Local Recurrence of Soft Tissue Sarcoma Revisited: Is there a Role for "Selective" Radiation?

Nathan E Saxby; Qiang An; Benjamin J Miller

Back

Local Recurrence of Soft Tissue Sarcoma Revisited: Is there a Role for "Selective" Radiation?

Journal article

Open access

Peer reviewed

Local Recurrence of Soft Tissue Sarcoma Revisited: Is there a Role for "Selective" Radiation?

Nathan E Saxby, Qiang An and Benjamin J Miller

The Iowa orthopaedic journal, Vol.42(1), pp.239-248

06/01/2022

PMCID: PMC9210402

PMID: 35821921

Appears in Diamond Open Access

Files and links (1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210402View

Published (Version of record) Open Access

Abstract

BackgroundRadiation therapy (RT) is often utilized in cases of high-grade soft tissue sarcoma (STS), but there remain situations where treatment is with surgical excision alone. Our goals were to determine (1) the local recurrence (LR) rate with and without perioperative RT and (2) associations between local recurrence, patient, tumor, and treatment variables. MethodsWe performed a retrospective review of 165 consecutive STS patients. A Cox proportional hazards model was used to investigate variables associated with local recurrence. ResultsLR occurred in 15/78 (19%) without RT, 4/29 (14%) with postoperative RT, and 0/58 with preoperative RT (p=0.002). We found increased rates of local recurrence at 24 months for myxofibrosarcoma (p=0.001) and no-RT (p=0.003). Myxofibrosarcoma accounted for 33 (20%) of the study patients and 12 (63%) of the local recurrences. ConclusionThe LR rate in patients treated with surgery alone was disproportionately attributable to myxofibrosarcoma (11/23 cases, 48%). Other subtypes demonstrated a lower rate of LR in the absence of RT (4/55 cases, 7%), and no LR occurred when final margins were >2 mm. In certain circumstances treatment with a negative margin surgical resection followed by close observation is justifiable. RT is effective and should continue to be considered routinely in myxofibrosarcoma or when surgical margins are inadequate. Level of Evidence: III.

Details

Title: Subtitle: Local Recurrence of Soft Tissue Sarcoma Revisited: Is there a Role for "Selective" Radiation?
Creators: Nathan E Saxby
Qiang An
Benjamin J Miller
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.42(1), pp.239-248
Publisher: Dept. of Orthopaedics, The University of Iowa; United States
PMID: 35821921
PMCID: PMC9210402
ISSN: 1541-5457
eISSN: 1555-1377
Language: English
Date published: 06/01/2022
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984304692302771

Metrics

3 Record Views