Abstract
Background: Undifferentiated pleomorphic sarcomas are a frequent subtype within the heterogeneous group of soft tissue sarcomas. As the attainment of negative margins can be complicated at the extremities, we determined the prognostic significance of surgical margins in our patient population. Methods: We retrospectively determined the relationship between local recurrence-free survival (LRFS), overall survival (OS), and potential prognostic factors in 192 patients with UPS of the extremities who were suitable for surgical treatment in curative intent. The median follow-up time was 5.1 years. Results: The rates of LRFS and OS after 2 years were 75.7% and 87.2% in patients with R0-resected primary tumors and 49.1% and 81.8% in patients with R1/R2-status (LRFS: p = 0.013; OS: p = 0.001). Adjuvant radiotherapy significantly improved LRFS (5-year: 67.6% vs. 48.4%; p < 0.001) and OS (5-year: 82.8 vs. 61.8; p = 0.016). Both, negative margins and adjuvant radiotherapy were found to be independent prognostic factors in multivariate analysis. Conclusions: The data from this study could underscore the beneficial prognostic impact of negative margins on LRFS and OS. However, the width of negative margins seemed to be not relevant. Notably, adjuvant radiotherapy was not only able to decrease the risk of local failure but also improved OS in a significant manner.
Highlights
Soft tissue sarcomas are a heterogeneous group of rare, solid malignancies with a mesenchymal origin
We focused on the prognostic impact of treatment-related factors such as surgical margins, clear margin widths, and adjuvant radiotherapy on disease outcome
At the end of the follow-up time, 119 (62.0%) patients did not show any evidence of disease, In contrast, 11 patients (5.7%) were alive with the local recurrent disease and 13 (6.8%) were alive with distant metastases
Summary
Soft tissue sarcomas are a heterogeneous group of rare, solid malignancies with a mesenchymal origin. They account for approximately 1% of all adult malignancies with an incidence rate of 6 per. Soft tissue sarcomas (STS) comprise a group of more than 50 different histologic subtypes that differ in their oncological behavior and outcome [3] Due to their rarity and heterogeneity, most studies regarding treatment outcomes in STS include all subtypes rather than focusing on specific subtypes. Methods: We retrospectively determined the relationship between local recurrence-free survival (LRFS), overall survival (OS), and potential prognostic factors in 192 patients with UPS of the extremities who were suitable for surgical treatment in curative intent. Adjuvant radiotherapy significantly improved LRFS (5-year: 67.6% vs. 48.4%; p < 0.001)
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