[Management and prognosis of patients with locally recurrent soft tissue sarcomas].

OBJECTIVE: The results and prognositic factors in treating locally recurrent soft tissue sarcoma (STS) of the extremities and trunk were identified.

METHODS: The clinical, pathologic, and therapeutic characteristics of 96 STS patients were investigated using univariate and multivariate analyses. Seventy-six patients (79.2%) had high grade sarcoma and 20 patients (20.8%) had low grade sarcoma. Operative procedures were wide excision (surgical margin > or = 2 cm) in 66, local excision (surgical margin < 2 cm) in 6, and amputation in 24 patients. Adjuvant radiotherapy and chemotherapy was administered in 24 and 36 patients respectively.

RESULTS: After reoperation of the recurrent tumor, the 5-year local control and overall survival rates were 70.1% and 59.1%, respectively. High grade, large size, and tumor in the upper extremities were associated with decreased overall survival.

CONCLUSION: The authors emphasize that the initial management of primary STS should be adequate and suggest that safty margin of > or = 2 cm should be adhered to. In patients with local recurrence only, the overall survival may not be adversely affected if the recurrent lesion is properly treated. Investigations of more effective multimodality therapy needs to be done.