European Journal of Cancer
Volume 39, Issue 13 , Pages 1872-1880 , September 2003

Does adjuvant radiation therapy increase loco-regional control after optimal resection of soft-tissue sarcoma of the extremities?

  • K. Khanfir

      Affiliations

    • Department of Radiotherapy, Institut Gustave Roussy, Villejuif 94805, France
  • ,
  • L. Alzieu

      Affiliations

    • Department of Epidemiology and Statistics, Institut Gustave Roussy, Villejuif 94805, France
  • ,
  • P. Terrier

      Affiliations

    • Department of Histopathology, Institut Gustave Roussy, Villejuif 94805, France
  • ,
  • C. Le Péchoux

      Affiliations

    • Department of Radiotherapy, Institut Gustave Roussy, Villejuif 94805, France
  • ,
  • S. Bonvalot

      Affiliations

    • Department of Surgery, Institut Gustave Roussy, Villejuif 94805, France
  • ,
  • D. Vanel

      Affiliations

    • Department of Radiolology, Institut Gustave Roussy, Villejuif 94805, France
  • ,
  • A. Le Cesne

      Affiliations

    • Department of Medicine, Institut Gustave Roussy, 39, rue Camille Desmoulins, Villejuif 94805, France
    • Corresponding Author InformationCorresponding author. Tel.: +33-1-4211-4316; fax: +33-1-4211-5231

Received 2 December 2002 ,Revised 4 February 2003 ,Accepted 30 April 2003.

References 

  1. Lindberg RD, Martin RG, Romsdahl MM, et al.  Conservative surgery and postoperative radiotherapy in 300 adults with soft-tissue sarcomas. Cancer. 1981;47:2391–2397
  2. Rosenberg SA, Tepper J, Gladstein E, et al.  The treatment of soft tissue sarcomas of the extremities (prospective evaluation of limb sparing surgery plus radiation therapy compared with amputation and the role of adjuvant chemotherapy). Ann. Surg. 1982;196:305–315
  3. Leibel SA, Tranbaugh RF, Wara WM, et al.  Soft tissue sarcoma of the extremities. Survival and patterns of failure with conservative surgery and postoperative irradiation compared to surgery alone. Cancer. 1982;50:1076–1083
  4. Suit HD, Mankin HJ, Wood WC, et al.  Preoperative, intraoperative and postoperative radiation in the treatment of primary soft tissue sarcoma. Cancer. 1989;1555:2659–2667
  5. Abbatucci JC, Levy C, Boulier N, et al.  Systematic radio-surgical combination in the treatment of sarcoma of soft tissues in adults. Results in 106 cases at the Centre Francois Baclesse. Ann. Radiol. (Paris). 1989;32:117–122
  6. Stotter AT, A'Hern RP, Fisher C, et al.  The influence of local recurrence of extremity soft tissue sarcoma on metastasis and survival. Cancer. 1990;65:1119–1129
  7. Herbert SH, Corn BW, Solin LJ, et al.  Limb preserving treatment for soft tissue sarcomas of the extremities. The significance of surgical margins. Cancer. 1993;72:1230–1238
  8. Karakousis CP, Proimakis C, Walsh D. Primary soft tissue sarcoma of the extremities in adults. B. J. Surg. 1985;82:1208–1212
  9. Gustafson P. Soft tissue sarcoma.Epidemiology and prognosis in 508 patients. Acta Orthop. Scand. 1994;65(Suppl. 259):1–31
  10. Coindre JM, Terrier P, Bui NB, et al.  Pronostic factors in adult patients with locally controlled soft tissue sarcoma (a study of 546 patients from the French Federation of Cancer Centers Sarcoma Group). J. Clin. Oncol. 1996;14:869–877
  11. Lewis J, Leung D, Espat J, et al.  Effect of reresection in extremity soft tissue sarcoma. Ann Surg. 2000;231:655–663
  12. Goodlad JR, Fletcher C, Smith M, et al.  Surgical resection of primary soft-tissue sarcoma. J. Bone Joint Surg. 1996;78B:658–661
  13. Giuliano AE, Eilber FR. The rationale for planned reoperation after unplanned total excision of soft tissue sarcomas. J. Clin. Oncol. 1985;3:1344–1348
  14. Noria S, Davis A, Kandel R, et al.  Residual disease following unplanned excision of a soft tissue sarcoma. J. Bone Joint Surg. 1996;78A:650–655
  15. Pisters WT, Leung D, Woodruff J, et al.  Analysis of pronostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities. J. Clin. Oncol. 1996;14:1679–1689
  16. LeVay J, O'Sullivan B, Catton C, et al.  Outcome and prognostic factors in soft tissue sarcoma of the adult. Int. J. Radiat. Oncol. Biol. Phys. 1993;27:1091–1099
  17. Fein DA, Lee WR, Lanciano RM, et al.  Management of extremity soft tissue sarcomas with limb-sparing surgery and postoperative irradiation (do total dose, overall treatment time, and the surgery-radiotherapy interval impact on local control?). Int. J. Radiat. Oncol. Biol. Phys. 1995;32:969–976
  18. Suit HD, Mankin HJ, Wood WC, et al.  Treatment of the patient with stage Mo soft tissue sarcoma. J. Clin. Oncol. 1988;6:854–862
  19. Gaynor JJ, Tan CT, Casper ES, et al.  Refinement of clinicopathologic staging for localised soft tissue sarcoma of the extremity (a study of 423 adults). J. Clin. Oncol. 1992;10:1317–1329
  20. Heslin M, Woodruff J, Brennan M. Pronostic significance of a positive microscopic margin in high risk extremity soft tissue sarcoma (implications for management). J. Clin. Oncol. 1996;14:473–478
  21. Le Doussal V, Coindre JM, Leroux A, et al.  Pronostic factors for patients with localized primary malignant fibrous histiocytoma. Cancer. 1996;77:1823–1830
  22. Rydholm A, Gustafson P, Rooser B, et al.  Limb-sparing surgery without radiotherapy based on anatomic location of soft tissue sarcoma. J. Clin. Oncol. 1991;9:1757–1765
  23. Baldini EH, Goldberg J, Jenner C, et al.  Longterm outcomes after function-sparing surgery without radiotherapy for soft tissue sarcoma of the extremities and trunk. J. Clin. Oncol. 1999;17:3252–3259
  24. Geer RJ, Woodruff J, Casper ES, et al.  Management of small soft tissue sarcoma of the extremity in adults. Arch. Surg. 1992;127:1285–1289
  25. Gibbs CP, Peabody TD, Mundt AJ, et al.  Oncological Outcomes of operative treatment of subcutaneous soft-tissue sarcomas. J. Bone Joint Surg. 1997;79A:888–897
  26. Markhede G, Angervall L, Stener B. A multivariate analysis of the prognosis after surgical treatment of malignant soft-tissue tumors. Cancer. 1982;49:1721–1733
  27. Yang JC, Chang AE, Baker AR, et al.  Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J. Clin. Oncol. 1998;16:197–203
  28. Stinson SF, Delaney TF, Greenberg J, et al.  Acute and long term effects on limb function of combined modality limb sparing therapy for extremity soft tissue sarcoma. Int. J. Radiat. Oncol. Biol. Phys. 1991;21:1493–1499
  29. Wiklund TA, Alvegard TA, Mouridsen HT, et al.  Marginal surgery and postoperative radiotherapy in soft tissue sarcomas. Eur. J. Cancer. 1993;29A:306–309
  30. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin. Orthop. 1980;153:106–120
  31. Enzinger F, Weiss S. Soft Tissue Tumors. St Louis, MO: Mosby; 1988;
  32. Coindre JM, Trojani M, Contesso G, et al.  Reproductibility of a histopathologic grading system for adult soft tissue sarcoma. Cancer. 1986;58:306–309
  33. Le Péchoux C, Le Deley MC, Delaloge S, et al.  Postoperative radiotherapy in the management of adult soft tissue sarcoma of the extremities (results with 2 different total dose, fractionation and overall treatment time schedules). Int. J. Radiat. Oncol. Biol. Phys. 1999;44:879–886
  34. Kaplan E, Meier P. Nonparametric estimation from incomplete observations. J. Am. Stat. Assoc. 1958;457–481
  35. Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother. Rep. 1966;50:163–170
  36. Cox DR. Regression models and life tables [with discussion]. J. R. Statist. Soc. B. 1972;34:187–220
  37. Simon MA, Enneking WF. The management of soft tissue sarcoma of the extremities. J. Bone Joint. Surg. 1976;58A:317–327
  38. Erlandson RA, Woodruff JM. The role of electron microscopy in the evaluation of soft-tissue neoplasms,with emphasis on spindle and pleomorphic tumors. Human Pathol. 1998;29:1372–1381
  39. Lewis J, Leung D, Casper E, et al.  Multifactorial analysis of long-term follow-up (more than 5 years) of primary extremity sarcoma. Arch Surg. 1999;134:190–194
  40. Fleming J, Berman RS, Cheng S, et al.  Long-term outcome of patients with American Joint Committee on Cancer Stage IIB extremity softtissue sarcoma. J. Clin. Oncol. 1999;17:2772–2780
  41. Karakousis C, Driscoll D. Treatment and local control of primary extremity soft tissue sarcomas. J. Surg. Oncol. 1999;71:155–161
  42. Pisters PWT, Harrison LB, Leung DHY, et al.  Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J. Clin. Oncol. 1996;14:859–868
  43. Collin C, Godbold J, Hadju S, et al.  Localised extremity soft tissue sarcoma (an analysis of factors affecting survival). J. Clin. Oncol. 1987;5:601–612
  44. Singer S, Corson JM, Gonin R, et al.  Prognostic factors predictive of survival and local recurrence for extremity soft tissue sarcoma. Ann. Surg. 1994;219:165–173
  45. Fagundes HM, Lai PP, Dehner LP, et al.  Postoperative radiotherapy for malignant fibrous histiocytoma. Int. J. Radiat. Oncol. Biol. Phy. 1992;23:615–619
  46. Dinges S, Budach V, Budach W, et al.  Local recurrences of soft tissue sarcomas in adults (a retrospective analysis of prognostic factors in 102 cases after surgery and radiation therapy). Eur. J. Cancer. 1994;30A:1636–1642
  47. Rossi C, Foletto M, Alessio S, et al.  Limb-sparing treatment for soft tissue sarcoma (influence of prognostic factors). J. Surg. Oncol. 1996;63:3–8
  48. Alektiar KM, Leung D, Zelfsky MJ, Brennan M. Adjuvant radiation for stage II-B soft tissue sarcoma of the extremity. J. Clin. Oncol. 2002;20:1643–1650
  49. Fletcher CDM. Pleomorphic malignant fibrous histiocytoma (fact or fiction? A critical reappraisal based on159 tumors diagnosed as pleomorphic sarcoma?). Am. J. Surg. Pathol. 1992;16:213–228
  50. Mertens F, Fletcher CD, Dal Cin P, et al.  Cytogenetic analysis of 46 pleomorphic soft tissue sarcoma and correlation with morphologic and clinical features of the CHAMP Study Group. Chromosomes and morphology. Genes Chromo Cancer. 1998;22:16–25

PII: S0959-8049(03)00426-X

doi: 10.1016/S0959-8049(03)00426-X

European Journal of Cancer
Volume 39, Issue 13 , Pages 1872-1880 , September 2003