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Limb-sparing surgery without radiotherapy based on anatomic location of soft tissue sarcoma

Rydholm, A. LU ; Gustafson, P. LU ; Rooser, B. ; Willen, H. ; Akerman, M. LU ; Herrlin, K. and Alvegard, T. LU (1991) In Journal of Clinical Oncology 9(10). p.1757-1765
Abstract

From 1980 through 1986, 119 patients with soft tissue sarcomas of the extremities were referred to our tumor center either before surgery (n = 78) or immediately after incisional biopsy or marginal excision (n = 41). The tumors were classified according to anatomic location at admittance as subcutaneous (n = 40), intramuscular (n = 30), and extramuscular tumors (n = 49). Open biopsy was omitted in 75 of the 78 patients referred before surgery; the preoperative diagnosis was based on physical and radiographic findings and fine-needle aspiration cytology. The surgical intention for subcutaneous tumor was to obtain a wide margin, which required a cuff of fat tissue around the tumor and inclusion of the deep fascia beneath the tumor. A wide... (More)

From 1980 through 1986, 119 patients with soft tissue sarcomas of the extremities were referred to our tumor center either before surgery (n = 78) or immediately after incisional biopsy or marginal excision (n = 41). The tumors were classified according to anatomic location at admittance as subcutaneous (n = 40), intramuscular (n = 30), and extramuscular tumors (n = 49). Open biopsy was omitted in 75 of the 78 patients referred before surgery; the preoperative diagnosis was based on physical and radiographic findings and fine-needle aspiration cytology. The surgical intention for subcutaneous tumor was to obtain a wide margin, which required a cuff of fat tissue around the tumor and inclusion of the deep fascia beneath the tumor. A wide margin for an intramuscular tumor implied no open biopsy and an unbroken muscle fascia or thick muscle cuff around the tumor (primary myectomy). The 70 patients with subcutaneous and intramuscular tumors were all treated by local surgery. A wide margin was obtained in 56 patients who were not given radiotherapy. During a median follow-up of 5 years (range, 3.5 to 10 years), four of these 56 patients-47 of whom had high-grade malignant tumors-had a local recurrence. We conclude that routine combination of limb-sparing surgery with adjuvant radiotherapy is not necessary in patients with soft tissue sarcoma. Two thirds of soft tissue sarcomas of the extremities are primarily subcutaneous or intramuscular tumors, the majority of which can be treated by local surgery without local adjuvant therapy with a local recurrence rate of less than 10%, irrespective of malignancy grade.

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author
publishing date
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publication status
published
subject
in
Journal of Clinical Oncology
volume
9
issue
10
pages
9 pages
publisher
American Society of Clinical Oncology
external identifiers
  • scopus:0025954848
  • pmid:1919628
ISSN
0732-183X
DOI
10.1200/JCO.1991.9.10.1757
language
English
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no
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8c29c6b8-4b25-4187-9a56-0950f1a664e1
date added to LUP
2019-05-25 07:59:18
date last changed
2020-01-13 01:54:15
@article{8c29c6b8-4b25-4187-9a56-0950f1a664e1,
  abstract     = {<p>From 1980 through 1986, 119 patients with soft tissue sarcomas of the extremities were referred to our tumor center either before surgery (n = 78) or immediately after incisional biopsy or marginal excision (n = 41). The tumors were classified according to anatomic location at admittance as subcutaneous (n = 40), intramuscular (n = 30), and extramuscular tumors (n = 49). Open biopsy was omitted in 75 of the 78 patients referred before surgery; the preoperative diagnosis was based on physical and radiographic findings and fine-needle aspiration cytology. The surgical intention for subcutaneous tumor was to obtain a wide margin, which required a cuff of fat tissue around the tumor and inclusion of the deep fascia beneath the tumor. A wide margin for an intramuscular tumor implied no open biopsy and an unbroken muscle fascia or thick muscle cuff around the tumor (primary myectomy). The 70 patients with subcutaneous and intramuscular tumors were all treated by local surgery. A wide margin was obtained in 56 patients who were not given radiotherapy. During a median follow-up of 5 years (range, 3.5 to 10 years), four of these 56 patients-47 of whom had high-grade malignant tumors-had a local recurrence. We conclude that routine combination of limb-sparing surgery with adjuvant radiotherapy is not necessary in patients with soft tissue sarcoma. Two thirds of soft tissue sarcomas of the extremities are primarily subcutaneous or intramuscular tumors, the majority of which can be treated by local surgery without local adjuvant therapy with a local recurrence rate of less than 10%, irrespective of malignancy grade.</p>},
  author       = {Rydholm, A. and Gustafson, P. and Rooser, B. and Willen, H. and Akerman, M. and Herrlin, K. and Alvegard, T.},
  issn         = {0732-183X},
  language     = {eng},
  month        = {01},
  number       = {10},
  pages        = {1757--1765},
  publisher    = {American Society of Clinical Oncology},
  series       = {Journal of Clinical Oncology},
  title        = {Limb-sparing surgery without radiotherapy based on anatomic location of soft tissue sarcoma},
  url          = {http://dx.doi.org/10.1200/JCO.1991.9.10.1757},
  doi          = {10.1200/JCO.1991.9.10.1757},
  volume       = {9},
  year         = {1991},
}