[Therapeutic strategies in malignant soft tissue tumors. Results of the soft tissue tumor register study of the Surgical Oncology Working Group].
BACKGROUND
This study, carried out by the Surgical Oncology Working Group (CAO) of the German Society for Surgery, was performed to analyse the strategies in the treatment of soft tissue sarcomas in adults.


METHODS
In a period of 19 months the data on 292 patients suffering from soft tissue sarcomas, treated in 99 surgical departments in Germany, were analysed prospectively. A special questionnaire was developed including pretherapeutic biopsy, previous treatment, definitive surgical treatment, combined modality approach and histopathological results.


RESULTS
Thirty-nine per cent of the tumours were treated in university hospitals, 36% in medical centres, 24% in regional hospitals. During the observation period two patients were treated on average (median) by each hospital. Limb-sparing treatment was performed in 96% of the extremity tumours. There was no significant difference in the frequency of R0 resections between the different hospitals. At the university hospitals local extended operations and additive measures were used more often. The indication for adjuvant radiotherapy differed: after compartmental resection, adjuvant radiotherapy was performed in 39% of cases (19/49); after wide-excision of high-grade tumours, in 45% of cases (20/44) no adjuvant radiotherapy was necessary. In spite of less radical treatment in tumours of the trunk, additional radiotherapy was not more frequently performed.


CONCLUSIONS
To improve the quality in the treatment of soft tissue sarcomas it seems to be of great importance to avoid inadequate initial treatment (18%), to respect the rules of oncological surgery (tumour rupture in 7% of cases), to improve the histopathological examination (no R classification in 5-12%) and to develop guidelines for multimodality treatment.
Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes-Gutenberg-Universität, Mainz.
T
T
Junginger
C
C
Kettelhack
M
M
Schönfelder
H D
HD
Saeger
H
H
Rieske
F
F
Krummenauer
P
P
Hermanek
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005858:Germany; D018219:Histiocytoma, Benign Fibrous / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D007890:Leiomyosarcoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D008080:Liposarcoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D018208:Liposarcoma, Myxoid / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D018317:Nerve Sheath Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012042:Registries; D012509:Sarcoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D011795:Surveys and Questionnaires
D000970:Antineoplastic Agents