Intra-muscular location in soft tissue sarcomas: impact on oncologic outcome

Eur J Surg Oncol. 2014 Sep;40(9):1131-5. doi: 10.1016/j.ejso.2014.01.015. Epub 2014 Feb 10.

Abstract

Background: Soft tissue sarcoma (STS) of intra-muscular location is confined within well-defined barrier, amenable to easier surgical resection. It is generally assumed that STS of intra-muscular location would have favorable outcomes compared to those of inter-muscular location. However, no clear evidence on this assumption can be found. This study examined if intra-muscular location of STS would have favorable effect on oncologic outcomes.

Methods: Among the 161 patients treated for previously untreated, non-metastatic and deep-seated STS, extra-compartmental tumors (65) or tumors that spread beyond the muscle of origin (23) were excluded. Remaining 73 patients were classified into two groups according to tumor location; intra-muscular group (confined within muscle of origin, n = 32) and inter-muscular group (located between muscles, n = 41).

Results: Two patients (6.3%) in intra-muscular group developed local recurrence whereas 10 patients (24.3%) developed local recurrence in inter-muscular group (p = 0.056). Patients in intra-muscular group showed significantly better local recurrence-free survival than those in inter-muscular group (p = 0.029). However, there was no significant difference in development of metastasis (p = 0.143) nor disease-specific survival (p = 0.106).

Conclusions: Our study indicates that STS of intra-muscular location is associated with better local control. Whether this advantage is due to its biological property or surgical resectability remains to be elucidated.

Keywords: Barrier; Compartment; Intra-muscular; Outcome; Soft tissue sarcoma.

MeSH terms

  • Adult
  • Arm / surgery*
  • Chemoradiotherapy, Adjuvant
  • Disease-Free Survival
  • Female
  • Humans
  • Leg / surgery*
  • Leiomyosarcoma / pathology
  • Leiomyosarcoma / surgery
  • Leiomyosarcoma / therapy
  • Liposarcoma / pathology
  • Liposarcoma / surgery
  • Liposarcoma / therapy
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Muscle Neoplasms / pathology
  • Muscle Neoplasms / surgery*
  • Muscle Neoplasms / therapy
  • Neoplasm Recurrence, Local*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Sarcoma / pathology
  • Sarcoma / surgery*
  • Sarcoma / therapy
  • Sarcoma, Synovial / pathology
  • Sarcoma, Synovial / surgery
  • Sarcoma, Synovial / therapy
  • Treatment Outcome