Long-term salvageability for patients with locally recurrent soft-tissue sarcomas
S. Singer, K. Antman, J. M. Corson and T. J. Eberlein
Department of Surgery, Brigham & Women's Hospital/Harvard Medical School, Boston, MA 02115.
Between 1971 and 1988, 39 patients were referred because of local
recurrence of soft-tissue sarcomas and data from their patient records were
analyzed to determine the parameters governing local recurrence. Mean
follow-up was 11.1 years, with a mean time to local recurrence of 22
months. Twenty-one patients had local recurrence only, without metastatic
disease. Salvage was provided for 14 (67%) of these patients after
reexcision of local recurrence, and all 14 patients remained free of
disease (mean follow-up, 112 months). We conclude that (1) excisional
biopsy of tumors larger than 3 cm leads to potential contamination of clean
tissue planes, limits ability to achieve an adequate margin of resection,
and may compromise the definitive excision, and (2) in patients with local
recurrence only, there is a high rate of long-term salvage (67% for
follow-up of 9.3 years) after radical compartmental excision with or
without postoperative radiation therapy.
