Radiotherapy and Limb sparing Surgery in the Management of Localized Soft Tissue Sarcomas: Tertiary care center experience from Pakistan

Objective: when combined with radiotherapy, limb salvage surgery is an alternative to amputation. This study is sought to determine the limb sparing treatment outcomes in patients diagnosed with soft tisse extremity sarcomas treated at our institution.

Methods: A retrospective review of the patients diagnosed with extremity soft tissue sarcomas treated between January 2017 till December 2019 at Shaukat Khanam Cancer Hospital. All patients above age 18 years who received radical treatment(Surgery & Radiation) were included in the study. Patient's age, gender, stage and grade of the disease were reviewed. Treatment details were recorded. Primary end point was disease free survival.

Results: A total of 122 patients were included in the study. Mean age was 42 years (Range 19-82) and 64 (52.5%) were males. Majority of the patients were diagnosed with the stage III and grade III. The most common surgical modality was wide local excision that was performed in 106 patients. Adjuvant radiotherapy was given in 111 patients while 11 received it in neoadjuvant setting. Mean dose was 58 Gray (Range 46-66 Gray). Complete, partial, stable and progressive responses were 58.2%, 0.8%, 0.8% and 32.7% respectively. Disease progression was observed in almost 40 patients. Median disease free survival was 8 months.

Conclusion: About two third of the patients were successfully treated with limb salvage strategy, surgery and radiation therapy. However, high rates of relapse warrants further novel strategies.