Retrospective analysis of multimodal primary treatment of localized myxofibrosarcoma

There is no concensus on the optimal primary therapy of localized myxofibrosarcoma (MFS) . Primary resection is complicated by a high rate of local recurrence, and the refractoriness to non-surgical treatment results in a higher risk of metastasis. A retrospective analysis of 134 MFS patients of a sarcoma-specialized center in Berlin (Germany) evaluated multimodal treatment for localized MFS with combination of surgery, radiation, chemotherapy, hyperthermia, and isolated limb perfusion. The 5-year overall survival rate was 74.9%, while the 5-year local recurrence-free survival rate was 66.1% and the distant metastasis-free survival rate was 80.8%. Older age, tumor size cT≥2, non-extremity localization, and distant metastasis were adverse predictive factors for overall survival. Performing incision biopsy, wide local excision or compartment-oriented excision, negative margins, and radiotherapy were favorable predictive factors for local recurrence. Tumor size cT≥3 was an adverse predictive factor for distant metastasis. Adjuvant radiation had a favorable impact on local recurrence-free survival in all localized tumor stages, while chemotherapy did not have a significant impact on distant metastasis-free survival.