Epithelioid sarcomas: how important is loco-regional control?

Publication date: Available online 19 July 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): A. Pradhan, R.J. Grimer, A. Abudu, R.M. Tillman, S.R. Carter, L. Jeys, P.C. Ferguson, A.M. Griffin, J.S. Wunder
AimsTo investigate the impact of the method of treatment on the oncological outcomes in patients with epithelioid sarcomas managed at two international specialty sarcoma centres.MethodsThe databases of two centres were used to identify patients treated for epithelioid sarcomas between 1985 to 2012. Patient, tumor, treatment and outcome data was collected.ResultsThere were 36 males and 18 females with a mean age of 38.3 years (range 9 to 79). Of 49 patients who were treated surgically, limb salvage surgery was carried out in 38 patients (78%) and limb amputation in 11 (22%). Of 49 total patients who underwent surgery for ES, 48 (98%) with ES had negative margin resection and 24 (49%) received (neo) adjuvant radiotherapy. Regional lymph node metastases developed in 5 (13%) patients. The five-year risk of local recurrence was 14%. The overall survival rate at five and ten years was 70% and 66% respectively. In multivariate analysis of patients with localized disease and negative margins, survival and risk of metastases was worse in those treated by amputation.ConclusionThis series has shown that although the rate of local recurrence is not influenced by the type of surgery, the risk of metastases is higher following amputation. This finding is likely due to patients with larger, deeper and more locally advanced tumors requiring amputation. However, we could not prove that immediate amputation was likely to affect overall survival.



http://ift.tt/2vmpGMa