Background: Soft tissue sarcomas (515) of the extremities represe-tt a
diverse histologic group of malignancies at risk for local failure and distant
metastasis.
Aim of the work: The aim of this study was to evaluate the relarionships
between various clinicopathologic factors and the oncologic end
points local recurrence_ distant metastasis. local recurrence free-sal-L.:rat.
metastasis free-survival. and overall survival. To identify prognostic ariables
thar could be used to select patients most likely to benefit from adjuvant
or neoadjuvant treatment in future trials.
Patients and methods: Eighty seven patients with a non-metastatic and
locally controlled Sib. collected during the period 1996 through 001
from Minouftya Univers. Ind Hospital and Benha University Hospital. were
scathed. Patient. tumor. and pathologic factors u.ere analyzed by tint-artare
and multivariate techniques. The overall 5-year survival rate for the
it-hole series was 5396 (median 50: mean: 30.5+19.6: range. 12-60
months) with a median follow-up time of 35 months. The local recurrence
free-survival and metastasis free-survival races at 5-years were 3396 and
5296. respectively. The median post-metastasis survival was 13 months
(mean: 15.7+40.9; range. 4-23).
Results: Twenty-three (26.4%)- local recurrences and 21(24.1,6) dis:ant
metastases were rioted. The median time to development of local recur-rence and distant metastasis were 19 and 29 months, respectively. By
multivariate analysis the significant independent advert-i prognostic factors
for local recurrence were: positive microscopic surgical margins (13=
0.0001) and high histologic grade (P= 0.008). For distant metastasis
were: high histologic grade (P= 0.001) and tumor size greater than 10cm,
(P= 0.003). For overall survival were: positive microscopic surgical margins
(P= 0.005), high histologic grade (P= 0.007), and tumor size greater
than 10cm (P= 0.02). There was a significant association of local recurrence
with the development of subsequent distant metastasis and poor
overall survival, and that local recurrence is a poor prognostic fact r (P=
0.0001).
Conclusion: Grade, microscopic surgical margins, and tumor size could
be used to select patients with a high metastatic risk for which adjuvant
treatments could be beneficiaL Patients with local recurrence are at increased
risk for subsequent distant metastasis and poor overall survival. |
