International Journal of Hematology and Oncology 2019, Vol 29, Num 3 Page(s): 001-008
Long-Term Outcome of Soft Tissue Sarcomas of the Foot Treated with Limb Salvage Surgery and Radiotherapy

Didem C. OKSUZ1, Sefika A. ERGEN1, Sevim OZDEMIR1, Nuri KAYDIHAN1, Murat HIZ2, Sedat KOCA2, Fazilet O. DINCBAS1

1Istanbul University, Cerrahpasa Faculty of Medicine, Department of Radiation Oncology, Istanbul, TURKEY
2Istanbul University, Cerrahpasa Faculty of Medicine, Department of Orthopedic Surgery, Istanbul, TURKEY

Keywords: Soft tissue sarcoma, Foot, Radiotherapy
The objective of the present study was to review the long term follow up results of patients with primary soft tissue sarcomas (STS) of the foot who underwent limb sparing surgery with pre-or postoperative radiotherapy. Eleven patients with primary STS of the foot treated with limb sparing surgery and radiotherapy between 1980 and 2008 were retrospectively analyzed. The median tumor size was 5.5 cm (2-8 cm). All patients were treated with limb sparing surgery. Surgical margin was positive in 5 patients. The most frequent histopathological diagnosis was synovial sarcoma (73%). Radiotherapy was performed postoperatively to 8 patients and preoperatively to 3 patients. Six cases with high grade and large tumor received chemotherapy. The median follow-up period was 73 months (11 to 224 months). The 5-year overall survival was 78.8%. Three patients developed local recurrence at median of 12 months (6-13 months). The histopathology of these patients was synovial sarcoma. The surgical margins were positive in one of them. One of the recurrent patients was salvaged by further limb sparing surgery and 2 patients required amputation. These 3 cases developed lung metastasis and 2 of them died due to metastatic disease. Eight patients without local recurrence remained disease-free at a median follow up of 73 months. Multidisciplinary approach is essential as in the other localizations, to get good oncologic and functional treatment outcomes in primary soft tissue sarcomas of the foot. Radiotherapy enables the limb preservation with good local control rate.