Long-term outcome of patients with American Joint Committee on Cancer Stage IIB extremity soft tissue sarcomas

Jason B. Fleming, Russell S. Berman, Su Chun Cheng, Nancy P. Chen, Kelly K. Hunt, Barry W. Feig, Paula M. Respondek, Alan W. Yasko, Alan Pollack, Shreyaskumar R. Patel, Michael A. Burgess, Nicholas E. Papadopoulos, Carl Plager, Gunar Zagars, Robert S. Benjamin, Raphael E. Pollock, Peter W.T. Pisters

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Purpose: It has been suggested that patients with small (< 5 cm), high- grade extremity soft tissue sarcomas (STS) have an excellent overall prognosis and, consequently, may not require adjuvant therapies. Patients and Methods: A comprehensive review of all patients with extremity STS treated at a tertiary care cancer hospital over a 9-year period (January 1984 to December 1992) was performed. Prognostic factors, treatment data, and long- term outcome were evaluated in the subset of 111 patients with American Joint Committee on Cancer stage IIB (G3/4, T1 a/b) disease. Results: The median tumor size was 3.0 cm (range, 0.6 to 4.9 cm), and 55 tumors (50%) were deep in location. All patients underwent surgical resection; 68 (61%) received pre- or postoperative radiotherapy, and 32 (29%) received doxorubicin-based chemotherapy. The median follow-up was 76 months. Forty patients (36%) experienced 59 recurrences. First recurrences occurred at local, regional, and distant sites in 21, five, and 14 patients, respectively. The 5-year actuarial local recurrence-free, distant recurrence-free, disease-free, and overall survival rates were 82%, 83%, 68%, and 83%, respectively. The presence of a microscopically positive surgical margin was an independent adverse prognostic factor for both local recurrence (relative risk [RR] = 3.75; 95% confidence interval [CI], 1.25 to 11.25; P = .02) and disease-free survival (RR = 2.57; 95% CI, 1.33 to 4.98; P = .005). Conclusion: Event-free outcome for this subset of patients with high-grade STS does not seem as favorable as previously reported by other investigators. Patients who undergo maximal surgical resection with microscopically positive margins represent a subset of T1 STS patients who warrant consideration for adjuvant therapies.

Original languageEnglish (US)
Pages (from-to)2772-2780
Number of pages9
JournalJournal of Clinical Oncology
Issue number9
StatePublished - Sep 1999
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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