Impact factor analysis of postoperative local recurrence of soft tissue sarcoma

JIANG Jun; Oliver Peck; Nicholas D Clement; Daniel Edward Porter

doi:10.3969/j.issn.2095-252X.2015.07.009

Abstract：Objective To analyze the factors that lead to postoperative local recurrence of soft tissue sarcoma.Methods A retrospective analysis of a sequential series of 79 patients who had undergone surgical resection of soft tissue sarcomas in Royal Infirmary of Edinburgh between 1995 and 2010 was conducted. Forty-four males and 35 females with a mean age of 62.9 years ( range: 18-97 years ). Mean follow-up was 41 months ( range: 6-139 months ). Histological diagnosis was conifrmed by 2 pathologist members of national sarcoma histopathology panel ( UK ). Tumour grade was assessed using the Trojani grade system. Trojani grade 1 STS was deifned as low grade; grade 2 and 3 were deifned as high grades. Surgical margins were deifned as positive if tumour cells were found at any surgical resection margins in histological sections.Results In the series of 79 cases, 14 of 21 patients with positive margin recurred, 7 cases without recurrence; 9 of 58 cases with negative margin recurred, 49 cases without recurrence (P<0.0001,OR=10.9 ). Twenty of 53 cases with high-grade recurred, 33 cases without recurrence; 3 of 26 cases with low-grade recurred, 23 cases without recurrence (P=0.016,OR=4.6 ). Nineteen of 43 cases with adjuvant therapy recurred, 24 cases without recurrence; 4 of 36 cases with non-adjuvant therapy recurred, 32 cases without recurrence (P=0.001,OR=6.3 ). Eight of 17 cases with metastasis recurred, 9 cases without recurrence; 15 of 62 cases with non-metastasis recurred, 47 cases without recurrence (P=0.07,OR=2.8 ). Histological grade, positive margin and use of adjuvant therapy were the only factors associated with an increased risk of local recurrence. An association with metastasis at presentation was not statistically signiifcant. High grade tumours gave odds ratio of recurrence of 5.2 and positive margins gave odds ratio of 3.3, both were signiifcant independent risk factors of local recurrence.Conclusions Surgical margin and histological grade are the most important factors leading to local recurrence. High-grade tumors with positive margins generally increase the risk of recurrence.