Local control results in extremity soft tissue sarcomas

Abstract

Aim: The aim of this study is to investigate local control results and effective predictive factors in local control of extremity soft tissue sarcomas, retrospectively. Material and Method: 51 patients underwent postoperative adjuvant radiotherapy (RT) in Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital between October 2008-January 2022. Patients who underwent post-operative adjuvant RT were treated with 60-68 Gy in 2 phases from 2 Gy /day using conformal radiotherapy technique. IMA chemotherapy protocol was applied to 31.4% of the patients after radiotherapy. Results: The median follow up time was 46 months range (1-135). Recurrence was detected in 5 of the patients and the mean time of recurrence was 11.6 months (min: 3-max: 27). 10 patients developed metastasis at follow-up, the mean time until metastasis was 27 months (min: 18- max: 46). The mean overall survival (OS) was 103 (min:4-max:139) months and the OS of 2, 5 and 10 years were 93%, 65% and 60%, respectively. Disease-free survival (DFS) was 97 (min:4-max:139) months; 2, 5 and 10 years of DFS were 77%, 65% and 60%, respectively. The OS in patients aged ≥65 years old was significantly lower than in patients <65 years old (p=0.02). Overall and disease-free survival was significantly lower in patients undergoing chemotherapy (p=0.037 for overall survival, p=0.013 for disease-free survival). The occurrence of recurrence, metastasis or death within 3 years after the operation was significantly higher than after 3 years (p<0.001). Local failure was significantly higher in grade 3 tumors (p=0.05). All patients who recurred had grade 3 tumors. Metastasis and excitus were significantly higher in the follow-up of patients who underwent chemotherapy at one point during their treatment (p=0.027 for metastasis, p=0.042). Conclusion: While favorable local control results are obtained with adjuvant high dose-conformal radiotherapy in extremity sarcomas, close follow up is important for distant metastasis and local recurrence, especially in the first 3 years.