RESULTS OF SURGICAL AND COMPLEX TREATMENT OF PRIMARY AND RECURRENT SOFT TISSUE SARCOMAS: A SINGLE-CENTER RETROSPECTIVE COHORT STUDY

Abstract

Relevance: Soft tissue sarcomas are rare and heterogeneous malignant tumors in which local control depends on the radicality of the primary intervention, the size and biological aggressiveness of the tumor, and the appropriate use of radiation therapy. This study aimed to evaluate the frequency of local and recurrent local relapses after surgical and comprehensive treatment of primary and recurrent soft tissue sarcomas, as well as the proportion of patients alive after five years among those with completed fiveyear follow-up. Materials and methods: A single-center retrospective cohort study included 204 unique patients treated in 2000-2023. Primary soft tissue sarcoma (SMT) analysis covered 198 patients; local control data were available in 183/198 (92.4%). The relapse analysis included 75 patients, with size-stratified data available in 73/75 (97.3%). 139/204 (68.1%) had a full five-year follow-up. Results: After isolated surgery, local recurrence occurred in 43/59 patients with primary tumors <5 cm (72.9%) and in 36/60 patients with tumors >5 cm (60.0%); after surgery with postoperative radiation therapy, in 5/19 (26.3%) and 5/29 (17.2%), respectively. The unadjusted risk ratio (RR) was 0.36 (95% CI 0.17-0.78; p=0.001) and 0.29 (95% CI 0.13-0.66; p<0.001). In the historical group of preoperative LT and HCT followed by surgery for tumors >5 cm, recurrence was recorded in 6/15 patients (40.0%); the group was analyzed descriptively. In cases of recurrent CMT, there were no statistically convincing differences between repeat surgery and complex treatment. Among 139 patients with completed five-year follow-up, 82 (58.9%; 95% CI 50.3-67.3%) were alive after five years. In the dimensional subanalysis of primary tumors, the index was 20/24 (83.3%; 95% CI 62.6-95.3%) with a size of <5 cm and 15/30 (50%; 95% CI 31.3-68.7%) with a size of >5 cm (p=0.011). Conclusion: In this historical cohort, surgery with postoperative radiation therapy was associated with a lower uncorrected rate of local recurrence of primary CMT than isolated surgical treatment.