Functional and Oncological Outcomes in Patients With Surgically Treated Lower Extremity Soft Tissue Sarcoma
Bibliographic record
Abstract
Introduction Treatment of soft tissue sarcomas can profoundly impact on patients’ clinical and functional outcomes, and quality of life (QoL). In this study, we aimed to investigate the factors affecting oncological and functional outcomes in surgically treated lower extremity soft tissue sarcoma patients. Methods This retrospective study analyzed 52 patients with lower extremity soft tissue sarcoma treated between 2016 and 2022. All patients underwent surgical excision and radiotherapy, either in the neoadjuvant (n:32, 28 Gy over 10 days) or adjuvant (20 patients, 45 Gy 5 week) setting. QoL was assessed using the QLQ-C30 score, while functional outcomes were evaluated with the Musculoskeletal Tumor Society (MSTS) and Toronto Extremity Salvage Score (TESS) scales. Additionally, factors such as tumor location, histological subtype, surgical margins, tumor volume, and oncologic status were analyzed in relation to functional and QoL outcomes. Results Patients who received adjuvant radiotherapy had significantly higher mean MSTS and TESS scores compared to those who received neoadjuvant radiotherapy ( P = 0.032, P = 0.010, respectively). Patients who received adjuvant radiotherapy had also significantly higher total QLQ-C30 scores and subscale scores for Physical Functioning, Role Functioning, and Social Functioning compared to those who underwent neoadjuvant treatment ( P = 0.033, P = 0.005, P = 0.005, P <0.001, respectively). Five-year overall survival was 72%, and local control was 69%. Mortality rate was higher in patient with pelvic tumors and metastatic disease. In the multivariate analysis, only the presence of metastasis was found to have a significant effect on overall survival ( P < 0.05). Conclusion Our study highlights that tumor location, particularly pelvic involvement, and the presence of metastases are associated with poorer oncologic outcomes in patients with lower extremity soft tissue sarcomas. Additionally, adjuvant radiotherapy, delivered using a conventional fractionation scheme, is linked to better functional outcomes and improved QoL compared to neoadjuvant radiotherapy, which is administered in a hypo-fractionated regimen.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".