title: Compartmental resection for subfascial extremity soft tissue sarcoma and quality of life in long-term survivors.
abstract: The surgical management of soft tissue sarcoma has changed over the past years, resulting in an interdisciplinary multimodal approach and limb-preserving treatment modalities. From 464 consecutive patients with a soft tissue sarcoma (STS) of an extremity, a compartmental resection was performed in 82 patients, usually for primary subfascial large tumors. Postoperative quality of life was evaluated using the EORTC Score C30. In our study population, 52% of STS was poorly differentiated, 32% moderately, and 16% well differentiated. Survival proved to be dependent on tumor grade and tumor biology, but not on tumor size. The overall survival rate was 81.5%, 71.9%, and 58.3% after 2, 3, and 5 years, respectively. Leiomyosarcoma (39%) and malignant fibrous histiocytoma (42%) are associated with poor 5-year survival rate compared to liposarcoma (82%). Metastases were observed in 33% of T1 and 43% of T2 tumors corresponding to 51% with G3 tumors, 52% with G2 and 23% with G1 tumors. We found a decreased quality of life score in our patients in all dimensions compared to a normal population. Despite the elevated risk of a functional deficit, compartmental resection reduces the risk of local recurrence comparable to the recurrence rates after the most radical surgery limb amputation.
authors: Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Heinrich-Heine-Universität, Düsseldorf, Germany.
authors: Matthias
authors: M
authors: Peiper
authors: Hanno
authors: H
authors: Matthaei
authors: Edwin
authors: E
authors: Bölke
authors: David
authors: D
authors: Zurakowski
authors: Klaus
authors: K
authors: Orth
authors: Antje
authors: A
authors: Heinecke
authors: Wolfram Trudo
authors: WT
authors: Knoefel
mesh_terms: D000328:Adult; D000368:Aged; D003299:Cooperative Behavior; D005121:Extremities / Q000473:pathology / Q000601:surgery*; D005205:Fascia / Q000473:pathology; D000071938:Fasciotomy; D005260:Female; D051677:Histiocytoma, Malignant Fibrous / Q000473:pathology / Q000601:surgery; D006801:Humans; D033183:Interdisciplinary Communication; D007890:Leiomyosarcoma / Q000473:pathology / Q000601:surgery; D023821:Limb Salvage / Q000379:methods; D008080:Liposarcoma / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D010348:Patient Care Team; D011183:Postoperative Complications / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000601:surgery*; D017741:Survivors