title: Childhood soft tissue sarcoma: a 20-year experience.
abstract: OBJECTIVE
  To evaluate the disease-free and overall survival of pediatric patients with nonrhabdomyosarcoma soft-tissue sarcomas.
  
  
  METHODS
  We retrospectively analyzed the records of 67 pediatric patients with a diagnosis of nonrhabdomyosarcoma soft tissue sarcoma treated with curative intent between 1970 and 1992. Median follow-up time for the 52 survivors was 120 months (range, 7 to 277 months). Fifty-nine patients received external beam radiotherapy, in a median dose of 5400 cGy (range, 1800 to 6660 cGy.) All patients underwent an initial surgical procedure. Eighteen patients had gross residual disease, and 15 had gross total excision with microscopic residual disease or positive margins. Adjuvant chemotherapy was administered to 44 patients (65%).
  
  
  RESULTS
  The actuarial 10-year freedom from progression or recurrence and overall survival rates were 76% and 75%, and the 20-year rates were the same. Of 18 patients with gross residual disease, 9 (50%) had local progression and 6 died of local-only disease. By contrast, only one patient with microscopic residual disease who received postoperative radiotherapy had a local recurrence. The disease-free survival rate also correlated with histologic grade.
  
  
  CONCLUSIONS
  As with adult soft tissue sarcomas, gross residual disease predicts local failure. Our results suggest that pediatric patients with soft tissue sarcomas treated with surgery and postoperative radiotherapy generally have a favorable overall survival rate.
authors.affiliation: Children's Hospital, Department of Radiation Oncology, Boston, MA 02115, USA.
authors.forename: K C
authors.initials: KC
authors.lastname: Marcus
authors.forename: H E
authors.initials: HE
authors.lastname: Grier
authors.forename: R C
authors.initials: RC
authors.lastname: Shamberger
authors.forename: M C
authors.initials: MC
authors.lastname: Gebhardt
authors.forename: A
authors.initials: A
authors.lastname: Perez-Atayde
authors.forename: B
authors.initials: B
authors.lastname: Silver
authors.forename: N J
authors.initials: NJ
authors.lastname: Tarbell
mesh_terms: D000293:Adolescent; D000328:Adult; D017024:Chemotherapy, Adjuvant; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012509:Sarcoma / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D015996:Survival Rate