Multifactorial Analysis of Long-Term Follow-up (More Than 5 Years) of Primary Extremity Sarcoma

• Main Authors: Lewis, J. J., Leung, Denis H. Y., Casper, E. S., Woodruff, J. M., Hajdu, S. I., Brennan, M. F.
• Format: text
• Language: English
• Published: Institutional Knowledge at Singapore Management University 1999
• Subjects: Economics
• Online Access: https://ink.library.smu.edu.sg/soe_research/28
• Institution: Singapore Management University

The majority of survival studies in patients with extremity soft tissue sarcoma have focused on early recurrence and mortality. There are few data addressing long-term follow-up and survival. Objective: To analyze survival and recurrence in patients with extremity soft tissue sarcoma who survive for more than 5 years. Methods: Patients who underwent treatment for primary tumors (July 1982 to July 1994) and were followed up for more than 5 years were the subject of study. Disease-specific and disease-free survival were determined actuarially. Significance was evaluated using log-rank testing for univariate analysis and Cox model stepwise regression for multivariate analysis. Results: A total of 495 patients with primary extremity tumors were treated before July 1989 and eligible for 5-year follow-up. Of these, 282 have been followed up for more than 5 years (median follow-up, 84.4 months). Actuarial disease-specific survival of patients who survive for longer than 5 years was 79% ± 7% (±SEM) at 10 years, and of those who were metastasis free at 5 years was 91% ± 4% at 10 years. On univariate analysis, post-5-year disease-specific survival was influenced by positive microscopic margin and initial tumor size of 5 cm or greater. On multivariate analysis, post-5-year disease-specific survival was influenced only by positive margins. Conclusions: Based on these analyses, 21% of patients with primary extremity sarcoma who survive for 5 years will die of disease within 5 years. Even of those who are metastasis free at 5 years, 9% will die of disease within 5 years, In contrast to early mortality, tumor grade has no influence on post-5-year prognosis. Patients with positive microscopic margins are at risk for post-5-year disease-specific mortality and therefore require long-term follow-up and consideration for investigational therapy.