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INFLUENCE OF LOCAL RECURRENCE ON THE PROGNOSIS OF SOFT-TISSUE SARCOMAS

T. Ueda, MD, Musculoskeletal Tumour Surgeon; H. Yoshikawa, MD, Chief of Musculoskeletal Tumour Surgery; and S. Mori, MD, Musculoskeletal Tumour Surgeon

Department of Orthopaedic Surgery, Osaka Medical Centre for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537, Japan.

N. Araki, MD, Musculoskeletal Tumour Surgeon; A. Myoui, MD, Musculoskeletal Tumour Surgeon; S. Kuratsu, MD, Musculoskeletal Tumour Surgeon; and A. Uchida, MD, Musculoskeletal Tumour Surgeon

Department of Orthopaedic Surgery, Osaka University Medical School, 2-2 Yamadaoka, Suita 565, Japan.

Correspondence should be sent to Dr T. Ueda.

We have investigated the significance of local recurrence on survival in 173 patients with localised soft-tissue sarcomas of the limbs and of the trunk.

The overall survival rates at five and ten years were 75.2% and 68.0%, respectively. After definitive surgery at our hospitals, there was local recurrence in 25 patients (14.5%). After inadequate operations elsewhere, there was a higher incidence of late local recurrence (28.3%), in comparison with those with primary tumours treated by us (9.0%), or patients referred to us immediately after inadequate surgery elsewhere (10.2%). Because of small numbers these differences in the survival rates were not statistically significantly different.

Univariate survival analysis showed that local recurrence after definitive surgery (p = 0.006) together with the histological grade (p = 0.0002), the size of the tumour (p = 0.002), its depth in relation to deep fascia (p = 0.003), and the surgical margin (p = 0.0001) were the significant prognostic factors. Local recurrence at the initial presentation did not affect survival. Multivariate analysis showed that local recurrence after definitive surgery also lost its apparent prognostic significance.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General