Janice L Austin1, Walley J Temple2, Shannon Puloski3, Norman S Schachar3, Elizabeth Oddone Paolucci4, Elizabeth Kurien5, Kourosh Sarkhosh6, Lloyd A Mack2. 1. Division of General Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada. 2. Division of Surgical Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada. 3. Division of Orthopedic Surgery, University of Calgary, Calgary, Alberta, Canada. 4. Departments of Surgery and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 5. Division of Radiation Oncology, University of Calgary, Calgary, Alberta, Canada. 6. Department of Surgery, Kaiser Permanente, Fresno, California.
Abstract
BACKGROUND AND OBJECTIVES: Currently, standard treatment of soft tissue sarcoma (STS) is wide local excision and adjuvant radiation, but radiation may be unnecessary in superficial STS. The primary objective is to assess local recurrence rates in patients treated with surgical management alone for superficial STS. METHODS: A retrospective cancer registry review of patients treated with surgery alone for superficial STS at the Tom Baker Cancer Center (TBCC) was performed. Patient and tumor characteristics as well as recurrence data were collected. RESULTS: Sixty-one patients met study criteria. Local and overall recurrence rates were 7/61 (11.5%) and 12/61 (19.7%), respectively. The proportion with a T2 tumor was 38.8% versus 33.3% (P = 0.69), with Grade 2 or 3 tumors was 59.2% versus 83.3% (P = 0.14), and with resection margins <1 cm was 28.6% versus 75.0% (P = 0.008) for patients without and with recurrence, respectively. Median time to recurrence was 1.7 (0.4-5.2) years. CONCLUSIONS: Surgical resection alone appears to be a viable option for superficial STS that can save patients from potential side effects of radiation. The association between recurrence and inadequate margins (<1 cm) requires additional treatment be offered to this subset of patients.
BACKGROUND AND OBJECTIVES: Currently, standard treatment of soft tissue sarcoma (STS) is wide local excision and adjuvant radiation, but radiation may be unnecessary in superficial STS. The primary objective is to assess local recurrence rates in patients treated with surgical management alone for superficial STS. METHODS: A retrospective cancer registry review of patients treated with surgery alone for superficial STS at the Tom Baker Cancer Center (TBCC) was performed. Patient and tumor characteristics as well as recurrence data were collected. RESULTS: Sixty-one patients met study criteria. Local and overall recurrence rates were 7/61 (11.5%) and 12/61 (19.7%), respectively. The proportion with a T2 tumor was 38.8% versus 33.3% (P = 0.69), with Grade 2 or 3 tumors was 59.2% versus 83.3% (P = 0.14), and with resection margins <1 cm was 28.6% versus 75.0% (P = 0.008) for patients without and with recurrence, respectively. Median time to recurrence was 1.7 (0.4-5.2) years. CONCLUSIONS: Surgical resection alone appears to be a viable option for superficial STS that can save patients from potential side effects of radiation. The association between recurrence and inadequate margins (<1 cm) requires additional treatment be offered to this subset of patients.
Authors: Andrea Ferrari; Yueh-Yun Chi; Gian Luca De Salvo; Daniel Orbach; Bernadette Brennan; R Lor Randall; M Beth McCarville; Jennifer O Black; Rita Alaggio; Douglas S Hawkins; Gianni Bisogno; Sheri L Spunt Journal: Eur J Cancer Date: 2017-04-07 Impact factor: 9.162