The Journal of Bone and Joint Surgery, Vol 58, Issue 3 317-327, Copyright © 1976 by Journal of Bone and Joint Surgery, Inc
The management of soft-tissue sarcomas of the extremities
MA Simon and WF Enneking
Of fifty-four patients with a soft-tissue sarcoma of an extremity, having a
projected five-year survival rate of 62 per cent, forty-six treated by an
"adequate" surgical procedure (either radical local resection or ablation
at an appropriate level, depending on defined circumstances) had a local
recurrence rate of 2 per cent. In the other eight patients, whose surgical
procedures were not adequate for one reason or another, the local
recurrence rate was 100 per cent. The combined recurrence rate after both
the adequate and the inadequate procedures was 16.7 per cent. The
recurrences were noted prior to thirty months post-operatively and the
metastases, prior to sixty months. Histogenesis of the sarcoma, one or more
recurrences after previous operations, and treatment by an immediate
definitive procedure at the time of biopsy and diagnosis by frozen section
had no significant relationship to the rates of local recurrence or
metastasis. Adequate radical local resection controlled these sarcomas as
well as ablative surgery in terms of local recurrence and metastasis. The
significant factors affecting local recurrence that were identified in this
study were the location of the sarcoma and the adequacy of the surgical
procedure.
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