Survival outcomes in non-operative cases of localized extremity sarcoma.

Background: Soft-tissue sarcomas (STSs) are a diverse group of malignancies challenging to treat when surgery is not an option. The aim of this study was to investigate the survival of non-surgical cases in STSs, and to examine the impact of radiation therapy (RT) on survival within this group of cases.

Methods: Utilizing the SEER database, we conducted a retrospective cohort study of localized extremity non-small round cell sarcoma diagnosed between 2000 and 2019. A total of 444 non-operative cases were identified and analyzed for cancer-specific survival (CSS) and overall survival (OS) using Kaplan-Meier and Cox proportional hazards models.

Results: Among the non-operative cohort, the median age at diagnosis was 72 years. The median survival was 10 months, with AJCC 8th edition clinical stage-specific 5-year CSS rates of 80 % for Stage 1B, 53 % for Stage 2, 47 % for Stage 3A, and 22 % for Stage 3B. The 5-year OS rates were 56 % for Stage 1B, 31 % for Stage 2, 26 % for Stage 3A, and 14 % for Stage 3B. Nearly half of the patients received RT, which was more prevalent in higher clinical stages. RT was associated with improved survival rates for both CSS and OS in patients who are unable to undergo surgical intervention.

Conclusions: RT is associated with improved survival in non-operative localized extremity non-small round cell sarcoma patients. These insights are vital for clinical decision-making, emphasizing the need for personalized, non-surgical interventions to improve outcomes for patients where surgery is not feasible.