PRIMARY SOFT-TISSUE SARCOMA OF THE EXTREMITIES IN ADULTS

The modern literature on adult extremity sarcoma implies that adjuvant therapy (usually irradiation) is mandatory for adequate local control , at least in patients with high-grade tumours undergoing limb-sparing procedures. In 152 primary extremity soft tissue sarcomas, wide or ra dical resection was employed (116 patients) including amputation in ni ne patients (6 per cent), or local excision followed by adjuvant posto perative radiation therapy (36). Local recurrence alone occurred in 5 per cent of patients, and in combination with distant metastases in 9 per cent. The total rate of local recurrence was 10 per cent after wid e resection (with or without chemotherapy) and 25 per cent after conse rvative resection and radiotherapy (with or without chemotherapy). Lim b sparing was possible in 94 per cent of patients. The majority (76 pe r cent) had surgical resection alone as local treatment with satisfact ory results. Wide resection, when feasible, provides acceptable local control and may be preferable to local excision plus radiation therapy .