The soft tissue sarcomas are rare malignant tumor and ubiquitous neoplasm that arise in the soft or connective tissue of the body. They are characterized by diversity, not only in histologic appearance but in biologic behavior and anatomic
location. The
treatment of extremity soft tissue sarcoma is directed at limb salvage with addition of variant adjuvant therapy to improve survival. To achieve this goal, the knowlege of the prognostic factors for extremity soft tissue sarcomas is essential. In
this
regard. Authors reviewed 40 cases of extremity soft tissue sarcoma which had been diagnosed histologically and treated surgically from Jan. 1980 to Dec. 1991 at Seoul National University Hospital, department of surgery.
@ES The results are followed:
@EN 1) Twelve histologic types were identified; major three histologic types were malignant fibrous histiocytoma(26.8%), liposarcoma(24.4%), synovial sarcoma(17.1%).
2) Mean age was 46.6 years and male to female sex ratio was 2.1 : 1.
3) Lower extremities(68%) were more frequently involved than upper extremites(32%). Major occurrence sites were, thigh and inguinal area, buttock in lower extremity, shoulder and forearm in upper extremity.
4) Radical surgery such as wide excision or radical compartmental exision was performed in 77.5% of cases. Combined adjuvant radiotherapy and chemotherapy was introduced in 57.5% of cases.
5) Local recurrence was occurred in 20% of all cases treated in our hospital and was related to the type of surgery: compartmental and wide excision showed a relatively lower recurrence rate than local excision.
6) The acturial 5-year survival rate was 58% in all cases. Accoding to stage, 100% in stage,Ⅰ57% in stageⅡ, 21% in stage Ⅲand 0% in stage IV.
7) Two statistically significant prognostic factors were identified(P<0.05); histological grade and local recurrence.
In conclusion, the correct histologic grading is essential for treatment and for proguostication of extremity soft tissue sarcoma.
In order to improve survial rate, in low grade sarcoma, radical excision is needed to lessen local recurrence and in high grade sarcoma, multidisciplinary therapy including radical excision is recommended.
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