Predictors and clinical significance of local recurrence in extremity soft tissue sarcoma

Figures & data

Figure 1. Positive margins are the strongest positive predictor of local recurrence.

Figure 2. Local recurrence free survival for patients with positive margins versus those without.

Table I. Comparative demographics and tumor characteristics between residual and no residual group.

Variable	No residual (N = 77)	Residual (N = 29)	p-Value	Total (N = 106)
Age, yrs, median (IQ range)	53 (38, 68)	59 (39, 67)	0.77	55.5 (38, 67)
Sex			0.77
Female	40 (52.0%)	16 (55.2%)		56 (52.8%)
Male	37 (48.0%)	13 (44.8%)		50 (47.2%)
Race			0.35
White	71 (92.2%)	25 (86.2%)		96 (90.6%)
Non-white	6 (7.8%)	4 (13.8%)		10 (9.4%)
Site			0.12
Upper extremity	27 (35.1%)	15 (51.7%)		42 (39.6%)
Lower extremity	50 (64.9%)	14 (48.2%)		64 (60.4%)
Size, cm, median (IQ range)	5 (3, 8)	4 (3, 7)	0.46	5 (3, 8)
Depth			0.82
Superficial	17 (22.1%)	7 (24.1%)		24 (22.6%)
Deep	60 (77.9%)	22 (75.9%)		82 (77.4%)
Grade			0.81
I	21 (27.3%)	6 (21.7%)		27 (25.5%)
II	11 (14.3%)	6 (21.7%)		17 (16.0%)
III	45 (58.4%)	17 (22.1%)		62 (58.5%)
AJCC stage			0.39
Stage I	26 (34.2%)	9 (31.0%)		35 (33%)
Stage II	21 (27.6%)	11 (34.5%)		32 (30.2%)
Stage III	7 (9.2%)	5 (17.2%)		12 (11.3%)
Stage IV	22 (29.0%)	5 (17.2%)		27 (25.5%)
Microscopic margins			0.74
Negative	73 (94.8%)	27 (93.1%)		100 (95.3%)
Positive	4 (5.2%)	2 (6.9%)		6 (4.7%)
Histology type			0.31
Fibrosarcoma	10 (13.0%)	2 (6.9%)		12 (11.3%)
Leiomyosarcoma	5 (6.5%)	6 (20.7%)		11 (10.4%)
Liposarcoma	2 (2.6%)	1 (3.5%)		3 (2.8%)
Malignant peripheral Nerve Sheath Tumor(MPNST)	3 (3.9%)	2 (6.9%)		5 (4.7%)
Malignant Fibrous Histiocytoma (MFH)	29 (37.7%)	9 (31.0%)		38 (35.9%)
Synovial sarcoma	11 (14.3%)	4 (13.8%)		15 (14.2%)
Vascular sarcoma	7 (9.1%)	0 (0%)		7 (6.6%)
Rhabdomyosarcoma	1 (1.3%)	0 (0%)		1 (0.9%)
Others	9 (11.7%)	5 (17.2%)		14 (13.2%)
Radiation therapy			0.76	38 (35.9%)
No	25 (32.5%)	13 (44.8%)		9 (8.5%)
Preop radiation	7 (9.1%)	2 (6.9%)		53 (50.0%)
Postoperative radiation	40 (52.0%)	13 (44.8%)		6 (5.7%)
Both: pre and post	5 (6.5%)	1 (3.5%)		38 (35.85%)
Chemotherapy			0.58
Yes	15 (19.5%)	4 (13.8%)		19 (17.9%)
No	62 (80.5%)	25 (86.2%)		87 (82.1%)
Survival status			0.38
Alive	51 (66.2%)	23 (79.3%)		74 (69.8%)
Died of disease	16 (20.8%)	3 (10.3%)		19 (17.9%)
Died of other causes	10 (13.0%)	3 (10.3%)		13 (12.2%)
Local recurrence			0.27
Yes	17 (22.1%)	3 (10.3%)		20 (18.9%)
No	60 (77.9%)	26 (89.7%)		86 (81.1%)
Distant metastasis			0.41
Yes	22 (28.6%)	6 (20.7%)		28 (26.4%)
No	55 (71.4%)	23 (79.3%)		78 (73.6%)

Table II. Comparative demographics and tumor characteristics between recurrence and no recurrence group.

Variable	Recurrence (N = 41)	No recurrence (N = 237)	p-Value	Total (N = 278)
Age, yrs, median (IQ range)	62 (51, 71)	56 (42, 69)	0.08	58 (43, 69)
Sex			0.88
Female	23 (56.1%)	130 (54.9%)		153 (55.0%)
Male	18 (43.9%)	107 (45.1%)		125 (45.0%)
Race			0.88
White	36 (87.8%)	206 (86.9%)		242 (87.1%)
Non-white	5 (12.2%)	31 (13.1%)		36 (12.9%)
Site			0.005
Upper extremity	19 (46.3%)	59 (24.9%)		78 (28.1%)
Lower extremity	22 (53.7%)	178 (75.1%)		200 (71.9%)
Size, cm, median (IQ range)	8 (6, 12)	10 (5, 16)	0.54	9 (5–16)
Depth			0.85
Superficial	6 (14.6%)	32 (13.5%)		38 (13.6%)
Deep	35 (85.3%)	205 (86.5%)		240 (86.3%)
Grade			0.27
I	8 (19.5%)	61 (25.7%)		69 (24.8%)
II	3 (7.3%)	33 (13.9%)		36 (12.9%)
III	30 (73.2%)	143 (60.3%)		173 (62.2%)
AJCC stage			0.66
Stage I	9 (22.0%)	70 (29.5%)		79 (28.4%)
Stage II	9 (22.0%)	43 (18.1%)		52 (18.6%)
Stage III	7 (17.1%)	48 (20.3%)		55 (19.6%)
Stage IV	16 (39.0%)	76 (32.1%)		92 (33.5%)
Microscopic margins			0.001
Negative	30 (73.2%)	226 (95.3%)		256 (92.1%)
Positive	11 (26.8%)	11 (4.6%)		22 (7.9%)
Histology type			0.12
Fibrosarcoma	3 (7.3%)	17 (7.2%)		20 (7.2%)
Leiomyosarcoma	0 (0%)	25 (10.6%)		25 (9.0%)
Liposarcoma	5 (12.2%)	54 (22.8%)		59 (21.2%)
Malignant peripheral nerve sheath tumor (MPNST)	2 (4.9%)	5 (2.1%)		7 (2.3%)
Malignant fibrous histiocytoma (MFH)	21 (51.2%)	80 (33.8%)		101 (36.3%)
Synovial sarcoma	5 (12.2%)	21 (8.9%)		26 (9.4%)
Vascular sarcoma	3 (7.3%)	10 (4.2%)		13 (4.7%)
Rhabdomyosarcoma	0 (0%)	4 (1.7%)		4 (1.4%)
Others	2 (4.9%)	21 (8.9%)		23 (8.3%)
Radiation therapy			0.75
No	72 (29.6%)	8 (22.9%)		80 (28.8%)
Preop radiation	30 (12.4%)	4 (11.4%)		34 (12.2%)
Postoperative radiation	112 (46.1%)	17 (48.6%)		129 (46.4%)
Both: pre and post	29 (11.9%)	6 (17.1%)		35 (12.6%)
Chemotherapy			0.89
Yes	8 (19.5%)	44 (18.6%)		52 (18.7%)
No	33 (80.5%)	193 (81.4%)		226 (81.3%)
Survival status			0.09
Alive	20 (48.8%)	154 (65.0%)		174 (62.6%)
Died of disease	13 (31.7%)	59 (24.9%)		72 (25.9%)
Died of other causes	8 (19.5%)	24 (10.1%)		32 (10.8%)
Distant metastasis			0.44
Yes	16 (39.0%)	78 (32.9%)		94 (33.8%)
No	25 (61.0%)	159 (67.1%)		184 (76.2%)

Figure 3. Survival curves for patients with and without local recurrence.

Figure 4. Metastasis curves for patients with and without local recurrence.