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Clinical Orthopaedics and Related Research®

, Volume 468, Issue 11, pp 3012–3018 | Cite as

Local Recurrence After Initial Multidisciplinary Management of Soft Tissue Sarcoma: Is there a Way Out?

  • Sarantis Abatzoglou
  • Robert E. TurcotteEmail author
  • Abdurahman Adoubali
  • Marc H. Isler
  • David Roberge
Symposium: Highlights of the ISOLS/MSTS 2009 Meeting

Abstract

Background

Multimodality treatment of primary soft tissue sarcoma by expert teams reportedly affords a low incidence of local recurrence. Despite advances, treatment of local recurrence remains difficult and is not standardized.

Questions/purposes

We (1) determined the incidence of local recurrence from soft tissue sarcoma; (2) compared characteristics of the recurrent tumors with those of the primary ones; (3) evaluated local recurrences, metastases and death according to treatments; and (4) explored the relationship between the diagnosis of local recurrence and the occurrence of metastases.

Methods

From our prospective database, we identified 618 soft tissue sarcomas. Thirty-seven of the 618 patients (6%) had local recurrence. Leiomyosarcoma was the most frequent diagnosis (eight of 37). The mean delay from original surgery was 22 months (range, 2–75 months). Mean size was 4.8 cm (range, 0.4–28.0 cm). Median followup after local recurrence was 16 months (range, 0–98 months).

Results

Recurrent tumors had a tendency toward becoming deeper seated and higher graded. Nineteen of the 37 patients with recurrence underwent limb salvage (nine free flaps) and six had an amputation. Twenty-two (59%) had metastases, including 10 occurring after the local recurrence event at an average delay of 21 months (range, 1–34 months). Six patients developed additional local recurrences, with no apparent difference in risk between amputation (two of six) and limb salvage (four of 19).

Conclusions

Patients with a local recurrence of a soft tissue sarcoma have a poor prognosis. Limb salvage and additional radiotherapy remain possible but with substantial complications. Amputation did not prevent additional local recurrence or death.

Level of Evidence

Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Keywords

Local Recurrence Soft Tissue Sarcoma Limb Salvage Local Relapse Soft Tissue Sarcoma Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We thank Ms Cindy Wong, RN, for her invaluable help with the management of the sarcoma database and the data collection.

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Copyright information

© The Association of Bone and Joint Surgeons® 2010

Authors and Affiliations

  • Sarantis Abatzoglou
    • 1
  • Robert E. Turcotte
    • 1
    Email author
  • Abdurahman Adoubali
    • 2
  • Marc H. Isler
    • 2
  • David Roberge
    • 1
  1. 1.McGill University Health CentreMontrealCanada
  2. 2.Maisonneuve-Rosemont HospitalMontrealCanada

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