romsdahl
authors.forename: R E
authors.initials: RE
authors.lastname: Pollock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012509:Sarcoma / Q000188:drug therapy / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D012782:Shoulder; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery