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

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Abstract

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
Pages (from-to)2772-2780
Number of pages9
JournalJournal of Clinical Oncology
Volume17
Issue number9
StatePublished - Sep 1 1999
Externally publishedYes

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Sarcoma
Extremities
Neoplasms
Recurrence
Disease-Free Survival
Confidence Intervals
Cancer Care Facilities
Tertiary Healthcare
Doxorubicin
Radiotherapy
Therapeutics
Survival Rate
Research Personnel
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Fleming, J. B., Berman, R. S., Cheng, S. C., Chen, N. P., Hunt, K. K., Feig, B. W., ... Pisters, P. W. T. (1999). Long-term outcome of patients with American Joint Committee on Cancer Stage IIB extremity soft tissue sarcomas. Journal of Clinical Oncology, 17(9), 2772-2780.

Long-term outcome of patients with American Joint Committee on Cancer Stage IIB extremity soft tissue sarcomas. / Fleming, Jason B.; Berman, Russell S.; Cheng, Su Chun; Chen, Nancy P.; Hunt, Kelly K.; Feig, Barry W.; Respondek, Paula M.; Yasko, Alan W.; Pollack, Alan; Patel, Shreyaskumar R.; Burgess, Michael A.; Papadopoulos, Nicholas E.; Plager, Carl; Zagars, Gunar; Benjamin, Robert S.; Pollock, Raphael E.; Pisters, Peter W T.

In: Journal of Clinical Oncology, Vol. 17, No. 9, 01.09.1999, p. 2772-2780.

Research output: Contribution to journalArticle

Fleming, JB, Berman, RS, Cheng, SC, Chen, NP, Hunt, KK, Feig, BW, Respondek, PM, Yasko, AW, Pollack, A, Patel, SR, Burgess, MA, Papadopoulos, NE, Plager, C, Zagars, G, Benjamin, RS, Pollock, RE & Pisters, PWT 1999, 'Long-term outcome of patients with American Joint Committee on Cancer Stage IIB extremity soft tissue sarcomas', Journal of Clinical Oncology, vol. 17, no. 9, pp. 2772-2780.
Fleming JB, Berman RS, Cheng SC, Chen NP, Hunt KK, Feig BW et al. Long-term outcome of patients with American Joint Committee on Cancer Stage IIB extremity soft tissue sarcomas. Journal of Clinical Oncology. 1999 Sep 1;17(9):2772-2780.
Fleming, Jason B. ; Berman, Russell S. ; Cheng, Su Chun ; Chen, Nancy P. ; Hunt, Kelly K. ; Feig, Barry W. ; Respondek, Paula M. ; Yasko, Alan W. ; Pollack, Alan ; Patel, Shreyaskumar R. ; Burgess, Michael A. ; Papadopoulos, Nicholas E. ; Plager, Carl ; Zagars, Gunar ; Benjamin, Robert S. ; Pollock, Raphael E. ; Pisters, Peter W T. / Long-term outcome of patients with American Joint Committee on Cancer Stage IIB extremity soft tissue sarcomas. In: Journal of Clinical Oncology. 1999 ; Vol. 17, No. 9. pp. 2772-2780.
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abstract = "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.",
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T1 - Long-term outcome of patients with American Joint Committee on Cancer Stage IIB extremity soft tissue sarcomas

AU - Fleming, Jason B.

AU - Berman, Russell S.

AU - Cheng, Su Chun

AU - Chen, Nancy P.

AU - Hunt, Kelly K.

AU - Feig, Barry W.

AU - Respondek, Paula M.

AU - Yasko, Alan W.

AU - Pollack, Alan

AU - Patel, Shreyaskumar R.

AU - Burgess, Michael A.

AU - Papadopoulos, Nicholas E.

AU - Plager, Carl

AU - Zagars, Gunar

AU - Benjamin, Robert S.

AU - Pollock, Raphael E.

AU - Pisters, Peter W T

PY - 1999/9/1

Y1 - 1999/9/1

N2 - 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.

AB - 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.

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