Extremity soft tissue sarcoma: Factors predictive of local recurrence and survival

Background: To identify risk factors for local recurrence and overall survi val in patients with extremity soft tissue sarcoma. Methods: A retrospective study was performed of all patients with extremity soft tissue sarcoma treated at the Combined Surgical Oncology Clinic in th e Institute of Oncology at Prince of Wales Hospital between 1972 and 1992. Variables analysed included clinical presentation, patient characteristics, tumour characteristics, treatment factors and outcome. Results: One hundred and nineteen patients were eligible for the study. The most common type of presentation was with a painless mass, usually in the thigh. Local control rates at 5 and 10 years were 75% and 73%. Local contro l was higher in patients who had more radical surgery and in those who rece ived adjuvant radiotherapy. Tumour size and high grade were independent ris k factors for poorer survival. Patients over 50 had poorer survival than yo unger patients and those who presented with recurrent tumours also tended t o have poor survival compared to patients presenting de nolo. The respectiv e 5- and 10-year survival rates were 65% and 62%. Conclusion: This Study suggests that local control of extremity soft tissue sarcoma is improved by radical surgery and by the addition of radiotherapy when more conservative procedures are used. Overall survival appeared to b e largely determined by patient (age, recurrent presentation) and tumour ch aracteristics (grade, size).