LOCAL EXCISION WITHOUT RADIATION FOR HIGH GRADE SOFT TISSUE SARCOMA OF EXTREMITY AND SUPERFICIAL TRUNK

Weir LM, VanBergeyk AB, Masri BA , Grafton CA, Duncan CP, Goddard KJ

Background: Limb sparing surgery combined with radiation treatment has become the accepted treatment for patients with high-grade soft tissue sarcoma. Adjuvant radiation was not routinely used at this institution for patients with clear margins after surgery. This retrospective review analyzes the outcome of this group of patients.

Methods: Patients studied were referred from 1984 to 1995, were over 16 years of age, were diagnosed with primary high-grade soft tissue sarcoma of the extremity or superficial trunk, had clear margins after excision, and had not received radiation as a part of their initial treatment. A total of 46 patients were identified.

Results: At 5 years, the local control rate was 87%, disease specific survival was 75% and overall survival was 68%. Of the 6 local recurrences, 3 were located in the buttock (out of a total of 7 patients with primary tumours of the buttock ) and 3 had a primary tumour size of 10 cm or more (out of a total of 8 primary tumors of that size).

Discussion: Our data and that from other reports, suggests that in selected patients, appropriate surgery alone results in acceptable local control and survival, and the morbidity of radiation can be avoided.