Conservative surgery and postoperative radiotherapy in 300 adults with soft-tissue sarcomas

Authors

  • Robert D. Lindberg MD,

    Corresponding author
    1. Division of Radiotherapy, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute, Houston, Texas
    • Division of Radiotherapy, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute, 6723 Bertner Avenue, Houston TX 77030
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  • Richard G. Martin MD,

    1. Department of Surgery, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute, Houston, Texas
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  • Marvin M. Romsdahl MD, PhD,

    1. Department of Surgery, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute, Houston, Texas
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  • H. Thomas Barkley Jr MD

    1. Division of Radiotherapy, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute, Houston, Texas
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Abstract

From January 1963 through December 1977, 300 adults with soft-tissue sarcomas were treated by a conservative surgical excision and postoperative radiotherapy. The absolute two- and five-year disease-free survival rates are 74% (222/300) and 61.3% (103/168), respectively. The five-year survival rate varies with: (1) anatomic site, e.g., 69.4% (75/108) for extremity lesions vs. 33% (5/15) for abdominal lesions; (2) histopathologic diagnosis, e.g., 86.4% (19/22) for fibrosarcoma vs. 50% (15/30) for neurofibrosarcoma; and (3) stage of the lesion. The overall local recurrence rate was 22.3% (67/300) and 27% (81/300) of the patients developed distant metastases. The incidence of lymph node metastases as an initial site of spread was only 2.7% (8/300); therefore, elective treatment of the regional lymphatics is not indicated. The 6.5% incidence of significant complications in extremities is low and might be further diminished by careful treatment planning. The combination of conservative surgery and postoperative radiation therapy maintains a functional limb in 84.5% (169/200) of patients with extremity lesions. This rate is comparable to the five-year survival rate attained with radical surgery.

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