The Impact of Surgical Margins and Adjuvant Radiotherapy in Patients with Undifferentiated Pleomorphic Sarcomas of the Extremities: A Single-Institutional Analysis of 192 Patients

Ole Goertz, Andreas Pieper, Leon von der Lohe, Ingo Stricker, Mehran Dadras, Björn Behr, Marcus Lehnhardt, Kamran Harati, Ole Goertz, Andreas Pieper, Leon von der Lohe, Ingo Stricker, Mehran Dadras, Björn Behr, Marcus Lehnhardt, Kamran Harati

Abstract

Background: Undifferentiated pleomorphic sarcomas are a frequent subtype within the heterogeneous group of soft tissue sarcomas. As the attainment of negative margins can be complicated at the extremities, we determined the prognostic significance of surgical margins in our patient population. Methods: We retrospectively determined the relationship between local recurrence-free survival (LRFS), overall survival (OS), and potential prognostic factors in 192 patients with UPS of the extremities who were suitable for surgical treatment in curative intent. The median follow-up time was 5.1 years. Results: The rates of LRFS and OS after 2 years were 75.7% and 87.2% in patients with R0-resected primary tumors and 49.1% and 81.8% in patients with R1/R2-status (LRFS: p = 0.013; OS: p = 0.001). Adjuvant radiotherapy significantly improved LRFS (5-year: 67.6% vs. 48.4%; p < 0.001) and OS (5-year: 82.8 vs. 61.8; p = 0.016). Both, negative margins and adjuvant radiotherapy were found to be independent prognostic factors in multivariate analysis. Conclusions: The data from this study could underscore the beneficial prognostic impact of negative margins on LRFS and OS. However, the width of negative margins seemed to be not relevant. Notably, adjuvant radiotherapy was not only able to decrease the risk of local failure but also improved OS in a significant manner.

Keywords: extremity; margins; pleomorphic sarcoma; surgery; survival.

Conflict of interest statement

The authors declare that they have no potential conflicts of interest.

Figures

Figure 1
Figure 1
Estimated local recurrence-free survival (LRFS) curves after primary diagnosis according to margin status.
Figure 2
Figure 2
Estimated overall survival (OS) curves after primary diagnosis according to margin status.

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Source: PubMed

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