BACKGROUND: Surgical resection and adjuvant radiation therapy are standard therapy for soft tissue @entity242 . When the @entity5 approximates bone, periosteal excision may be necessary. It was hypothesized that periosteal stripping and radiation therapy would increase the rate of pathologic @entity174 . METHODS: The soft tissue @entity242 data base at the Memorial Sloan-Kettering Cancer Center was used to identify a consecutive series of 205 @entity1 who were treated over a 15-year period (1982-1997). All @entity1 had a soft tissue @entity242 of the thigh, which was managed by limb-sparing surgery and radiation therapy. @entity1 who had bone invasion by @entity5 or bone resection were not included. RESULTS: Nine @entity1 , including eight @entity1 and one @entity1 , developed a @entity3330 in an area of previous radiation and surgery. All nine @entity1 had undergone periosteal excision. The risk of @entity174 , by Kaplan-Meier survivorship, was 29% at 5 years if the resection included periosteum (P < 0.0001). Cox multiple regression analysis showed that periosteal excision was the only independent prognostic factor for the entire set of 205 @entity1 at risk. However, for the subset of 54 @entity1 who had periosteal stripping, two factors were also found to be prognostically important: female gender (P=0.022) and chemotherapy (P=0.020). The risk of @entity174 was 47% and 45%, respectively. The treatment of the @entity174 was difficult. There were four nonunions and three delayed unions. CONCLUSIONS: Periosteal stripping and radiation therapy places the femur at high risk of pathologic @entity174 , especially for female @entity1 and @entity1 undergoing chemotherapy. When practical, the combination of periosteal stripping and radiation should be avoided.

Pathologic @entity3330 after periosteal excision and radiation for the treatment of soft tissue XXXX .

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients', 'man'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'fracture'] @entity242 :: ('MESH:D012509', 'Disease') :: ['sarcoma', 'sarcomas'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity3330 :: ('MESH:D005264', 'Disease') :: ['femoral fracture']
@entity242 :: (MESH:D012509,Disease) :: ['sarcoma']
