The surgical treatment and outcome of soft-tissue sarcoma.

Cases of 251 patients with soft-tissue sarcoma of the extremities, trunk, head and neck, and retroperitoneum were reviewed. The overall five-, ten-, and 15-year survival rates were 45%, 30%, and 24%, respectively. The five-year survival rates after wide soft-tissue resections, local excision, and amputation were 59%, 42%, and 39%, respectively. Factors that significantly affected prognosis were tumor size, histologic type, local extent of the tumor, and the adequacy of the surgical procedure. The local recurrence rate was 36% after wide resection, 8% after amputation, and 65% after local excision. Local recurrence alone was treatable and evidenced overall five- and ten-year survival rates of 43% and 33%, respectively. Amputation was the most effective method to treat local recurrences in the extremities. Some guidelines are suggested to select high-risk patients for adjuvant treatment.