Survival of patients with soft tissue sarcoma (STS) correlated to tumor grade, size, site of origin & cell type. Does the high risk group need adjuvant systemic therapy?

Abstract

19510 Background: The prognosis of patients with STS depends on the tumor stage, which includes tumor size (T) and grade (G). Patients with low-grade tumors (G1) are managed by radical resection only. Patients with moderate (G2) and high-grade (G3) tumors require postoperative adjuvant radiation therapy (RT); this became standard therapy. This study was conducted to determine the efficacy of standard therapy on survival. Methods: This is a retrospective study of patients with primary STS, excluding those with skin, subcutaneous tissue and GIST. All patients underwent radical resections (S). Postoperative RT was requested for G2 and G3 tumors; 6 patients with G3 tumors received chemotherapy (C) prior to RT. Results: 52 patients were studied with a median follow-up of 84 mo. The overall survival ranged from 3 to 264 mo. with a median of 52 mo. The incidence of tumor grade and size were correlated to the survival. 37 patients had STS of the extremities and torso; 24 are alive. 10 patients had intra- and retro-peritoneal STS; 5 are alive. 4 of the 6 patients who received C are alive, 3 are disease-free for a period of 3 to 7 years. Life table analysis of patients with G3T2 tumors comparing the 3 treatment groups (S vs. S+RT vs. S+C+RT) showed no statistical difference in survival, but there was a trend in favor of S+C+RT. Conclusions: 1. Radical resection and postoperative RT may be insufficient for systemic control. 2. Adjuvant systemic chemotherapy may improve the survival, and may be safer than RT in the management of retroperitoneal and visceral sarcomas. [Table: see text] No significant financial relationships to disclose.