AIM: It is common to use either pre- or post-operative radiation for high grade @entity242 undergoing limb-conserving surgery. Since 1977, we have adopted a selective policy of post-operative radiation, given only in @entity1 with inadequate surgical margins. METHODS: A retrospective review of 114 @entity1 (1977-1995) with high grade adult soft tissue @entity242 of the extremities was carried out. Amputation was required in 10 (9%). @entity1 with a minimum surgical margin <2 cm (n=33) received adjuvant radiation (29%). RESULTS: No complications occurred in 81/114. Wound complications were @entity281 (14%), @entity2080 (6%), haematoma (4%), dehiscence (4%) and skin edge @entity39 (2%). Remedial operations were required in four (3%). Overall, the local recurrence rate was 23/114. @entity1 with surgery only (n=57) or surgery plus systemic chemotherapy (n=24) manifested local recurrence in 15/81 (19%) and those with surgery plus radiation (n=21) or surgery and radiation and chemotherapy (n=12) suffered local recurrence in 8/33. The local recurrence rate for @entity5 < or =5 cm was 6/32 and for those >5 cm 17/82, @entity6585 . The 5 year survival rate was 60% for @entity5 < or =5 cm (n=32) and 46% for @entity5 > or =5 cm (n=82) (P=0.009). CONCLUSIONS: (1) Limb preservation was feasible in 91% of @entity1 . (2) When the local treatment modality was surgery alone ('wide' margins) the local recurrence rate was 19%, and when it was surgery plus radiation (narrow margins) it was 24%. (3) Selective use of radiation (in @entity1 with narrow margins) and reliance on surgery alone in cases amenable to wide resection may be a legitimate alternative to universal application of radiation with conservative resection.

Radiation therapy for high grade soft tissue XXXX of the extremities treated with limb-preserving surgery.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity6585 :: ('6281', 'Gene') :: ['P=1.0'] @entity242 :: ('MESH:D012509', 'Disease') :: ['sarcomas'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumours'] @entity2080 :: ('MESH:D049291', 'Disease') :: ['seroma'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection']
@entity242 :: (MESH:D012509,Disease) :: ['sarcomas']
