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· DOS Abstracts
Soft-tissue sarcomas of the thoracic wall; surgical
margin and malignancy grade’s impact on survival
and local recurrence.
Tine Rytter Sørensen, Mathias Rædkjær, Peter Holmberg Jørgensen, Thomas
Baad-Hansen
Department of Orthopaedic Surgery, Aarhus University Hospital
Background:
Soft tissue sarcomas (STS) of the thoracic wall are often studied
in combination with either sarcomas of the extremities, or with bone tumors of
the thoracic wall.
Purpose / Aim of Study:
The aim was to assess the impact of surgical margin
and malignancy grade on survival and local recurrence for STS of the thoracic
wall and compare results with studies of STS in extremities.
Materials and Methods:
86 patients were diagnosed with a non- metastatic
STS located in the thoracic wall and treated surgically at the Aarhus Sarcoma
Centre between 1995-2013. Overall survival (OS) and local recurrence free
rate (LRFR) were estimated using the Kaplan-Meier method. Cox proportional
hazards model was used to determine prognostic factors for survival and local
recurrence.
Findings / Results:
5-year OS was 56%. Intralesional/marginal resection re-
sultet in an increased mortality (multivariate cox: HR 3,09, CI 95%: 1,25- 7,63)
compared to wide resection. Patients with intermediate/high grade tumors had
a higher risk of dying (multivariate cox: HR=8,24, CI 95%: 1,02-66,87) com-
pared to patients with low grade tumors. 5-year LRFR for intermediate/high
grade tumors was 80%. None of the patients with low grade tumor had local
recurrence. Intralesional/marginal resection had no significant impact on local
recurrence (HR = 1,00 CI 95%: 0,24- 4,16). Studies including STS of extremi-
ties have shown higher 5- year OS rates and 5-year LRFR.
Conclusions:
Intermediate/high malignancy grade was an unfavourable prog-
nostic factor for survival and local recurrence. Wide margin increased survival,
but did not affect local recurrence. STS of the thoracic wall showed lower mor-
tality and higher local recurrence rate compared to STS of the extremities, sug-
gesting that the removal of STS of the thoracic wall should be more aggressively
to increase mortality and reduce local recurrence.
No conflicts of interest reported
146.