Savaş Yıldırım1, Mert Çiftdemir2, Fethi Emre Ustabaşıoğlu3, Funda Üstün4, Ufuk Usta5

1Department of Orthopedics and Traumatology, Lüleburgaz State Hospital, Kırklareli, Türkiye
2Department of Orthopedics and Traumatology, Trakya University Faculty of Medicine, Edirne, Türkiye
3Department of Radiology, Trakya University Faculty of Medicine, Edirne, Türkiye
4Department of Nuclear Medicine, Trakya University Faculty of Medicine, Edirne, Türkiye
5Department of Pathology, Trakya University Faculty of Medicine, Edirne, Türkiye

Keywords: Local recurrence, soft tissue sarcoma, survival, thigh.

Abstract

Objectives: The aim of this study was to evaluate the factors affecting local recurrence and survival in patients with soft-tissue sarcomas located in the thigh.

Patients and methods: This retrospective cross-sectional study evaluated 41 soft tissue sarcoma patients (21 males, 20 females; mean age: 57.9±13.7 years; range, 18 to 90 years) with thigh involvement between January 2010 and December 2020. All surgical intervention was performed by one surgeon with an experience of 15 years in orthopedic oncologic surgery. Epidemiological, radiological, histopathological, and metabolic features, as well as surgical and oncological treatments and prognoses, were assessed. The data was statistically analyzed to determine factors affecting local recurrence and survival in these cases, staged using Enneking and the American Joint Committee on Cancer classifications.

Results: Liposarcomas were the most common type of tumor (39%), followed by undifferentiated pleomorphic sarcomas (32%). Tumors >10 cm were associated with decreased survival rates. High-grade tumors, tumor necrosis, Ki-67 index >20%, and positive surgical margins were also associated with lower survival rates. Metastatic patients had significantly lower survival rates. Local recurrence was significantly more frequent in patients with positive surgical margins. Survival rates were significantly lower in metastatic patients.

Conclusion: There are many factors that affect local recurrence and survival of soft tissue sarcomas. The size of the mass, the presence of necrosis, a high Ki-67 index, positive surgical margins, and the presence of metastasis are the main factors that should be taken into consideration.

Citation: Yıldırım S, Çiftdemir M, Ustabaşıoğlu FE, Üstün F, Usta U. Evaluation of the factors affecting survival and local recurrence in thigh soft tissue sarcomas. Jt Dis Relat Surg 2024;35(1):130-137. doi: 10.52312/jdrs.2023.1289.

Ethics Committee Approval

The study protocol was approved by the Trakya University Faculty of Medicine Dean's Office Scientific Research Ethics Committee (date: 09.11.2011, no: 18-02). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Concepted, designed and wrote the manuscript: M.Ç.; Made literature review, data collection, critical radiological analysis and revised the manuscript: F.E.U.; Performed the data collection, processing and statistical analysis: S.Y.; Performed data collection, analysis and interpretation of data: F.Ü.; Made literature review, supervision critical revision and interpretation of data: U.U.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.