Oncological Outcome and Prognostic Factors of Surgery for Soft Tissue Sarcoma After Neoadjuvant or Adjuvant Radiation Therapy: A Retrospective Analysis over 15 Years

Anticancer Res. 2021 Jan;41(1):359-368. doi: 10.21873/anticanres.14784.

Abstract

Background/aim: Surgical resection for soft tissue sarcomas (STSs) is the gold standard for a curative oncologic therapy in combination with neoadjuvant or adjuvant radiation therapy (NRT/ART). The aim of this study was to determine prognostic factors influencing the survival of patients with STS undergoing NRT or ART considering various parameters in a retrospective, single-centre analysis over 15 years.

Patients and methods: We included 119 patients (male 59) and the median follow-up period was 69 months (4-197). The patients received NRT (n=64) or ART (n=55). We recorded the histopathologic subtype of STS, tumour grade, localization, tumour margins, complications, survival, local recurrence, and metastases. Survival analysis was performed using the Kaplan-Meier method.

Results: The overall survival rate was 68.9% at 5 years. The localization (epifascial/subfascial), resection margin and type of radiation therapy (NRT/ART) had no significant impact on survival. Tumour grade, tumour size, local recurrence and metastases were significantly correlated with patient survival (p<0.05). Local recurrence was significantly higher in patients with ART (p=0.044).

Conclusion: Tumour grade and tumour size were independently associated with disease-specific survival, and patients with local recurrence and metastases had lower survival rates.

Keywords: Soft tissue sarcoma; prognostic factors; radiation therapy; surgery.

MeSH terms

  • Adult
  • Aged
  • Combined Modality Therapy
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / adverse effects
  • Neoadjuvant Therapy / methods
  • Neoplasm Grading
  • Neoplasm Staging
  • Prognosis
  • Radiotherapy, Adjuvant / adverse effects
  • Radiotherapy, Adjuvant / methods
  • Retreatment
  • Retrospective Studies
  • Sarcoma / diagnosis
  • Sarcoma / mortality*
  • Sarcoma / surgery*
  • Soft Tissue Neoplasms / diagnosis
  • Soft Tissue Neoplasms / mortality*
  • Soft Tissue Neoplasms / surgery*
  • Treatment Outcome