Posters— Surgical Treatment of Sarcomas

SURGICAL MARGINS INFLUENCE LOCAL RECURRENCE OF SOFT TISSUE SARCOMAS IN THE THIGH, BUT NOT SURVIVAL IN 152 PATIENTS

S. Vraa, J. Keller, O. Nielson, A.G. Jurik, O.M. Jenson (Center for Bone and Soft-Tissue Sarcomas, University Hospital of Aarhus, DK-8000 Arhus C, Denmark)

In a 19 year period (1979-1998) 152 consecutive patients with soft tissue sarcomas in the thigh were surgically treated in the Sarcoma center in Aarhus. Prognostic clinicopathologic factors for local recurrence and survival were studied by use of multivariate statistical analysis. 27 patients (18%) had a low-grade tumor, 26 (17%) an intermediate-grade and 99 (65%) a high-grade tumor (Jensen 1991). 27 patients (18%) were amputated and 125 (82%) had local resection. 21 patients (14%) underwent a marginal resection, 82 patients (54%) had a wide resection and 49 (32%) had a compartmental resection. 14 patients (9%) developed local recurrence. All patients but one had the local recurrence surgically removed. The patients with local recurrence had a significantly poorer survival compared to patients without local recurrence. 49 patients (32%) developed distant metastases. The 5-year recurrence-free rate was 91%. The multivariate analysis selected marginal resection (vs wide and compartmental resection) and histological-high grade (vs intermediate and low-grade) as unfavorable prognostic factors for local recurrence . The 5 year survival rate was 68%. High age (vs age less than median age) and hitological high grade (vs intermediate and low-grade) were selected as unfavorable prognostic factors for survival in a multivariate analysis. In the present study surgical margin influenced local recurrence but not the overall survival in sarcomas in the thigh. O..M. Jensen et al. Histopathologica grading of soft tissue tumours, Prognostic significance in a prospective study of 278 consecutive patients. Pathol 199 1; 163: 19-24.