TY - JOUR
T1 - Clinicopathologic features and treatment of postirradiation sarcoma of bone and soft tissue
AU - Inoue, Yoshiya Z.
AU - Frassica, Frank J.
AU - Sim, Franklin H.
AU - Unni, K. Krishnan
AU - Petersen, Ivy A.
AU - McLeod, Richard A.
PY - 2000/10/13
Y1 - 2000/10/13
N2 - Background and Objectives: An analysis of the clinicopathologic features and treatment of patients with postirradiation sarcoma of bone and soft tissue was performed to guide modem evaluation and management. Methods: A retrospective analysis of 135 sarcomas in 130 patients was performed. Results: The mean age of the 130 patients was 48 years, and there was a female predominance because of irradiation for carcinomas of the breast and uterus. Indication for irradiation was a soft tissue lesion (such as lymphoma or breast cancer) in 58.5% of patients and a bone lesion (such as giant cell tumor or fibrous dysplasia) in 41.5%. The latent period (interval between irradiation and discovery of the sarcoma) ranged from 4-55 years (mean, 17 years). Of the lesions, 74% were stage IIB (high-grade extra-compartmental) and 24% were stage III (metastases). Ninetyfour patients received their treatment at our institution. Of the 61 patients with resectable disease, 49 had amputations and 12 had limb salvage procedures. The 5-year cumulative survival rate was 68.2% for patients with peripheral (extremities, including proximal femur and hip) resectable lesions and 27.3% for patients with central (pelvis, head/neck, and ribs) resectable lesions. The local recurrence rate correlated with the surgical margin achieved: intralesional, 73%, marginal, 64%, and wide, 23%. Conclusions: The prognosis for patients with peripheral resectable post-irradiation sarcomas is good if a wide surgical margin can be achieved. This group of patients should be treated aggressively because they have a new cancer. (C) 2000 Wiley-Liss, Inc.
AB - Background and Objectives: An analysis of the clinicopathologic features and treatment of patients with postirradiation sarcoma of bone and soft tissue was performed to guide modem evaluation and management. Methods: A retrospective analysis of 135 sarcomas in 130 patients was performed. Results: The mean age of the 130 patients was 48 years, and there was a female predominance because of irradiation for carcinomas of the breast and uterus. Indication for irradiation was a soft tissue lesion (such as lymphoma or breast cancer) in 58.5% of patients and a bone lesion (such as giant cell tumor or fibrous dysplasia) in 41.5%. The latent period (interval between irradiation and discovery of the sarcoma) ranged from 4-55 years (mean, 17 years). Of the lesions, 74% were stage IIB (high-grade extra-compartmental) and 24% were stage III (metastases). Ninetyfour patients received their treatment at our institution. Of the 61 patients with resectable disease, 49 had amputations and 12 had limb salvage procedures. The 5-year cumulative survival rate was 68.2% for patients with peripheral (extremities, including proximal femur and hip) resectable lesions and 27.3% for patients with central (pelvis, head/neck, and ribs) resectable lesions. The local recurrence rate correlated with the surgical margin achieved: intralesional, 73%, marginal, 64%, and wide, 23%. Conclusions: The prognosis for patients with peripheral resectable post-irradiation sarcomas is good if a wide surgical margin can be achieved. This group of patients should be treated aggressively because they have a new cancer. (C) 2000 Wiley-Liss, Inc.
KW - Carcinoma
KW - Local recurrence rate
KW - Management
KW - Retrospective review
KW - Survival rate
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U2 - 10.1002/1096-9098(200009)75:1<42::AID-JSO8>3.0.CO;2-G
DO - 10.1002/1096-9098(200009)75:1<42::AID-JSO8>3.0.CO;2-G
M3 - Article
C2 - 11025461
AN - SCOPUS:0033803169
SN - 0022-4790
VL - 75
SP - 42
EP - 50
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
IS - 1
ER -