Smith, H. G., Memos, N., Thomas, J. M., Smith, M. J. F., Strauss, D. C., Hayes, A. J. (2016) Patterns of disease relapse in primary extremity soft-tissue sarcoma. BRITISH JOURNAL OF SURGERY, 103 (11). pp. 1487-1496. ISSN 0007-1323

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Abstract

BackgroundExtremity soft-tissue sarcomas comprise a range of distinct histological subtypes. This study aimed to characterize the patterns of disease relapse in patients undergoing resection of primary extremity soft-tissue sarcoma. MethodsAll patients who had resection of primary extremity soft-tissue sarcoma at the Royal Marsden Hospital between January 2004 and January 2014 were identified from an institutional database. ResultsIn the period examined, 556 patients underwent resection. The most common histological subtypes were undifferentiated pleomorphic sarcoma (169 patients, 304 per cent), well differentiated liposarcoma (63, 113 per cent), myxoid liposarcoma (62, 112 per cent), myxofibrosarcoma (54, 97percent) and leiomyosarcoma (39, 70 per cent). Local recurrence-free survival (LRFS) did not differ significantly between histological subtypes (P=0222). Distant metastasis-free survival (DMFS) and disease-specific survival (DSS) were found to differ significantly between subtypes (P<0001 for both DMFS and DSS), with the worst outcomes in patients with undifferentiated pleomorphic sarcoma (5-year survival rate: 568 (95 per cent c.i. 525 to 611) per cent for DMFS; 601 (556 to 646) per cent for DSS). However, on multivariable analysis, histological subtype was not found to be independently prognostic for LRFS, DMFS or DSS. Metastatic disease developed in 149 patients, with the lungs being the most common site of first metastasis (120 patients, 805 per cent). The site of first metastasis differed between subtypes, with extrapulmonary metastases predominant in myxoid liposarcoma (11 of 13 patients; P<0001). ConclusionAlthough histological subtype was not found to be an independent prognostic factor for oncological outcomes, the site of first metastasis differed significantly between subtypes. Subtype matters for follow-up

Item Type:	Article
Authors (ICR Faculty only):	Hayes, Andrew
All Authors:	Smith, H. G., Memos, N., Thomas, J. M., Smith, M. J. F., Strauss, D. C., Hayes, A. J.
Additional Information:	ISI Document Delivery No.: DX8WL Times Cited: 0 Cited Reference Count: 23 Smith, H. G. Memos, N. Thomas, J. M. Smith, M. J. F. Strauss, D. C. Hayes, A. J. 0 WILEY-BLACKWELL HOBOKEN BRIT J SURG
Uncontrolled Keywords:	PROGNOSTIC-FACTORS LOCAL RECURRENCE SURGICAL MARGIN SURVIVAL TRIAL
Research teams:	Clinical Units > Sarcoma Unit ICR divisions > Radiotherapy and Imaging > Sarcoma and Melanoma Surgery
Depositing User:	Barry Jenkins
Date Deposited:	07 Nov 2016 14:16
Last Modified:	07 Nov 2016 14:16
URI:	http://publications.icr.ac.uk/id/eprint/15417

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