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Late Local Recurrence and Metastasis in Soft Tissue Sarcoma of the Extremities and Trunk Wall : Better Outcome After Treatment of Late Events Compared with Early

von Konow, Arvid LU orcid ; Ghanei, Iman LU ; Styring, Emelie LU and Vult von Steyern, Fredrik LU (2021) In Annals of Surgical Oncology 28(12). p.7891-7902
Abstract

Background: Approximately 80% of soft tissue sarcoma (STS) recurrences, local and metastatic disease, are diagnosed within the first 3 years after primary diagnosis and treatment. Recurrences, however, can present after a longer period of remission. Our goal was to identify factors that may predict the risk of late recurrence. Methods: We identified 677 patients with STS of the extremities and trunk wall from a population-based sarcoma register. Of these, 377 patients were alive and event-free at 3 years and were included for analysis of possible risk factors for late recurrence. Results: Fifty-five of 377 (15%) patients developed late recurrence: 23 local recurrence, 21 metastasis, and 11 both manifestations. With R0 wide surgical... (More)

Background: Approximately 80% of soft tissue sarcoma (STS) recurrences, local and metastatic disease, are diagnosed within the first 3 years after primary diagnosis and treatment. Recurrences, however, can present after a longer period of remission. Our goal was to identify factors that may predict the risk of late recurrence. Methods: We identified 677 patients with STS of the extremities and trunk wall from a population-based sarcoma register. Of these, 377 patients were alive and event-free at 3 years and were included for analysis of possible risk factors for late recurrence. Results: Fifty-five of 377 (15%) patients developed late recurrence: 23 local recurrence, 21 metastasis, and 11 both manifestations. With R0 wide surgical margin as reference, R0 marginal (hazard ratio [HR] 2.6; p = 0.02) and R1 (HR 5.0; p = 0.005) margins were risk factors for late local recurrence. Malignancy grade (HR 8.3; p = 0.04) and R0 marginal surgical margin (HR 2.3; p = 0.04) were risk factors for late metastasis. We could not find a statistically significant correlation of late recurrence with many of the generally known risk factors for local recurrence and metastasis in STS. Outcome after treatment of late recurrences was better compared with outcome after treatment of early events. Conclusions: Late recurrences, albeit relatively rare, do occur. Outcome after treatment was good compared with outcome after early events. Long surveillance of all patients with high-grade STS, especially if R0 wide surgical margin is not achieved in the primary treatment, appear to be well justified.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Surgical Oncology
volume
28
issue
12
pages
7891 - 7902
publisher
Springer
external identifiers
  • scopus:85104832236
  • pmid:33861406
ISSN
1068-9265
DOI
10.1245/s10434-021-09942-8
project
Soft Tissue Sarcoma of the Extremities and Trunk Wall – epidemiology, treatment and follow-up
language
English
LU publication?
yes
additional info
Funding Information: This work was supported by the Maggie Stephens foundation, Erik and Angelica Sparres research foundation, Greta and Johan Kocks foundation, Skåne University Hospital Donation and Research Foundation, research grant from Region Skåne and through a regional agreement between Lund University and the Skåne County Council (ALF F 2014/413). Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
id
ed0a7402-deec-4036-8c67-24d029f2de11
date added to LUP
2021-05-11 15:13:07
date last changed
2024-06-15 11:06:06
@article{ed0a7402-deec-4036-8c67-24d029f2de11,
  abstract     = {{<p>Background: Approximately 80% of soft tissue sarcoma (STS) recurrences, local and metastatic disease, are diagnosed within the first 3 years after primary diagnosis and treatment. Recurrences, however, can present after a longer period of remission. Our goal was to identify factors that may predict the risk of late recurrence. Methods: We identified 677 patients with STS of the extremities and trunk wall from a population-based sarcoma register. Of these, 377 patients were alive and event-free at 3 years and were included for analysis of possible risk factors for late recurrence. Results: Fifty-five of 377 (15%) patients developed late recurrence: 23 local recurrence, 21 metastasis, and 11 both manifestations. With R0 wide surgical margin as reference, R0 marginal (hazard ratio [HR] 2.6; p = 0.02) and R1 (HR 5.0; p = 0.005) margins were risk factors for late local recurrence. Malignancy grade (HR 8.3; p = 0.04) and R0 marginal surgical margin (HR 2.3; p = 0.04) were risk factors for late metastasis. We could not find a statistically significant correlation of late recurrence with many of the generally known risk factors for local recurrence and metastasis in STS. Outcome after treatment of late recurrences was better compared with outcome after treatment of early events. Conclusions: Late recurrences, albeit relatively rare, do occur. Outcome after treatment was good compared with outcome after early events. Long surveillance of all patients with high-grade STS, especially if R0 wide surgical margin is not achieved in the primary treatment, appear to be well justified.</p>}},
  author       = {{von Konow, Arvid and Ghanei, Iman and Styring, Emelie and Vult von Steyern, Fredrik}},
  issn         = {{1068-9265}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{7891--7902}},
  publisher    = {{Springer}},
  series       = {{Annals of Surgical Oncology}},
  title        = {{Late Local Recurrence and Metastasis in Soft Tissue Sarcoma of the Extremities and Trunk Wall : Better Outcome After Treatment of Late Events Compared with Early}},
  url          = {{http://dx.doi.org/10.1245/s10434-021-09942-8}},
  doi          = {{10.1245/s10434-021-09942-8}},
  volume       = {{28}},
  year         = {{2021}},
}