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Resection status associated with improved locoregional recurrence rate in high-grade sarcoma

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In patients with high-grade extremity sarcomas, R0 resection status was associated with improved locoregional recurrence rate but did not significantly impact distant recurrence-free survival (RFS) and overall survival (OS), according to a study. Tumor size and gender were also predictive of OS in this patient population.

A cohort of 959 patients with primary, nonmetastatic, high-grade extremity sarcomas that underwent surgical resection were retrospectively reviewed. Median follow-up was 34.7 months from diagnosis.

R0 resection and R1 was achieved in 831 (86.7%) and 128 (13.3%) patients. For patients with R0 and R1 resection, locoregional recurrence occurred in 76 (9.1%) and 19 (14.8%) patients, respectively. Distant recurrence occurred in 205 (24.7%) and 34 (26.6%), respectively.

For patients with R0 resection, median RFS, and median OS was 171.2 and 149.8 months, respectively, compared to 48.5 and 71.5 months for patients with R1 resection.

Multivariate analyses found that female gender and adjuvant radiotherapy were associated with improved OS. Worse OS was associated with older age and tumor size. R0 resection status was associated with improved locoregional RFS but not with distant RFS.

Chouliaras K, Patel N, Senehi R, et al. Impact of resection margin on outcomes in high-grade soft tissue sarcomas of the extremity-A USSC analysis. J Surg Oncol. 2020; DOI: 10.1002/jso.26275. Epub ahead of print. PMID: 33150594.