Local recurrence is correlated with decreased overall survival in patients with intermediate high-grade localized primary soft tissue sarcoma of extremity and abdominothoracic wall

AimThe aim of this study was to determine the effect of local recurrence on overall survival in patients with intermediate high-grade localized primary soft tissue sarcoma (STS) of extremity and abdominothoracic wall. MethodsThis retrospective study identified 133 consecutive patients with intermediate high-grade localized primary STS of extremity and abdominothoracic wall from January 2000 to July 2010. Survival curves were constructed by the Kaplan-Meier method and log-rank test was used to assess statistical significance. Hazard ratios (HRs) were calculated based on multivariable Cox logistic regression method. ResultsThe 5-year cumulative incidence of local recurrence was 26.0% with a median follow-up of 68 months (range, 5-127 months). The univariate analysis showed that local recurrence was associated with decreased overall survival, with 5-year overall survival of 80.5% and 53.6% in the no local recurrence patients and local recurrence patients, respectively (P=0.001). The multivariate analysis demonstrated that local recurrence was a negative prognostic factor for overall survival (HR=2.115, 95% confidence interval [CI] 1.036-4.319, P=0.040). Radiotherapy significantly reduced local recurrence compared with surgery alone (HR=0.387, 95% CI 0.180-0.877, P=0.019), while larger tumor size (HR=3.184, 95% CI 1.351-7.506 P=0.008) was correlated with higher rate of local recurrence. ConclusionLocal recurrence in patients with intermediate high-grade localized primary STS is associated with decreased overall survival.