Selective combination of modalities in soft tissue sarcomas: limb salvage and survival.

One hundred fifty-two consecutive patients with soft tissue sarcomas were operated in the period 1977 through 1985. Eighty-seven patients with minimum resection margin of 2 cm or greater had no further local therapy, whereas 65 patients with minimum margin less than 2 cm had adjuvant postoperative radiation. Of 121 patients with extremity sarcomas, only 5 (4%) were managed with amputation. The overall 5-year survival rate is 58%, and for patients with extremity tumors, 67%. The 5-year local recurrence rate in extremity sarcomas was 10% for patients with minimum surgical margins 2 cm or greater and no further local therapy, and 6% for those with lesser surgical margins and adjuvant postoperative radiation. With selective combination of modalities limb salvage can now be practiced in 96% of the patients with acceptable local control and survival rates.