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Clinical importance of late recurrence in soft-tissue sarcomas

✍ Scribed by Gibbs, John F.; Lee, R. Jeffrey; Driscoll, Deborah L.; McGrath, Brian E.; Mindell, Eugene R.; Kraybill, William G.


Publisher
John Wiley and Sons
Year
2000
Tongue
English
Weight
118 KB
Volume
73
Category
Article
ISSN
0022-4790

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✦ Synopsis


Background and Objectives: Soft-tissue sarcomas (STS) represent a diverse histologic group of malignancies at risk for local and distant failure. We studied the impact of late (5 or more years) vs. early recurrence (less than 5 years) on subsequent outcome. Methods: Four hundred sixty-eight patients with STS treated between 1962 and 1992 were evaluated for late (n ‫ב‬ 39; 8%) or early (n ‫ב‬ 253; 54%) recurrence. Clinical and pathologic factors were reviewed. Survival data were analyzed by the Kaplan-Meier method and the log-rank test. Results: Of the 39 patients with a late recurrence (median follow-up 156 months), 18 patients had local recurrence, 7 patients developed distant recurrence, and 14 patients had local and distant recurrence. Thirty patients with late local and/or distant recurrence underwent complete or wide excision (n ‫ב‬ 16), amputation (n ‫ב‬ 4), or local resection (n ‫ב‬ 10). The overall 5-year survival rate following late recurrence was 61%. The 5-year overall survival rate was statistically better for patients with a late local recurrence alone than for patients with distant failure, 94% vs. 36%, respectively (P ‫ב‬ 0.003). Neither the site of the primary STS, age, primary margin status, nor histology had any effect on subsequent local or distant failure and subsequent survival. Conclusions: These data suggest that an aggressive approach is appropriate in patients who present with late recurrence (more than 5 years) following treatment of the primary STS. Impressive survival rates can be achieved in the treatment of local recurrences.


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