The Result of Surgical Tratment of Soft - tissue Sarcoma

Lee, Han Koo; Lee, Sang Hoon; Lee, Ji Ho; Yoon, Byung Hwa

Abstract

Soft-tissue sarcomas are derived from mesodermal tissues and with few exceptions are located in deeper planes of the musculoaponeurotic structures. Despite differences in histogenesis, the rate of locsl recurrence snd distant metastasis of these sarcomas reveals that their rstes are almost the same. These soft-fissue sarcomas do not respond well to chemotherpy or radiotheraphy. And soft-tissue sarcomas located on different anatomical sites, so the surgical approach to them located centrally is difficult than the approach to them located peripherally. The authors reviewed 75 cases of soft-tissue sarcoma, which were confirmed by pathological reports, and also analysed the results of some kinds of surgery on 60 cases of that tumor at the Department of Orthopedidic Surgery, Seoul National University Hospital during the period from January 1976 to Decomber 1985, and following results were obtained. 1. There were 54 males and 21 females, and the age incidence wss highest in 5th decade. There was no special age-peak. 2. Malignant fibrous histiocytomas accounted for 26.7% of the tumors in this study. Liposarcoma, rhabdomyosarcoma, and synovial sarcoma were the next common tumors. 3. The lower extremity was the most common anatomicsl site of malignant soft-tissue sarcomas, which acconted for 46.7% in this study. There showed low incidence below the wrist and ankle joints. 4. Enneking's stage II B was the most common tumor, which accounted for 41.7%. 5. When we decided the prognosis at 2 years postoperatively, in the inadequately treated group the local recurrence rate was 97.1%, distant metastasis rate was 80.0%, and 2 YSR was 28.6%. In the adequately treated group the local recurrence rate was 20.0%, distant metastasis rate was 24.0%, and 2 YSR was 84.0%. 6. The most common site of distant metastasis was the lungs, which accounted for 82.4%. So the significant factors affecting the prognosis of soft-tissued sarcomas were the location of sarcomas and the adequacy of sugical procedure.