Abstract 1937
Background
Soft tissue sarcoma (STS) has been treated by achieving safe surgical margin rather than by using adjuvant radiotherapy (RT) in our country and 2-cm wide margin can be considered as adequate margin according to Kawaguchi’s criteria. We evaluated local recurrence (LR) and prognosis following resection of high-grade large STS using JOA surgical margin concept.
Methods
Treatment strategy: Surgical resection with at least 2cm-wide margin was attempted whenever possible. Marginal or 1cm-wide margin are acceptable when preserving neurovascular bundles. RT is conducted postoperatively for marginal or R1 margin. Chemotherapy is indicated for patients less than 60 years old with deep seated, high grade and large tumor. PATIENTS: Inclusion criteria are localized STS in the extremities or trunk, larger than 5cm, FNCLCC grade 2 or 3, limb sparing surgery, primary complete resection at our institution, and minimum 3 years of follow-up. We retrospectively analyzed 69 patients treated between 2007 and 2014.
Results
Median follow-up was 64 months. Median tumor size was 8.7cm. 6 patients underwent postoperative RT due to inadequate surgical margin. 21 (30%) patients received chemotherapy. There were 7 (10%) LR with average 14.5 months after surgery. Average size of tumor developing LR (14.8cm) was statistically larger than that without LR (9.8cm, p < 0.05). Only 1 of 9 patients developed LR after postoperative RT for inadequate resection. Distant metastasis was shown in 14 patients with average 20 months after surgery. There was no statistical difference of LR-free and overall survival between wide resection alone and inadequate resection with postoperative RT. Chemotherapy did not significantly affect overall survival.
Conclusions
In this series of high-grade large STS, resection alone with 2cm-wide margin led to good local control, which is identical to previous reports with surgery plus RT. Adjuvant RT should be given for resection with marginal margin or R1 margin of the resected specimen.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4210 - Efficacy and safety of apatinib for advanced gastrointestinal stromal tumors after failure of imatinib and sunitinib: An open-label, multicenter, single-arm, phase II trial
Presenter: Zhaolun Cai
Session: Poster Display session 1
Resources:
Abstract
4526 - Long-term outcome of neoadjuvant tyrosine kinase inhibitors (TKI) in locally advanced dermatofibrosarcoma protuberans (DFSP)
Presenter: Jessica Beaziz
Session: Poster Display session 1
Resources:
Abstract
1214 - Neo-adjuvant (NA) Imatinib for gastrointestinal stromal tumours (GISTs): What is the optimal length of treatment?
Presenter: Tom Wilson
Session: Poster Display session 1
Resources:
Abstract
2690 - Gastrointestinal Stromal Tumours (GIST) in adolescents and young adults (AYA)
Presenter: Nikki Ijzerman
Session: Poster Display session 1
Resources:
Abstract
4558 - Radiomics improves response evaluation for desmoid tumors treated with chemotherapy
Presenter: Amandine Crombe
Session: Poster Display session 1
Resources:
Abstract
2751 - Radiomics of gastrointestinal stromal tumors; risk classification based on computed tomography images – a pilot study
Presenter: Milea Timbergen
Session: Poster Display session 1
Resources:
Abstract
2737 - Differentiating well-differentiated liposarcomas from lipomas using a radiomics approach
Presenter: Melissa Vos
Session: Poster Display session 1
Resources:
Abstract
1282 - The immune landscape of chondrosarcoma reveals an anti inflammatory environment
Presenter: Iseulys Richert
Session: Poster Display session 1
Resources:
Abstract
1572 - Impact of Immunotherapy and Targeted Therapy on Tumor Growth Rate in Sarcoma
Presenter: Esmail Al-ezzi
Session: Poster Display session 1
Resources:
Abstract
3414 - DNA methylation profiles of angiosarcoma subtypes.
Presenter: Marije Weidema
Session: Poster Display session 1
Resources:
Abstract