Surgical therapy of fibrosarcoma of extremities: a reappraisal.

During an 18-year period from 1949 to 1967 at Memorial Sloan-Kettering Cancer Center, 75 patients with fibrosarcoma of the extremities had definitive surgical therapy with an overall five- and ten-year survival of 70% and 60%, respectively, and a local recurrence rate of 28%. Soft part resection was attempted in all cases. Amputation was done where adequate margin could not be obtained as determined by site and size of tumor; neurovascular, bone, or joint involvement; and multicentric origin. Results indicate that a second local recurrence justifies amputation. Regional lymph node dissection is not indicated. The determining factor in death of patients due to fibrosarcoma is distant metastasis, 78% of which is pulmonary.