Influence of surgical margins on outcome in patients with preoperatively irradiated extremity soft tissue sarcomas

Background. Limb‐sparing surgery for soft tissue sarcomas of the extremities may result in microscopically positive surgical margins. The consequences of these microscopically positive margins are unknown. We have analyzed the influence of surgical margins on local disease control and overall survival in patients with extremity soft tissue sarcomas who received preoperative radiation therapy followed by limb‐sparing surgery.

[1]  J. Fortner,et al.  Surgical Treatment of 297 Soft Tissue Sarcomas of the Lower Extremity , 1975, Annals of surgery.

[2]  C. Fisher,et al.  The influence of local recurrence of extremity soft tissue sarcoma on metastasis and survival , 1990, Cancer.

[3]  J. Godbold,et al.  Localized extremity soft tissue sarcoma: an analysis of factors affecting survival. , 1987, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  S. Rosenberg,et al.  High‐grade soft tissue sarcomas of the extremities , 1986, Cancer.

[5]  M. Zelefsky,et al.  Limb salvage in soft tissue sarcomas involving neurovascular structures using combined surgical resection and brachytherapy. , 1990, International journal of radiation oncology, biology, physics.

[6]  K. Aozasa,et al.  Multivariate analysis for clinical prognostic factors in 163 patients with soft tissue sarcoma , 1988, Cancer.

[7]  J BERKSON,et al.  Calculation of survival rates for cancer. , 1950, Proceedings of the staff meetings. Mayo Clinic.

[8]  H. Suit,et al.  Rationale for combining surgery and radiation therapy , 1985, Cancer.

[9]  F. Eilber,et al.  Limb salvage for high-grade soft tissue sarcomas of the extremity: Experience at the University of California, Los Angeles , 1985 .

[10]  S. Steinberg,et al.  Adjuvant chemotherapy for patients with high-grade soft-tissue sarcomas of the extremity. , 1988, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[11]  B. Hilaris,et al.  Control of locally advanced extremity soft tissue sarcomas by function‐saving resection and brachytherapy , 1984, Cancer.

[12]  D. Rosenthal,et al.  Treatment of the patient with stage M0 soft tissue sarcoma. , 1988, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  M. Talbert,et al.  Conservative surgery and radiation therapy for soft tissue sarcoma of the wrist, hand, ankle, and foot , 1990, Cancer.

[14]  B. Stener,et al.  A multivariate analysis of the prognosis after surgical treatment of malignant soft‐tissue tumors , 1982, Cancer.

[15]  L. Anderson,et al.  Limb preservation and tumor control in the treatment of popliteal and antecubital soft tissue sarcomas , 1986, Cancer.

[16]  D. Boone,et al.  Primary malignant tumors of the upper extremity: retrospective analysis of one hundred twenty-six cases. , 1985, The Journal of hand surgery.

[17]  J. Tepper,et al.  The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. , 1982, Annals of surgery.

[18]  J. Petiot,et al.  Prognostic factors in soft tissue sarcomas. A multivariate analysis of 109 cases , 1989, Cancer.

[19]  W. Wood,et al.  Preoperative, intraoperative, and postoperative radiation in the treatment of primary soft tissue sarcoma , 1985, Cancer.

[20]  C. Karakousis,et al.  Feasibility of limb salvage and survival in soft tissue sarcomas , 1986, Cancer.

[21]  E. Casper,et al.  Comparison of Amputation With Limb‐sparing Operations for Adult Soft Tissue Sarcoma of the Extremity , 1992, Annals of surgery.

[22]  D. Cox.  Regression Models and Life-Tables , 1972 .

[23]  E. Casper,et al.  The role of multimodality therapy in soft-tissue sarcoma. , 1991, Annals of surgery.

[24]  R. Lindberg,et al.  Conservative surgery and postoperative radiotherapy in 300 adults with soft‐tissue sarcomas , 1981, Cancer.

[25]  Elisa T. Lee,et al.  A computer program for comparing K samples with right-censored data. , 1972, Computer programs in biomedicine.

[26]  L J Emrich,et al.  The effect of local recurrence on survival time in adult high-grade soft tissue sarcomas. , 1989, Journal of clinical epidemiology.

[27]  R. Lindberg,et al.  Treatment of soft tissue sarcomas by preoperative irradiation and conservative surgical resection. , 1988, International journal of radiation oncology, biology, physics.

[28]  J. Godbold,et al.  Prognostic factors for local recurrence and survival in patients with localized extremity soft-tissue sarcoma. , 1988, Seminars in surgical oncology.

[29]  J. Godbold,et al.  Localized, operable soft tissue sarcoma of the lower extremity. , 1986, Archives of surgery.

[30]  D. Driscoll,et al.  Clinical factors and treatment parameters affecting prognosis in adult high-grade soft tissue sarcomas: a retrospective review of 267 cases. , 1989, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[31]  D. Deakin,et al.  Combined modality management of local and disseminated adult soft tissue sarcomas: a review of 257 cases seen over 10 years at the Christie Hospital & Holt Radium Institute, Manchester. , 1985, British Journal of Cancer.

[32]  J. Godbold,et al.  Localized Operable Soft Tissue Sarcoma of the Upper Extremity: Presentation, Management, and Factors Affecting Local Recurrence in 108 Patients , 1987, Annals of surgery.

[33]  F. Eilber,et al.  Patterns of metastatic spread following resection of extremity soft-tissue sarcomas and strategies for treatment. , 1988, Seminars in surgical oncology.

[34]  M. Brennan,et al.  Local recurrence in adult soft-tissue sarcoma. A randomized trial of brachytherapy. , 1987, Archives of surgery.

[35]  C. Karakousis,et al.  Limb salvage in soft tissue sarcomas with selective combination of modalities. , 1991, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.