title: Clinicopathologic features and treatment of postirradiation sarcoma of bone and soft tissue.
abstract: OBJECTIVE
  An analysis of the clinicopathologic features and treatment of patients with postirradiation sarcoma of bone and soft tissue was performed to guide modern evaluation and management.
  
  
  METHODS
  A retrospective analysis of 135 sarcomas in 130 patients was performed.
  
  
  RESULTS
  The mean age of the 130 patients was 48 years, and there was a female predominance because of irradiation for carcinomas of the breast and uterus. Indication for irradiation was a soft tissue lesion (such as lymphoma or breast cancer) in 58.5% of patients and a bone lesion (such as giant cell tumor or fibrous dysplasia) in 41.5%. The latent period (interval between irradiation and discovery of the sarcoma) ranged from 4-55 years (mean, 17 years). Of the lesions, 74% were stage IIB (high-grade extra-compartmental) and 24% were stage III (metastases). Ninety-four patients received their treatment at our institution. Of the 61 patients with resectable disease, 49 had amputations and 12 had limb salvage procedures. The 5-year cumulative survival rate was 68.2% for patients with peripheral (extremities, including proximal femur and hip) resectable lesions and 27.3% for patients with central (pelvis, head/neck, and ribs) resectable lesions. The local recurrence rate correlated with the surgical margin achieved: intralesional, 73%, marginal, 64%, and wide, 23%.
  
  
  CONCLUSIONS
  The prognosis for patients with peripheral resectable postirradiation sarcomas is good if a wide surgical margin can be achieved. This group of patients should be treated aggressively because they have a new cancer.
authors.affiliation: Department of Orthopedics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
authors.forename: Y Z
authors.initials: YZ
authors.lastname: Inoue
authors.forename: F J
authors.initials: FJ
authors.lastname: Frassica
authors.forename: F H
authors.initials: FH
authors.lastname: Sim
authors.forename: K K
authors.initials: KK
authors.lastname: Unni
authors.forename: I A
authors.initials: IA
authors.lastname: Petersen
authors.forename: R A
authors.initials: RA
authors.lastname: McLeod
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000601:surgery*