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.