Bone invasion in extremity soft‐tissue sarcoma

BACKGROUND The purpose of the current study was to evaluate histologic bone invasion as a predictor of oncologic outcome in extremity soft‐tissue sarcoma (STS) patients presenting to a specialty sarcoma center between 1986 and 2001. METHODS All patients who underwent surgery for extremity STS were identified from the prospective database at the study institution. Patient demographic features were compared using chi‐square analyses or independent‐sample Student t ‐tests. The disease outcomes were compared for those with and without bone invasion using Kaplan–Meier survival analysis and Cox modeling. RESULTS In a review of 874 patients with STS of the extremity, 48 patients (5.5%) had evidence of bone invasion. Patients with bone invasion presented with larger tumors that were more frequently deep in the extremity and more often had metastases at presentation. Patients with bone invasion had lower metastasis‐free survival but bone invasion was not found to be an independent prognostic factor ( P = .274) on Cox modeling. Bone invasion was found to be prognostic of overall survival on multivariate analysis ( P <.0001). CONCLUSIONS In a small percentage of patients with STS, bone resection may be required to obtain an adequate surgical margin, thereby limiting the risk of local tumor recurrence. Histologic bone invasion portends a poorer prognosis in terms of overall survival. Cancer 2006.