BACKGROUND: We explored the prognostic meaning of local relapse and surgical margins in adult soft tissue sarcoma of the extremities. METHODS: Out of a series of 1017 @entity1 with @entity242 treated over 20 years, we picked a group of 238 @entity1 operated on at our institution for their first local relapse: 88 after their primary operation performed at the same center and 150 elsewhere. At operation for relapse, margins were microscopically negative in 77% and 75% of @entity1 , respectively. Median follow-up was 107 months. RESULTS: The 10-year mortality rate was 22% in the absence of local relapse, whereas in locally relapsing @entity1 it was 54% and 43%, respectively, for @entity1 first operated on at our institute and for those who were not. The hazard ratio of positive versus negative surgical margins was 1.7 for cause-specific death and 2.1 for distant @entity3 in @entity1 first operated on at our institute, as opposed to 1.2 and 1.3 for the others. CONCLUSIONS: Local relapse was an unfavorable prognostic factor. In the face of a consistent surgical policy for local relapse in a single-institution setting, @entity1 relapsing after the first operation performed at our institution received rescue treatment less frequently than those previously operated on outside a referral center. This is likely due to an inherently higher tumor @entity146 . In the presence of such a higher @entity146 , the adequacy of surgical margins at operation for first relapse seemed more critical prognostically. This may have clinical and speculative implications.

XXXX : adding to the prognostic meaning of local failure.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity242 :: ('MESH:D012509', 'Disease') :: ['extremity soft tissue sarcoma'] @entity146 :: ('MESH:D001523', 'Disease') :: ['aggressiveness']
@entity242 :: (MESH:D012509,Disease) :: ['Extremity soft tissue sarcoma']
