Consequences of local recurrence of soft tissue sarcoma - 205 patients from the Scandinavian Sarcoma Group Register

From the Scandinavian Sarcoma Group Register, information on 1,224 surgical ly-treated patients with soft tissue sarcoma (STS) of the extremity or trun k wall, diagnosed between 1987 and 1995, was collected. 205 patients, one t hird of whom were referred to a center with a local recurrence, had a total of 284 local recurrences. This analysis describes the treatment for these local recurrences, complications and risk of further recurrences. 169 patients were surgically treated for their first local recurrence. An i ntralesional or marginal margin was achieved in 110 of these patients, 59 o f whom were also given radiotherapy. 54 of the 169 patients had a second lo cal recurrence. The second local recurrence rate was 0.50 if the first loca l recurrence had been treated with only surgery with a marginal margin, com pared to 0.28 if treated with surgery with a marginal margin and radiothera py or with a wide margin (p = 0.0008), In extremity STS, the crude amputati on rate for local recurrences was 0.22 (31 of 142)-i.e., higher than for pr imary tumors 0.09 (96 of 1065) (p < 0.0001), A high local recurrence rate after treatment outside of sarcoma centers has earlier been shown. We conclude that the consequences of local recurrence in terms of morbidity and costs justifies referral of STS patients for mult idisciplinary evaluation and multimodality treatment.