Post-radiation sarcomas. Clinical outcome of 52 Patients

Background Previous studies reported on post-radiation sarcomas. However, the incidence, latency from radiation therapy, treatment, and survival has been difficult to evaluate. We performed a retrospective, single-institutional study to determine these factors for post-radiation sarcomas. Materials and Methods: We retrospectively studied 52 patients with post-radiation sarcomas diagnosed and treated from 1985 to 2011. The mean age was 49 years; 45 patients had bone and 7 soft tissue sarcoma. The mean follow-up was 45 months. Survival was analyzed with respect to age at diagnosis, type ( bone vs. soft tissue), histology, location ( trunk vs. extremities), size, and surgical treatment ( resection vs. amputation). Results: The risk of post-radiation sarcoma was 0.06% at a mean latency of 15 years ( 3-50 years) after radiation therapy. The most common histology was osteosarcoma followed by malignant fibrous histiocytoma and fibrosarcoma; all sarcomas were high grade. Survival of the patients with post-radiation sarcomas was 85% at 1 year, 51% at 2 years, 48% at 3 years, and 45% at 5 years. Univariate predictor of survival was only the type of the sarcoma. No variable was significant in multivariate analysis. Conclusions: Prognosis of post-radiation sarcomas is poor; the type of the sarcomas is the only significant variable for survival. J. Surg. Oncol. 2012; 105: 570-576. (C) 2011 Wiley Periodicals, Inc.