Treatment outcome of conservative surgery plus postoperative radiotherapy for extremity soft tissue sarcoma

Jieun Lee, Young Je Park, Dae-Sik Yang, Won Sup Yoon, Jung Ae Lee, Chai Hong Rim, Chul Yong Kim

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). Materials and Methods: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. Results: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no signifi cant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) infl uenced the development of distant metastases. Histologic grade was unique signifi cant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). Conclusion: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the fi eld. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.

Original languageEnglish
Pages (from-to)62-69
Number of pages8
JournalRadiation Oncology Journal
Volume30
Issue number2
DOIs
Publication statusPublished - 2012 Jun 1

Fingerprint

Sarcoma
Radiotherapy
Extremities
Recurrence
Survival
Neoplasm Metastasis
Radiation Dosage
Korea
Terminology
Disease-Free Survival
Multivariate Analysis
Drug Therapy
Therapeutics
Neoplasms

Keywords

  • Extremity
  • Postoperative
  • Radiotherapy
  • Sarcoma
  • Treatment outcome

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Treatment outcome of conservative surgery plus postoperative radiotherapy for extremity soft tissue sarcoma. / Lee, Jieun; Park, Young Je; Yang, Dae-Sik; Yoon, Won Sup; Lee, Jung Ae; Rim, Chai Hong; Kim, Chul Yong.

In: Radiation Oncology Journal, Vol. 30, No. 2, 01.06.2012, p. 62-69.

Research output: Contribution to journalArticle

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abstract = "Purpose: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). Materials and Methods: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. Results: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9{\%}) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0{\%}) and distant metastases developed in 10 patients (23.3{\%}). The 5-year overall survival (OS) was 69.2{\%} and disease free survival was 67.9{\%}. The 5-year local relapse-free survival was 90.7{\%} and distant relapse-free survival was 73.3{\%}. On univariate analysis, no signifi cant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) infl uenced the development of distant metastases. Histologic grade was unique signifi cant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0{\%}) and severe late complications in 2 patients (4.7{\%}). Conclusion: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the fi eld. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.",
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N2 - Purpose: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). Materials and Methods: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. Results: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no signifi cant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) infl uenced the development of distant metastases. Histologic grade was unique signifi cant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). Conclusion: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the fi eld. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.

AB - Purpose: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). Materials and Methods: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. Results: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no signifi cant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) infl uenced the development of distant metastases. Histologic grade was unique signifi cant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). Conclusion: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the fi eld. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.

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