High Recurrence Rate of Myxofibrosarcoma: The Effect of Radiotherapy Is Not Clear.

Hjalmar Teurneau,Fredrik Vult Von Steyern,Emelie Styring,Iman Ghanei,Jacob Engellau

doi:10.1155/2019/8517371

Hjalmar Teurneau, Fredrik Vult Von Steyern + Show 3 more

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https://doi.org/10.1155/2019/8517371

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Journal: Sarcoma	Publication Date: Oct 1, 2019
Citations: 33	License type: CC BY 4.0

Affiliation: Lund University

Abstract

Background Myxofibrosarcoma (MFS) is one of the more common types of soft-tissue sarcoma (STS) in patients over 60 years of age. Local recurrence (LR) rates have been reported to be higher compared to other STS types. Patients and Methods Using a population-based series from the southern Sweden health care region, 56 consecutive patients with MFS and localized disease at diagnosis were analyzed with respect to LR and distant metastases after surgery ± adjuvant treatment. Results The overall local recurrence (n = 15) and metastasis (n = 13) rates were 27% and 21%, respectively; 6 patients had both. Surgical margin was the only statistically significant prognostic factor for LR. Patients operated with a marginal margin had an HR of 4.5 (CI 1.3–15.1, p=0.02) and those operated with an intralesional margin 9.4 (CI 2.0–43.5, p=0.004) compared to those operated with a wide surgical margin. There was no difference in the LR rate depending on radiotherapy or not, although the latter group had smaller and more superficial tumors. 23 patients received radiotherapy, 9 of whom developed LR, all within the irradiated field. A tumor size >5 cm and intralesional surgical margin were shown to be risk factors for distant metastases. Conclusions The rate of LR for patients with myxofibrosarcoma was high. The impact of RT on local tumor control was unclear. The surgical margin was important for both local and distant tumor control. Large tumor size was a risk factor for distant metastasis.

Highlights

Myxofibrosarcomas (MFSs) are malignant soft-tissue tumors typically presenting as a slowly growing, painless mass in the extremities or the superficial trunk. ey most commonly occur in patients between 60 and 70 years of age, with a slight predominance in males
In 8 cases, the primary surgery was performed outside the sarcoma center. e 10 patients who had 2 surgeries for primary tumor all had the second surgery performed at the sarcoma center. e final surgical margins, after one or two surgeries for the primary tumor, were wide in 30 patients, marginal in 19 patients, and intralesional in 7 patients
Our results indicate a rather high rate of Local recurrence (LR) compared to a mixed series of soft-tissue sarcoma (STS) where the LR rate has been reported to be 15–20% [10, 11]

Summary

Introduction

Myxofibrosarcomas (MFSs) are malignant soft-tissue tumors typically presenting as a slowly growing, painless mass in the extremities or the superficial trunk. ey most commonly occur in patients between 60 and 70 years of age, with a slight predominance in males. Myxofibrosarcomas (MFSs) are malignant soft-tissue tumors typically presenting as a slowly growing, painless mass in the extremities or the superficial trunk. MFS has a reported LR rate of 17–54% which is high compared to other soft-tissue sarcomas [1, 3,4,5,6,7,8,9,10,11]. Myxofibrosarcoma (MFS) is one of the more common types of soft-tissue sarcoma (STS) in patients over 60 years of age. Local recurrence (LR) rates have been reported to be higher compared to other STS types. A tumor size >5 cm and intralesional surgical margin were shown to be risk factors for distant metastases. E surgical margin was important for both local and distant tumor control. Large tumor size was a risk factor for distant metastasis

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