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. 1975 Nov;182(5):597–602. doi: 10.1097/00000658-197511000-00011

Surgical treatment of 297 soft tissue sarcomas of the lower extremity.

M H Shiu, E B Castro, S I Hajdu, J G Fortner
PMCID: PMC1344044  PMID: 1190864

Abstract

The results of surgical treatment of 297 soft tissue sarcomas arising in the lower extremity were critically examined. En bloc wide soft part resection (158 cases) yielded five and ten year survival rates of 63% and 50%. Amputation or major disarticulation (139 cases) gave corresponding survival rates of 45% and 29%. The most frequent cause of treatment failure was distant metastases, commonly in the lungs. The tissue type of sarcoma, histologic grade of malignancy, and tumor size appear to be important determinants of survival irrespective of the type of surgical treatment. Local recurrence of sarcoma occurred in 18% of the cases, more commonly after soft part resections than amputations. The proximity of a sarcoma to major vessels, bone or joint tends to compromise the margins of a wide soft part resection, thus increasing the risk of local recurrence. In appropriate cases, the scope of soft part resection can be extended by en bloc excision of the femoral vessels, with the hope of improving local control of sarcoma. Amputation should br resorted to if an adequate margin of resection cannot otherwise be obtained. This decision must be weighted against the high frequency of distant metastases in this disease. Postoperative adjuvant chemotherapy and immunotherapy offer prospects of prevention of this tragic outcome.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ATKINSON L., GARVAN J. M., NEWTON N. C. BEHAVIOR AND MANAGEMENT OF SOFT CONNECTIVE TISSUE SARCOMAS. Cancer. 1963 Dec;16:1552–1562. doi: 10.1002/1097-0142(196312)16:12<1552::aid-cncr2820161206>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  2. BARBER J. R., COVENTRY M. B., MCDONALD J. R. The spread of soft-tissue sarcomata of the extremities along peripheral-nerve trunks. J Bone Joint Surg Am. 1957 Jun;39-A(3):534–540. [PubMed] [Google Scholar]
  3. BOWDEN L., BOOHER R. J. The principles and technique of resection of soft parts for sarcoma. Surgery. 1958 Dec;44(6):963–977. [PubMed] [Google Scholar]
  4. Brennhovd I. O. The treatment of soft tissue sarcomas--a plea for a more urgent and aggressive approach. Acta Chir Scand. 1966 May;131(5):438–442. [PubMed] [Google Scholar]
  5. Cantin J., McNeer G. P., Chu F. C., Booher R. J. The problem of local recurrence after treatment of soft tissue sarcoma. Ann Surg. 1968 Jul;168(1):47–53. doi: 10.1097/00000658-196807000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Castro E. B., Hajdu S. I., Fortner J. G. Surgical therapy of fibrosarcoma of extremities: a reappraisal. Arch Surg. 1973 Aug;107(2):284–286. doi: 10.1001/archsurg.1973.01350200146030. [DOI] [PubMed] [Google Scholar]
  7. Hirshaut Y., Pei D. T., Marcove R. C., Mukherji B., Spielvogel A. R., Essner E. Seroepidemiology of human sarcoma antigen (S1). N Engl J Med. 1974 Nov 21;291(21):1103–1107. doi: 10.1056/NEJM197411212912103. [DOI] [PubMed] [Google Scholar]
  8. LAWRENCE W., Jr, JEGGE G., FOOTE F. W., Jr EMBRYONAL RHABDOMYOSARCOMA. A CLINICOPATHOLOGICAL STUDY. Cancer. 1964 Mar;17:361–376. doi: 10.1002/1097-0142(196403)17:3<361::aid-cncr2820170312>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  9. McNeer G. P., Cantin J., Chu F., Nickson J. J. Effectiveness of radiation therapy in the management of sarcoma of the soft somatic tissues. Cancer. 1968 Aug;22(2):391–397. doi: 10.1002/1097-0142(196808)22:2<391::aid-cncr2820220217>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  10. PERRY H., CHU F. C. Radiation therapy in the palliative management of soft tissue sarcomas. Cancer. 1962 Jan-Feb;15:179–183. doi: 10.1002/1097-0142(196201/02)15:1<179::aid-cncr2820150125>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  11. RABEN M., CALABRESE A., HIGINBOTHAM N. L., PHILLIPS R. MALIGNANT SYNOVIOMA. Am J Roentgenol Radium Ther Nucl Med. 1965 Jan;93:145–153. [PubMed] [Google Scholar]
  12. Shiu M. H., Chu F., Castro E. B., Hajdu S. I., Fortner J. H. Results of surgical and radiation therapy in the treatment of liposarcoma arising in an extremity. Am J Roentgenol Radium Ther Nucl Med. 1975 Mar;123(3):577–582. doi: 10.2214/ajr.123.3.577. [DOI] [PubMed] [Google Scholar]
  13. THORBJARNARSON B. Sarcomata the New York Hospital. Arch Surg. 1961 Apr;82:489–510. doi: 10.1001/archsurg.1961.01300100003001. [DOI] [PubMed] [Google Scholar]
  14. Wood W. C., Morton D. L. Host immune response to a common cell-surface antigen in human sarcomas. N Engl J Med. 1971 Mar 18;284(11):569–572. doi: 10.1056/NEJM197103182841102. [DOI] [PubMed] [Google Scholar]

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