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Ann Surg. 1995 Feb; 221(2): 185–195.
PMCID: PMC1234952

Prognostic factors predictive of survival for truncal and retroperitoneal soft-tissue sarcoma.


OBJECTIVE: The authors identified prognostic factors relevant to clinical outcomes (especially survival) in truncal and retroperitoneal soft-tissue sarcoma. SUMMARY BACKGROUND DATA: These results can be used to optimize surgical management and select patients most likely to benefit from novel therapeutic strategies in future trials. METHODS: A retrospective analysis was performed of a prospectively compiled database of 183 consecutive patients with truncal and retroperitoneal sarcomas seen at the Brigham and Women's Hospital and the Dana Farber Cancer Institute between 1970 to 1994. RESULTS: For truncal sarcoma, multivariate analysis showed that high-grade histology was associated with an eightfold increased risk of death compared with low-grade histology (p = 0.001). In addition to grade, gross positive margin of resection (p = 0.001), microscopic positive margin (p = 0.023), and tumors greater than 5 cm in size (p = 0.018) were important independent prognostic factors for survival. In this series, postoperative radiation therapy for truncal sarcoma was associated with a 2.4-fold decreased risk of death compared with truncal sarcoma patients receiving no adjuvant radiation therapy, having adjusted for the other prognostic factors (p = 0.030). In contrast, for retroperitoneal sarcoma, multivariate analysis showed that high-grade and intermediate-grade histology were associated with a five- to sixfold increased risk of death compared with low-grade histology (p = 0.009). In addition to grade, gross positive margin of resection (p = 0.001) and microscopic positive margin (p = 0.004) were important independent prognostic factors for survival in retroperitoneal sarcoma. Patients who received either preoperative or postoperative chemotherapy for retroperitoneal sarcoma had a 4.6-fold (p = 0.002) and 3-fold (p = 0.010) increased risk of death, respectively, compared with patients receiving no adjuvant chemotherapy, having adjusted for the other prognostic factors. CONCLUSIONS: The histologic grade and the margin of resection are prognostic for survival in both truncal and retroperitoneal soft-tissue sarcoma. Tumor size was an independent prognostic factor for truncal sarcoma, but not for retroperitoneal sarcoma. Postoperative adjuvant radiation was beneficial to overall survival for truncal sarcoma. In this series of patients receiving a heterogeneous mixture of chemotherapeutic regimens-either as preoperative "neoadjuvant" therapy or as postoperative "adjuvant" therapy, there were no beneficial effects on survival compared with nonrandomized patients not receiving chemotherapy.

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  • Rosenberg SA, Tepper J, Glatstein E, Costa J, Baker A, Brennan M, DeMoss EV, Seipp C, Sindelar WF, Sugarbaker P, et al. The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. Ann Surg. 1982 Sep;196(3):305–315. [PMC free article] [PubMed]
  • Brennan MF, Hilaris B, Shiu MH, Lane J, Magill G, Friedrich C, Hajdu SI. Local recurrence in adult soft-tissue sarcoma. A randomized trial of brachytherapy. Arch Surg. 1987 Nov;122(11):1289–1293. [PubMed]
  • Bevilacqua RG, Rogatko A, Hajdu SI, Brennan MF. Prognostic factors in primary retroperitoneal soft-tissue sarcomas. Arch Surg. 1991 Mar;126(3):328–334. [PubMed]
  • Zornig C, Weh HJ, Krüll A, Schwarz R, Hilgert RE, Schröder S. Soft tissue sarcomas of the extremities and trunk in the adult. Report of 124 cases. Langenbecks Arch Chir. 1992;377(1):28–33. [PubMed]
  • Mazanet R, Antman KH. Adjuvant therapy for sarcomas. Semin Oncol. 1991 Dec;18(6):603–612. [PubMed]
  • Antman K, Suit H, Amato D, Corson J, Wood W, Proppe K, Harmon D, Carey R, Greenberger J, Blum R, et al. Preliminary results of a randomized trial of adjuvant doxorubicin for sarcomas: lack of apparent difference between treatment groups. J Clin Oncol. 1984 Jun;2(6):601–608. [PubMed]
  • Alvegård TA, Sigurdsson H, Mouridsen H, Solheim O, Unsgaard B, Ringborg U, Dahl O, Nordentoft AM, Blomqvist C, Rydholm A, et al. Adjuvant chemotherapy with doxorubicin in high-grade soft tissue sarcoma: a randomized trial of the Scandinavian Sarcoma Group. J Clin Oncol. 1989 Oct;7(10):1504–1513. [PubMed]
  • Suit HD, Russell WO, Martin RG. Sarcoma of soft tissue: clinical and histopathologic parameters and response to treatment. Cancer. 1975 May;35(5):1478–1483. [PubMed]
  • Singer S, Corson JM, Gonin R, Labow B, Eberlein TJ. Prognostic factors predictive of survival and local recurrence for extremity soft tissue sarcoma. Ann Surg. 1994 Feb;219(2):165–173. [PMC free article] [PubMed]
  • Collin C, Godbold J, Hajdu S, Brennan M. Localized extremity soft tissue sarcoma: an analysis of factors affecting survival. J Clin Oncol. 1987 Apr;5(4):601–612. [PubMed]
  • Geer RJ, Woodruff J, Casper ES, Brennan MF. Management of small soft-tissue sarcoma of the extremity in adults. Arch Surg. 1992 Nov;127(11):1285–1289. [PubMed]
  • Pezzi CM, Rawlings MS, Jr, Esgro JJ, Pollock RE, Romsdahl MM. Prognostic factors in 227 patients with malignant fibrous histiocytoma. Cancer. 1992 Apr 15;69(8):2098–2103. [PubMed]
  • Lindberg RD, Martin RG, Romsdahl MM, Barkley HT., Jr Conservative surgery and postoperative radiotherapy in 300 adults with soft-tissue sarcomas. Cancer. 1981 May 15;47(10):2391–2397. [PubMed]
  • Nielsen OS, Cummings B, O'Sullivan B, Catton C, Bell RS, Fornasier VL. Preoperative and postoperative irradiation of soft tissue sarcomas: effect of radiation field size. Int J Radiat Oncol Biol Phys. 1991 Nov;21(6):1595–1599. [PubMed]
  • Pao WJ, Pilepich MV. Postoperative radiotherapy in the treatment of extremity soft tissue sarcomas. Int J Radiat Oncol Biol Phys. 1990 Oct;19(4):907–911. [PubMed]
  • Robinson M, Barr L, Fisher C, Fryatt I, Stotter A, Harmer C, Wiltshaw E, Westbury G. Treatment of extremity soft tissue sarcomas with surgery and radiotherapy. Radiother Oncol. 1990 Jul;18(3):221–233. [PubMed]

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