Stage Oriented Analysis of Soft Tissue Sarcomas / 대한정형외과학회잡지

ABSTRACT

PURPOSE: Soft tissue sarcomas have a wide variety of manifestation and its course is still unpredictable in many cases. This study altlempts to analyze the meaningful prognostic factors and to find optimal treatment strategies for each clinical stage. MATERIALS AND METHODS: From May 1985 to Mar. 1997, 432 soft tissue sarcomas were enlisted and 319 cases were eligible for this retrospective study. Staging followed AJCC classification and there were 34 stage I, 69 stage II, 151 stage III and 64 cases of stage IV. For stage I and II, operation was a major tool. Radiotherapy and chemotherapy were added for each situation. Intensive chemotherapy and surgery were done for stage III and IV. Metastasectomy was added in feasible cases. RESULTS: Actual survival rate for the 319 cases was 50% at 152 months. Disease free survival for stage I, II, III was 84%, 41%, and 38%, respectively. The stage itself had a statistical significance (P<0.00001). In univariate analysis, surgical margin in stage II and local recurrence in stage III had statistical significance. Multivariate study revealed the local recurrence as the only meaningful factor in stage I, II, III. An aggressive treatment for stage IV and I, II, III with late metastasis group had significant gain on survival. CONCLUSIONS: The stage itself predicts the course of soft tissue sarcomas. Evaluation of sound surgical margin to prevent the local recurrence is necessary.