title: Treatment outcome of conservative surgery plus postoperative radiotherapy for extremity soft tissue sarcoma.
abstract: OBJECTIVE
  To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS).
  
  
  METHODS
  Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy.
  
  
  RESULTS
  The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%).
  
  
  CONCLUSIONS
  Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.
authors.affiliation: Department of Radiation Oncology, Korea University Medical Center, Seoul, Korea.
authors.forename: Jieun
authors.initials: J
authors.lastname: Lee
authors.forename: Young Je
authors.initials: YJ
authors.lastname: Park
authors.forename: Dae Sik
authors.initials: DS
authors.lastname: Yang
authors.forename: Won Sup
authors.initials: WS
authors.lastname: Yoon
authors.forename: Jung Ae
authors.initials: JA
authors.lastname: Lee
authors.forename: Chai Hong
authors.initials: CH
authors.lastname: Rim
authors.forename: Chul Yong
authors.initials: CY
authors.lastname: Kim