PURPOSE: Positive margins (PM) remain after surgery in some soft-tissue sarcoma (STS) patients. We investigated the efficacy of radiation therapy (RT) in STS patients with PM. METHODS AND MATERIALS: A retrospective chart review was performed on 154 patients with STS at various anatomic sites with PM, defined as tumor on ink, who underwent RT with curative intent between 1970 and 2001. Local control (LC), disease-free survival (DFS), and overall survival (OS) rates were evaluated by univariate (log-rank) and multivariate analysis of prognostic and treatment factors. RESULTS: At 5 years, actuarial LC, DFS, and OS rates were: 76%, 46.7%, and 65.2%, respectively. LC was highest with extremity lesions (p < 0.01), radiation dose >64 Gy (p < 0.05), microscopically (vs. grossly visible) positive margin (p = 0.03), and superficial lesions (p = 0.05). Patients receiving >64 Gy had higher 5-year LC, DFS, and OS rates of 85%, 52.1%, and 67.8% vs. 66.1%, 41.8%, and 62.9% if < or =64 Gy, p < 0.04. OS was worse in patients with G2/G3 tumors with local failure (LF), p < 0.001. Other known prognostic factors, including grade, stage, size, and age (>50), also significantly influenced OS. By multivariate analysis, the best predictors of LC were site (extremity vs. other), p < 0.01 and dose (>64 vs. < or =64 Gy), p < 0.05; the best predictors for OS were size, p < 0.001, gross vs. microscopic PM, p < 0.05, and LF, p < 0.01. CONCLUSION: Local control is achieved in most PM STS patients undergoing RT. Doses >64 Gy, superficial location, and extremity site are associated with improved LC. OS is worse in patients with tumors with lesions >5 cm, grossly positive margins, and after local failure.
PURPOSE: Positive margins (PM) remain after surgery in some soft-tissue sarcoma (STS) patients. We investigated the efficacy of radiation therapy (RT) in STS patients with PM. METHODS AND MATERIALS: A retrospective chart review was performed on 154 patients with STS at various anatomic sites with PM, defined as tumor on ink, who underwent RT with curative intent between 1970 and 2001. Local control (LC), disease-free survival (DFS), and overall survival (OS) rates were evaluated by univariate (log-rank) and multivariate analysis of prognostic and treatment factors. RESULTS: At 5 years, actuarial LC, DFS, and OS rates were: 76%, 46.7%, and 65.2%, respectively. LC was highest with extremity lesions (p < 0.01), radiation dose >64 Gy (p < 0.05), microscopically (vs. grossly visible) positive margin (p = 0.03), and superficial lesions (p = 0.05). Patients receiving >64 Gy had higher 5-year LC, DFS, and OS rates of 85%, 52.1%, and 67.8% vs. 66.1%, 41.8%, and 62.9% if < or =64 Gy, p < 0.04. OS was worse in patients with G2/G3 tumors with local failure (LF), p < 0.001. Other known prognostic factors, including grade, stage, size, and age (>50), also significantly influenced OS. By multivariate analysis, the best predictors of LC were site (extremity vs. other), p < 0.01 and dose (>64 vs. < or =64 Gy), p < 0.05; the best predictors for OS were size, p < 0.001, gross vs. microscopic PM, p < 0.05, and LF, p < 0.01. CONCLUSION: Local control is achieved in most PM STS patients undergoing RT. Doses >64 Gy, superficial location, and extremity site are associated with improved LC. OS is worse in patients with tumors with lesions >5 cm, grossly positive margins, and after local failure.
Authors: Esther Carbó-Laso; Pablo Sanz-Ruiz; José Antonio Calvo-Haro; Miguel Cuervo-Dehesa; Rubén Pérez-Mañanes; Lydia Mediavilla-Santos; Coral Sánchez-Pérez; Ana Álvarez-González; Javier Vaquero-Martín Journal: Int J Clin Oncol Date: 2017-07-17 Impact factor: 3.402
Authors: Emily Z Keung; Jen-Wei Tsai; Ali M Ali; Janice N Cormier; Andrew J Bishop; B Ashleigh Guadagnolo; Keila E Torres; Neeta Somaiah; Kelly K Hunt; Jennifer A Wargo; Alexander J Lazar; Wei-Lien Wang; Christina L Roland Journal: Oncoimmunology Date: 2017-10-31 Impact factor: 8.110
Authors: Christopher L Tinkle; Israel Fernandez-Pineda; April Sykes; Zhaohua Lu; Chia-Ho Hua; Michael D Neel; Armita Bahrami; Barry L Shulkin; Sue C Kaste; Alberto Pappo; Sheri L Spunt; Matthew J Krasin Journal: Cancer Date: 2017-07-31 Impact factor: 6.860
Authors: Armin Arshi; Justin Sharim; Don Y Park; Howard Y Park; Hamed Yazdanshenas; Nicholas M Bernthal; Arya N Shamie Journal: Spine J Date: 2016-11-14 Impact factor: 4.166
Authors: Nicole J Look Hong; Francis J Hornicek; David C Harmon; Edwin Choy; Yen-Lin Chen; Sam S Yoon; G Petur Nielsen; Jackie Szymonifka; Beow Y Yeap; Thomas F DeLaney; John T Mullen Journal: Eur J Cancer Date: 2012-10-22 Impact factor: 9.162