Why do patients with radiation-induced sarcomas have a poor sarcoma-related survival?
Identifieur interne : 000090 ( Pmc/Curation ); précédent : 000089; suivant : 000091Why do patients with radiation-induced sarcomas have a poor sarcoma-related survival?
Auteurs : B. Bjerkehagen [Norvège] ; M C Sm Stuen [Norvège] ; K S Hall [Norvège] ; S. Skjeldal [Norvège] ; S. Smeland [Norvège] ; S D Foss [Norvège]Source :
- British Journal of Cancer [ 0007-0920 ] ; 2011.
Abstract
This study aims to provide reasons for the poor sarcoma-related survival in patients with radiation-induced sarcoma (RIS).
We performed a case–control study comparing sarcoma-related survival of 98 patients with RIS to that of 239 sporadic high-grade malignant sarcomas.
The cumulative sarcoma-related 5-year survival was 32% (95% confidence interval (CI): 22–42) for patients with RIS
The poor prognosis of RIS patients are not due to the previous radiotherapy
Url:
DOI: 10.1038/bjc.2011.559
PubMed: 22173669
PubMed Central: 3261679
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Bjerkehagen</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Pathology, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Norwegian Radium Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Oslo University Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sm Stuen, M C" sort="Sm Stuen, M C" uniqKey="Sm Stuen M" first="M C" last="Sm Stuen">M C Sm Stuen</name><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Oslo University Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4"><institution>National Resource Centre for Late Effects, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hall, K S" sort="Hall, K S" uniqKey="Hall K" first="K S" last="Hall">K S Hall</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Norwegian Radium Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Oslo University Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff5"><institution>Department of Oncology, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Skjeldal, S" sort="Skjeldal, S" uniqKey="Skjeldal S" first="S" last="Skjeldal">S. Skjeldal</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Norwegian Radium Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Oslo University Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6"><institution>Department of Orthopaedic Surgery, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Smeland, S" sort="Smeland, S" uniqKey="Smeland S" first="S" last="Smeland">S. Smeland</name><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Oslo University Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff7"><institution>Divisions of Surgery and Cancer Medicine, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff8"><institution>Institute for Clinical Medicine, University of Oslo, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Foss, S D" sort="Foss, S D" uniqKey="Foss S" first="S D" last="Foss">S D Foss</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Norwegian Radium Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Oslo University Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4"><institution>National Resource Centre for Late Effects, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff5"><institution>Department of Oncology, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff8"><institution>Institute for Clinical Medicine, University of Oslo, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">British Journal of Cancer</title><idno type="ISSN">0007-0920</idno><idno type="eISSN">1532-1827</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background:</title><p>This study aims to provide reasons for the poor sarcoma-related survival in patients with radiation-induced sarcoma (RIS).</p></sec><sec><title>Methods:</title><p>We performed a case–control study comparing sarcoma-related survival of 98 patients with RIS to that of 239 sporadic high-grade malignant sarcomas.</p></sec><sec><title>Results:</title><p>The cumulative sarcoma-related 5-year survival was 32% (95% confidence interval (CI): 22–42) for patients with RIS <italic>vs</italic> 51% (95% CI: 44–58) for controls (<italic>P</italic><0.001). Female gender, central tumour site and incomplete surgical remission were significantly more frequent among RIS patients than in controls. In multivariate analysis incomplete surgical remission (hazard ratio (HR) 4.48, 95% CI: 3.08–6.52), metastases at presentation (HR 2.93, 95% CI: 1.95–4.41), microscopic tumour necrosis (HR 1.88, 95% CI: 1.27–2.78) and central tumour site (HR 1.71, 95% CI: 1.18–2.47) remained significant adverse prognostic factors, but not sarcoma category (RIS <italic>vs</italic> sporadic).</p></sec><sec><title>Conclusion:</title><p>The poor prognosis of RIS patients are not due to the previous radiotherapy <italic>per se</italic>, but related to the unfavourable factors – central tumour site, incomplete surgical remission, microscopic tumour necrosis and the presence of metastases, the two former factors overrepresented in RIS.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Aksnes, Lh" uniqKey="Aksnes L">LH Aksnes</name></author><author><name sortKey="Hall, Ks" uniqKey="Hall K">KS Hall</name></author><author><name sortKey="Folleraas, G" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Br J Cancer</journal-id><journal-title-group><journal-title>British Journal of Cancer</journal-title></journal-title-group><issn pub-type="ppub">0007-0920</issn><issn pub-type="epub">1532-1827</issn><publisher><publisher-name>Nature Publishing Group</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22173669</article-id><article-id pub-id-type="pmc">3261679</article-id><article-id pub-id-type="pii">bjc2011559</article-id><article-id pub-id-type="doi">10.1038/bjc.2011.559</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical Study</subject></subj-group></article-categories><title-group><article-title>Why do patients with radiation-induced sarcomas have a poor sarcoma-related survival?</article-title><alt-title alt-title-type="running">The prognosis of radiation-induced sarcoma</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Bjerkehagen</surname><given-names>B</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="corresp" rid="caf1">*</xref></contrib><contrib contrib-type="author"><name><surname>Småstuen</surname><given-names>M C</given-names></name><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Hall</surname><given-names>K S</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="aff" rid="aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Skjeldal</surname><given-names>S</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="aff" rid="aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Smeland</surname><given-names>S</given-names></name><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="aff" rid="aff7">7</xref><xref ref-type="aff" rid="aff8">8</xref></contrib><contrib contrib-type="author"><name><surname>Fosså</surname><given-names>S D</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="aff" rid="aff4">4</xref><xref ref-type="aff" rid="aff5">5</xref><xref ref-type="aff" rid="aff8">8</xref></contrib><aff id="aff1"><label>1</label><institution>Department of Pathology, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></aff><aff id="aff2"><label>2</label><institution>Norwegian Radium Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></aff><aff id="aff3"><label>3</label><institution>Oslo University Hospital, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></aff><aff id="aff4"><label>4</label><institution>National Resource Centre for Late Effects, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></aff><aff id="aff5"><label>5</label><institution>Department of Oncology, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></aff><aff id="aff6"><label>6</label><institution>Department of Orthopaedic Surgery, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></aff><aff id="aff7"><label>7</label><institution>Divisions of Surgery and Cancer Medicine, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></aff><aff id="aff8"><label>8</label><institution>Institute for Clinical Medicine, University of Oslo, Postboks 4953</institution>, NO-0424 Oslo,<country>Norway</country></aff></contrib-group><author-notes><corresp id="caf1"><label>*</label>E-mail: <email>bodil.bjerkehagen@oslo-universitetssykehus.no</email></corresp></author-notes><pub-date pub-type="ppub"><day>17</day><month>01</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>15</day><month>12</month><year>2011</year></pub-date><volume>106</volume><issue>2</issue><fpage>297</fpage><lpage>306</lpage><history><date date-type="received"><day>03</day><month>08</month><year>2011</year></date><date date-type="rev-recd"><day>16</day><month>11</month><year>2011</year></date><date date-type="accepted"><day>24</day><month>11</month><year>2011</year></date></history><permissions><copyright-statement>Copyright © 2012 Cancer Research UK</copyright-statement><copyright-year>2012</copyright-year><copyright-holder>Cancer Research UK</copyright-holder></permissions><abstract><sec><title>Background:</title><p>This study aims to provide reasons for the poor sarcoma-related survival in patients with radiation-induced sarcoma (RIS).</p></sec><sec><title>Methods:</title><p>We performed a case–control study comparing sarcoma-related survival of 98 patients with RIS to that of 239 sporadic high-grade malignant sarcomas.</p></sec><sec><title>Results:</title><p>The cumulative sarcoma-related 5-year survival was 32% (95% confidence interval (CI): 22–42) for patients with RIS <italic>vs</italic> 51% (95% CI: 44–58) for controls (<italic>P</italic><0.001). Female gender, central tumour site and incomplete surgical remission were significantly more frequent among RIS patients than in controls. In multivariate analysis incomplete surgical remission (hazard ratio (HR) 4.48, 95% CI: 3.08–6.52), metastases at presentation (HR 2.93, 95% CI: 1.95–4.41), microscopic tumour necrosis (HR 1.88, 95% CI: 1.27–2.78) and central tumour site (HR 1.71, 95% CI: 1.18–2.47) remained significant adverse prognostic factors, but not sarcoma category (RIS <italic>vs</italic> sporadic).</p></sec><sec><title>Conclusion:</title><p>The poor prognosis of RIS patients are not due to the previous radiotherapy <italic>per se</italic>, but related to the unfavourable factors – central tumour site, incomplete surgical remission, microscopic tumour necrosis and the presence of metastases, the two former factors overrepresented in RIS.</p></sec></abstract><kwd-group><kwd>radiation</kwd><kwd>radiation-induced</kwd><kwd>sarcoma</kwd><kwd>secondary malignancies</kwd><kwd>prognosis</kwd><kwd>treatment-related morbidity</kwd></kwd-group></article-meta></front><floats-group><fig id="fig1"><label>Figure 1</label><caption><p>Flow chart showing the inclusion of patients in the case–control study including (<bold>A</bold>) radiation-induced sarcomas (cases, <italic>n</italic>=98) and (<bold>B</bold>) sporadic sarcomas (controls, <italic>n</italic>=239).</p></caption><graphic xlink:href="bjc2011559f1"></graphic></fig><fig id="fig2"><label>Figure 2</label><caption><p>The sarcoma-related survival in patients with radiation-induced sarcoma compared with patients with sporadic sarcomas, Kaplan–Meier plot, log rank <italic>P</italic><0.001.</p></caption><graphic xlink:href="bjc2011559f2"></graphic></fig><fig id="fig3"><label>Figure 3</label><caption><p>Kaplan–Meier plots showing sarcoma-related survival separating patients with radiation-induced sarcomas and sporadic sarcomas according to tumour size (<bold>A</bold>), presence of microscopic tumour necrosis (<bold>B</bold>), tumour site (<bold>C</bold>) and histology (<bold>D</bold>): malignant fibrous histiocytoma, osteosarcoma and others (malignant peripheral nerve sheath tumour, leiomyosarcoma and angiosarcoma).</p></caption><graphic xlink:href="bjc2011559f3"></graphic></fig><fig id="fig4"><label>Figure 4</label><caption><p>Kaplan–Meier plots showing sarcoma-related survival in patients in radiation-induced sarcomas and sporadic sarcomas according to performed surgery (<bold>A</bold> and <bold>B</bold>) and surgical remission (<bold>C</bold> and <bold>D</bold>) (incomplete surgical remission defined as no surgery at all or contaminated margins).</p></caption><graphic xlink:href="bjc2011559f4"></graphic></fig><fig id="fig5"><label>Figure 5</label><caption><p>Kaplan–Meier plots showing sarcoma-related survival in patients with radiation-induced soft-tissue sarcomas (<bold>A</bold>), sporadic soft-tissue sarcomas (<bold>B</bold>), radiation-induced osteosarcoma in bone (<bold>C</bold>) and sporadic osteosarcoma in bone (<bold>D</bold>), and according to complete surgical remission.</p></caption><graphic xlink:href="bjc2011559f5"></graphic></fig><table-wrap id="tbl1"><label>Table 1</label><caption><title>Baseline characteristics of radiation-induced sarcomas (cases) and sporadic sarcoma (controls)</title></caption><table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col><col align="char" char="("></col><col align="char" char="("></col><col align="char" char="("></col><col align="char" char="."></col></colgroup><thead valign="bottom"><tr><th align="left" valign="top" charoff="50"><bold>Variable</bold></th><th align="char" valign="top" char="(" charoff="50"><bold>RIS (<italic>n</italic>=98)</bold></th><th align="char" valign="top" char="(" charoff="50"><bold>Controls (<italic>n</italic>=239)</bold></th><th align="char" valign="top" char="(" charoff="50"><bold>Total (<italic>n</italic>=337)</bold></th><th align="char" valign="top" char="." charoff="50"><bold><italic>P</italic>-value</bold></th></tr></thead><tbody valign="top"><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Gender</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Female</td><td align="char" valign="top" char="(" charoff="50">72 (73%)</td><td align="char" valign="top" char="(" charoff="50">117 (49%)</td><td align="char" valign="top" char="(" charoff="50">189 (56%)</td><td align="char" valign="top" char="." charoff="50"><0.001</td></tr><tr><td align="left" valign="top" charoff="50"> Male</td><td align="char" valign="top" char="(" charoff="50">26 (27%)</td><td align="char" valign="top" char="(" charoff="50">122 (51%)</td><td align="char" valign="top" char="(" charoff="50">148 (44%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Age at sarcoma diagnosis (years)</italic></td></tr><tr><td align="left" valign="top" charoff="50"> <60</td><td align="char" valign="top" char="(" charoff="50">51 (52%)</td><td align="char" valign="top" char="(" charoff="50">124 (52%)</td><td align="char" valign="top" char="(" charoff="50">175 (52%)</td><td align="char" valign="top" char="." charoff="50">0.979</td></tr><tr><td align="left" valign="top" charoff="50"> ⩾60</td><td align="char" valign="top" char="(" charoff="50">47 (48%)</td><td align="char" valign="top" char="(" charoff="50">115 (48%)</td><td align="char" valign="top" char="(" charoff="50">162 (48%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Time period of diagnosis</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Before 1990</td><td align="char" valign="top" char="(" charoff="50">19 (19%)</td><td align="char" valign="top" char="(" charoff="50">65 (27%)</td><td align="char" valign="top" char="(" charoff="50">84 (25%)</td><td align="char" valign="top" char="." charoff="50">0.294</td></tr><tr><td align="left" valign="top" charoff="50"> 1990–1999</td><td align="char" valign="top" char="(" charoff="50">35 (36%)</td><td align="char" valign="top" char="(" charoff="50">82 (34%)</td><td align="char" valign="top" char="(" charoff="50">117 (35%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> From 2000</td><td align="char" valign="top" char="(" charoff="50">44 (45%)</td><td align="char" valign="top" char="(" charoff="50">92 (39%)</td><td align="char" valign="top" char="(" charoff="50">136 (40%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Histological diagnosis</italic><xref ref-type="fn" rid="t1-fn2">a</xref></td></tr><tr><td align="left" valign="top" charoff="50"> Angiosarcoma</td><td align="char" valign="top" char="(" charoff="50">12 (12%)</td><td align="char" valign="top" char="(" charoff="50">18 (7%)</td><td align="char" valign="top" char="(" charoff="50">30 (9%)</td><td align="char" valign="top" char="." charoff="50">0.637</td></tr><tr><td align="left" valign="top" charoff="50"> MFH</td><td align="char" valign="top" char="(" charoff="50">41 (42%)</td><td align="char" valign="top" char="(" charoff="50">97 (41%)</td><td align="char" valign="top" char="(" charoff="50">138 (41%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Osteosarcoma</td><td align="char" valign="top" char="(" charoff="50">26 (27%)</td><td align="char" valign="top" char="(" charoff="50">76 (32%)</td><td align="char" valign="top" char="(" charoff="50">102 (30%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> MPNST</td><td align="char" valign="top" char="(" charoff="50">7 (7%)</td><td align="char" valign="top" char="(" charoff="50">20 (8%)</td><td align="char" valign="top" char="(" charoff="50">27 (8%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Leiomyosarcoma</td><td align="char" valign="top" char="(" charoff="50">12 (12%)</td><td align="char" valign="top" char="(" charoff="50">28 (12%)</td><td align="char" valign="top" char="(" charoff="50">40 (12%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Tumour size</italic></td></tr><tr><td align="left" valign="top" charoff="50"> <5 cm</td><td align="char" valign="top" char="(" charoff="50">25 (26%)</td><td align="char" valign="top" char="(" charoff="50">41 (17%)</td><td align="char" valign="top" char="(" charoff="50">66 (20%)</td><td align="char" valign="top" char="." charoff="50">0.065</td></tr><tr><td align="left" valign="top" charoff="50"> ⩾5 cm</td><td align="char" valign="top" char="(" charoff="50">70 (74%)</td><td align="char" valign="top" char="(" charoff="50">195 (83%)</td><td align="char" valign="top" char="(" charoff="50">265 (80%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="char" valign="top" char="(" charoff="50">3</td><td align="char" valign="top" char="(" charoff="50">3</td><td align="char" valign="top" char="(" charoff="50">6</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Tumour necrosis</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">64 (69%)</td><td align="char" valign="top" char="(" charoff="50">149 (62%)</td><td align="char" valign="top" char="(" charoff="50">213 (67%)</td><td align="char" valign="top" char="." charoff="50">0.729</td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">29 (31%)</td><td align="char" valign="top" char="(" charoff="50">74 (31%)</td><td align="char" valign="top" char="(" charoff="50">103 (33%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="char" valign="top" char="(" charoff="50">5</td><td align="char" valign="top" char="(" charoff="50">16</td><td align="char" valign="top" char="(" charoff="50">21</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Bone or soft tissue/viscera</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Bone</td><td align="char" valign="top" char="(" charoff="50">29 (31%)</td><td align="char" valign="top" char="(" charoff="50">81 (33%)</td><td align="char" valign="top" char="(" charoff="50">110 (33%)</td><td align="char" valign="top" char="." charoff="50">0.595</td></tr><tr><td align="left" valign="top" charoff="50"> Soft tissue/viscera</td><td align="char" valign="top" char="(" charoff="50">65 (69%)</td><td align="char" valign="top" char="(" charoff="50">158 (67%)</td><td align="char" valign="top" char="(" charoff="50">223 (67%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="char" valign="top" char="(" charoff="50">4</td><td align="char" valign="top" char="(" charoff="50">0</td><td align="char" valign="top" char="(" charoff="50">4</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Site</italic><xref ref-type="fn" rid="t1-fn3">b</xref></td></tr><tr><td align="left" valign="top" charoff="50"> Extremity/trunk wall</td><td align="char" valign="top" char="(" charoff="50">39 (40%)</td><td align="char" valign="top" char="(" charoff="50">184 (77%)</td><td align="char" valign="top" char="(" charoff="50">223 (66%)</td><td align="char" valign="top" char="." charoff="50"><0.001</td></tr><tr><td align="left" valign="top" charoff="50"> Head/abdomen/axial/thoracic</td><td align="char" valign="top" char="(" charoff="50">59 (60%)</td><td align="char" valign="top" char="(" charoff="50">55 (23%)</td><td align="char" valign="top" char="(" charoff="50">114 (34%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Metastases at diagnosis</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">20 (20%)</td><td align="char" valign="top" char="(" charoff="50">39 (16%)</td><td align="char" valign="top" char="(" charoff="50">59 (18%)</td><td align="char" valign="top" char="." charoff="50">0.370</td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">78 (80%)</td><td align="char" valign="top" char="(" charoff="50">200 (84%)</td><td align="char" valign="top" char="(" charoff="50">278 (82%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Chemotherapy</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">37 (38%)</td><td align="char" valign="top" char="(" charoff="50">106 (45%)</td><td align="char" valign="top" char="(" charoff="50">143 (43%)</td><td align="char" valign="top" char="." charoff="50">0.257</td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">60 (62%)</td><td align="char" valign="top" char="(" charoff="50">130 (55%)</td><td align="char" valign="top" char="(" charoff="50">190 (57%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="char" valign="top" char="(" charoff="50">1</td><td align="char" valign="top" char="(" charoff="50">3</td><td align="char" valign="top" char="(" charoff="50">4</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Radiotherapy</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">22 (22%)</td><td align="char" valign="top" char="(" charoff="50">78 (33%)</td><td align="char" valign="top" char="(" charoff="50">100 (30%)</td><td align="char" valign="top" char="." charoff="50">0.046</td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">76 (78%)</td><td align="char" valign="top" char="(" charoff="50">155 (67%)</td><td align="char" valign="top" char="(" charoff="50">231 (70%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50">6</td><td align="char" valign="top" char="(" charoff="50">6</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Surgery</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">70 (71%)</td><td align="char" valign="top" char="(" charoff="50">215 (90%)</td><td align="char" valign="top" char="(" charoff="50">285 (85%)</td><td align="char" valign="top" char="." charoff="50"><0.001</td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">28 (29%)</td><td align="char" valign="top" char="(" charoff="50">24 (10%)</td><td align="char" valign="top" char="(" charoff="50">52 (15%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Complete surgical remission (operated patients only, n=70)</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">45 (64%)</td><td align="char" valign="top" char="(" charoff="50">165 (77%)</td><td align="char" valign="top" char="(" charoff="50">210 (74%)</td><td align="char" valign="top" char="." charoff="50">0.034</td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">25 (36%)</td><td align="char" valign="top" char="(" charoff="50">49 (23%)</td><td align="char" valign="top" char="(" charoff="50">74 (26%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50">1</td><td align="char" valign="top" char="(" charoff="50">1</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Complete surgical remission (all patients)</italic><xref ref-type="fn" rid="t1-fn4">c</xref></td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">45 (46%)</td><td align="char" valign="top" char="(" charoff="50">165 (69%)</td><td align="char" valign="top" char="(" charoff="50">210 (62%)</td><td align="char" valign="top" char="." charoff="50"><0.001</td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">53 (54%)</td><td align="char" valign="top" char="(" charoff="50">73 (31%)</td><td align="char" valign="top" char="(" charoff="50">126 (38%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50">1</td><td align="char" valign="top" char="(" charoff="50">1</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Surgery and radiotherapy</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">15 (15%)</td><td align="char" valign="top" char="(" charoff="50">67 (29%)</td><td align="char" valign="top" char="(" charoff="50">82 (25%)</td><td align="char" valign="top" char="." charoff="50">0.01</td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">83 (85%)</td><td align="char" valign="top" char="(" charoff="50">166 (71%)</td><td align="char" valign="top" char="(" charoff="50">249 (75%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50">6</td><td align="char" valign="top" char="(" charoff="50">6</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><italic>Local recurrences</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">29 (41%)</td><td align="char" valign="top" char="(" charoff="50">37 (17%)</td><td align="char" valign="top" char="(" charoff="50">66 (23%)</td><td align="char" valign="top" char="." charoff="50"><0.001</td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">41 (59%)</td><td align="char" valign="top" char="(" charoff="50">178 (83%)</td><td align="char" valign="top" char="(" charoff="50">219 (77%)</td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No surgery</td><td align="char" valign="top" char="(" charoff="50">28</td><td align="char" valign="top" char="(" charoff="50">24</td><td align="char" valign="top" char="(" charoff="50">52</td><td align="char" valign="top" char="." charoff="50"> </td></tr></tbody></table><table-wrap-foot><fn id="t1-fn1"><p>Abbreviations: MFH=malignant fibrous histiocytoma; MPNST=malignant peripheral nerve sheath tumour; RIS=radiation-induced sarcoma.</p></fn><fn id="t1-fn2"><label>a</label><p>Localisation of the RIS: all angiosarcomas and MPNST were localised in soft tissue. In all 68% of the MFH, 92% of the LMS and 27% of the OS were localised in soft tissue.</p></fn><fn id="t1-fn3"><label>b</label><p>(1) Extremities (bone and soft tissue) + trunk wall (soft tissue including the axillary region and groin). (2) Head and neck (bone and soft tissue), intrathoracic and intraabdominal (soft tissue and viscera), and axial skeleton including the scapula, clavicle, ribs and pelvic bones.</p></fn><fn id="t1-fn4"><label>c</label><p>Complete surgical remission also includes patients not operated.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tbl2"><label>Table 2</label><caption><title>Cox regression analysis of sarcoma-related survival in patients with radiation-induced sarcoma (cases) and sporadic sarcomas (controls)</title></caption><table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col><col align="left"></col><col align="char" char="."></col><col align="left"></col><col align="char" char="."></col><col align="center"></col></colgroup><thead valign="bottom"><tr><th align="left" valign="top" charoff="50"> </th><th align="left" valign="top" charoff="50"> </th><th align="char" valign="top" char="." charoff="50"><bold>Univariate analysis</bold><hr></hr></th><th colspan="3" align="center" valign="top" charoff="50"><bold>Multivariate weighted Cox regression<xref ref-type="fn" rid="t2-fn3">a</xref></bold><hr></hr></th></tr><tr><th align="left" valign="top" charoff="50"><bold>Prognostic factor</bold></th><th align="left" valign="top" charoff="50"><bold><italic>N</italic>=337</bold></th><th align="char" valign="top" char="." charoff="50"><bold><italic>P</italic>-value</bold></th><th align="left" valign="top" charoff="50"><bold><italic>P</italic>-value</bold></th><th align="char" valign="top" char="." charoff="50"><bold>HR</bold></th><th align="center" valign="top" charoff="50"><bold>95% CI for HR</bold></th></tr></thead><tbody valign="top"><tr><td align="left" valign="top" charoff="50"><italic>Radiation-induced sarcoma</italic></td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50">0.001</td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50">0.84</td><td align="center" valign="top" charoff="50">0.58–1.22</td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">98 (29%)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50">0.362</td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">239 (71%) ref</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Gender</italic></td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50">0.540</td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Female</td><td align="char" valign="top" char="(" charoff="50">189 (56%)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Male</td><td align="char" valign="top" char="(" charoff="50">148 (44%)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Age at sarcoma diagnosis (years)</italic></td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50">0.02</td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50">1.30</td><td align="center" valign="top" charoff="50">0.94–1.79</td></tr><tr><td align="left" valign="top" charoff="50"> <60</td><td align="char" valign="top" char="(" charoff="50">175 (52%) ref</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50">0.109</td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> ⩾60</td><td align="char" valign="top" char="(" charoff="50">162 (48%)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td colspan="6" align="left" valign="top" charoff="50"><italic>Time period of diagnosis</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Before 1990</td><td align="char" valign="top" char="(" charoff="50">84 (25%) ref</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> 1990–1999</td><td align="char" valign="top" char="(" charoff="50">117 (35%)</td><td align="char" valign="top" char="." charoff="50">0.941</td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> From 2000</td><td align="char" valign="top" char="(" charoff="50">136 (40%)</td><td align="char" valign="top" char="." charoff="50">0.224</td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td colspan="6" align="left" valign="top" charoff="50"><italic>Histological subtype</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Malignant fibrous histiocytoma</td><td align="char" valign="top" char="(" charoff="50">138 (41%) ref</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Osteosarcoma</td><td align="char" valign="top" char="(" charoff="50">102 (30%)</td><td align="char" valign="top" char="." charoff="50">0.333</td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Others</td><td align="char" valign="top" char="(" charoff="50">97 (29%)</td><td align="char" valign="top" char="." charoff="50">0.132</td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Tumour size</italic></td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50">1.57</td><td align="center" valign="top" charoff="50">0.97–2.55</td></tr><tr><td align="left" valign="top" charoff="50"> <5 cm</td><td align="char" valign="top" char="(" charoff="50">66 (20%) ref</td><td align="char" valign="top" char="." charoff="50">0.002</td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> ⩾5 cm</td><td align="char" valign="top" char="(" charoff="50">265 (80%)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50">0.067</td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="left" valign="top" charoff="50">6</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Microscopic tumour necrosis</italic></td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50">1.88</td><td align="center" valign="top" charoff="50">1.27–2.78</td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">213 (67%)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"><bold>0.002</bold></td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">103 (33%) ref</td><td align="char" valign="top" char="." charoff="50"><0.001</td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="left" valign="top" charoff="50">21</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td colspan="6" align="left" valign="top" charoff="50"><italic>Bone or soft-tissue tumour</italic></td></tr><tr><td align="left" valign="top" charoff="50"> Bone</td><td align="char" valign="top" char="(" charoff="50">110 (33%) ref</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Soft tissue/viscera</td><td align="char" valign="top" char="(" charoff="50">223 (67%)</td><td align="char" valign="top" char="." charoff="50">0.821</td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="left" valign="top" charoff="50">4</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Site</italic></td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50">1.71</td><td align="center" valign="top" charoff="50">1.18–2.47</td></tr><tr><td align="left" valign="top" charoff="50"> Extremity/trunk wall</td><td align="char" valign="top" char="(" charoff="50">232 (69%) ref</td><td align="char" valign="top" char="." charoff="50"><0.001</td><td align="char" valign="top" char="." charoff="50"><bold>0.004</bold></td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Head/abdomen/axial/thoracic</td><td align="char" valign="top" char="(" charoff="50">106 (31%)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Metastases at diagnosis</italic></td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50">2.93</td><td align="center" valign="top" charoff="50">1.95–4.41</td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">59 (18%)</td><td align="char" valign="top" char="." charoff="50"><0.001</td><td align="char" valign="top" char="." charoff="50"><bold><0.001</bold></td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">278 (82%) ref</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Complete surgical remission</italic></td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50">4.48</td><td align="center" valign="top" charoff="50">3.08–6.52</td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="(" charoff="50">210 (62%) ref</td><td align="char" valign="top" char="." charoff="50"><0.001</td><td align="char" valign="top" char="." charoff="50"><bold><0.001</bold></td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="(" charoff="50">126 (38%)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Unknown</td><td align="left" valign="top" charoff="50">1</td><td align="char" valign="top" char="." charoff="50"> </td><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr></tbody></table><table-wrap-foot><fn id="t2-fn1"><p>Abbreviations: CI=confidence interval; HR=hazard ratio; ref=reference; RIS=radiation-induced sarcoma.</p></fn><fn id="t2-fn2"><p>Significant values are given in bold.</p></fn><fn id="t2-fn3"><label>a</label><p>In the multivariate analysis 307 patients are included.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tbl3"><label>Table 3</label><caption><title>Cox regression analysis of sarcoma-related survival in patients with radiation-induced sarcoma (cases) and sporadic sarcomas (controls)</title></caption><table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col></colgroup><thead valign="bottom"><tr><th colspan="7" align="left" valign="top" charoff="50"><bold>(A) Patients with soft tissue sarcoma<xref ref-type="fn" rid="t3-fn2">a</xref></bold><hr></hr></th></tr><tr><th align="left" valign="top" charoff="50"> </th><th colspan="3" align="center" valign="top" charoff="50"><bold>All, <italic>n</italic>=204<xref ref-type="fn" rid="t3-fn3">b</xref></bold><hr></hr></th><th colspan="3" align="center" valign="top" charoff="50"><bold>Without metastasis at diagnosis, <italic>n</italic>=178<xref ref-type="fn" rid="t3-fn3">b</xref></bold><hr></hr></th></tr><tr><th align="left" valign="top" charoff="50"><bold>Prognostic factor</bold></th><th align="center" valign="top" charoff="50"><bold><italic>P</italic>-value</bold></th><th align="center" valign="top" charoff="50"><bold>HR</bold></th><th align="center" valign="top" charoff="50"><bold>95% CI for HR</bold></th><th align="center" valign="top" charoff="50"><bold><italic>P</italic>-value</bold></th><th align="center" valign="top" charoff="50"><bold>HR</bold></th><th align="center" valign="top" charoff="50"><bold>95% CI for HR</bold></th></tr></thead><tbody valign="top"><tr><td align="left" valign="top" charoff="50"><italic>Radiation-induced sarcoma</italic></td><td align="char" valign="top" char="." charoff="50">0.543</td><td align="char" valign="top" char="." charoff="50">0.87</td><td align="center" valign="top" charoff="50">0.56–1.35</td><td align="char" valign="top" char="." charoff="50">0.212</td><td align="char" valign="top" char="." charoff="50">0.72</td><td align="center" valign="top" charoff="50">0.44–1.20</td></tr><tr><td align="left" valign="top" charoff="50"> Yes (ref)</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Metastases at diagnosis</italic></td><td align="char" valign="top" char="." charoff="50"><0.001</td><td align="char" valign="top" char="." charoff="50">0.34</td><td align="center" valign="top" charoff="50">0.19–0.61</td><td align="center" valign="top" charoff="50">Not relevant</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Yes (ref)</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Complete surgical remission</italic></td><td align="char" valign="top" char="." charoff="50"><0.001</td><td align="char" valign="top" char="." charoff="50">4.96</td><td align="center" valign="top" charoff="50">3.14–7.84</td><td align="char" valign="top" char="." charoff="50"><0.001</td><td align="char" valign="top" char="." charoff="50">5.38</td><td align="center" valign="top" charoff="50">3.35–8.65</td></tr><tr><td align="left" valign="top" charoff="50"> Yes (ref)</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Microscopic tumour necrosis</italic></td><td align="char" valign="top" char="." charoff="50"><0.001</td><td align="char" valign="top" char="." charoff="50">0.39</td><td align="center" valign="top" charoff="50">0.23–0.66</td><td align="char" valign="top" char="." charoff="50"><0.001</td><td align="char" valign="top" char="." charoff="50">0.35</td><td align="center" valign="top" charoff="50">0.21–0.60</td></tr><tr><td align="left" valign="top" charoff="50"> Yes (ref)</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr></tbody></table><table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col><col align="char" char="."></col><col align="char" char="."></col><col align="center"></col><col align="char" char="."></col><col align="char" char="."></col><col align="center"></col></colgroup><thead valign="bottom"><tr><th colspan="7" align="left" valign="top" charoff="50"><bold>(B) Patients with osteosarcoma in bone</bold><hr></hr></th></tr><tr><th align="left" valign="top" charoff="50"> </th><th colspan="3" align="center" valign="top" char="." charoff="50"><bold>All, <italic>n</italic>=81<xref ref-type="fn" rid="t3-fn4">c</xref></bold><hr></hr></th><th colspan="3" align="center" valign="top" char="." charoff="50"><bold>Without metastasis at diagnosis, <italic>n</italic>=63<xref ref-type="fn" rid="t3-fn4">c</xref></bold><hr></hr></th></tr><tr><th align="left" valign="top" charoff="50"><bold>Prognostic factor</bold></th><th align="char" valign="top" char="." charoff="50"><bold><italic>P</italic>-value</bold></th><th align="char" valign="top" char="." charoff="50"><bold>HR</bold></th><th align="center" valign="top" charoff="50"><bold>95% CI for HR</bold></th><th align="char" valign="top" char="." charoff="50"><bold><italic>P</italic>-value</bold></th><th align="char" valign="top" char="." charoff="50"><bold>HR</bold></th><th align="center" valign="top" charoff="50"><bold>95% CI for HR</bold></th></tr></thead><tbody valign="top"><tr><td align="left" valign="top" charoff="50"><italic>Radiation-induced sarcoma</italic></td><td align="char" valign="top" char="." charoff="50">0.902</td><td align="char" valign="top" char="." charoff="50">0.95</td><td align="center" valign="top" charoff="50">0.38–2.34</td><td align="char" valign="top" char="." charoff="50">0.758</td><td align="char" valign="top" char="." charoff="50">0.86</td><td align="center" valign="top" charoff="50">0.33–2.22</td></tr><tr><td align="left" valign="top" charoff="50"> Yes</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No (ref)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Metastases at diagnosis</italic></td><td align="char" valign="top" char="." charoff="50">0.008</td><td align="char" valign="top" char="." charoff="50">0.36</td><td align="center" valign="top" charoff="50">0.17–0.76</td><td align="char" valign="top" char="." charoff="50">Not relevant</td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Yes (ref)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Complete surgical remission</italic></td><td align="char" valign="top" char="." charoff="50"><0.001</td><td align="char" valign="top" char="." charoff="50">5.11</td><td align="center" valign="top" charoff="50">2.38–11.00</td><td align="char" valign="top" char="." charoff="50">0.04</td><td align="char" valign="top" char="." charoff="50">4.74</td><td align="center" valign="top" charoff="50">1.67–13.46</td></tr><tr><td align="left" valign="top" charoff="50"> Yes (ref)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> No</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"><italic>Site</italic></td><td align="char" valign="top" char="." charoff="50">0.026</td><td align="char" valign="top" char="." charoff="50">2.80</td><td align="center" valign="top" charoff="50">1.13–6.96</td><td align="char" valign="top" char="." charoff="50">0.038</td><td align="char" valign="top" char="." charoff="50">3.31</td><td align="center" valign="top" charoff="50">1.07–10.24</td></tr><tr><td align="left" valign="top" charoff="50"> Extremity/trunk wall (ref)</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50"> Head/abdomen/axial/thoracic</td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td><td align="center" valign="top" charoff="50"> </td></tr></tbody></table><table-wrap-foot><fn id="t3-fn1"><p>Abbreviations: CI=confidence interval; HR=hazard ratio; ref=reference.</p></fn><fn id="t3-fn2"><label>a</label><p>Including MFH, angiosarcoma, malignant peripheral nerve sheath tumour and leiomyosarcoma, but not osteosarcoma in soft tissue.</p></fn><fn id="t3-fn3"><label>b</label><p>Gender, age at diagnosis, histology, time period at diagnosis, tumour size and site were not significant prognostic factors.</p></fn><fn id="t3-fn4"><label>c</label><p>Gender, age at diagnosis, time period at diagnosis, tumour size and microscopic tumour necrosis were not significant prognostic factors.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tbl4"><label>Table 4</label><caption><title>Local relapse and primary radiotherapy in patients offered surgery</title></caption><table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col><col align="char" char="("></col><col align="char" char="("></col><col align="char" char="."></col></colgroup><thead valign="bottom"><tr><th align="left" valign="top" charoff="50"> </th><th align="char" valign="top" char="(" charoff="50"><bold>RIS<xref ref-type="fn" rid="t4-fn1">a</xref></bold></th><th align="char" valign="top" char="(" charoff="50"><bold>Controls<xref ref-type="fn" rid="t4-fn2">b</xref></bold></th><th align="char" valign="top" char="." charoff="50"> </th></tr><tr><th align="left" valign="top" charoff="50"><bold>Characteristics</bold></th><th align="char" valign="top" char="(" charoff="50"><bold><italic>n</italic>=98</bold></th><th align="char" valign="top" char="(" charoff="50"><bold><italic>n</italic>=239</bold></th><th align="char" valign="top" char="." charoff="50"><bold><italic>P</italic>-value</bold></th></tr></thead><tbody valign="top"><tr><td align="left" valign="top" charoff="50">Surgery performed</td><td align="char" valign="top" char="(" charoff="50">70/98 (71%)</td><td align="char" valign="top" char="(" charoff="50">215/239 (90%)</td><td align="char" valign="top" char="." charoff="50"><0.001</td></tr><tr><td align="left" valign="top" charoff="50">Positive margins in operated patients</td><td align="char" valign="top" char="(" charoff="50">25/70 (36%)</td><td align="char" valign="top" char="(" charoff="50">40/215 (19%)</td><td align="char" valign="top" char="." charoff="50">0.003</td></tr><tr><td align="left" valign="top" charoff="50">Local relapse in patients with positive margins</td><td align="char" valign="top" char="(" charoff="50">18/25 (72%)</td><td align="char" valign="top" char="(" charoff="50">13/40 (33%)</td><td align="char" valign="top" char="." charoff="50">0.002</td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="4" align="left" valign="top" charoff="50"><italic>Radiotherapy</italic></td></tr><tr><td align="left" valign="top" charoff="50"> - In patients with positive margins</td><td align="char" valign="top" char="(" charoff="50">8/25 (32%)</td><td align="char" valign="top" char="(" charoff="50">21/40 (53%)</td><td align="char" valign="top" char="." charoff="50">0.106</td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="4" align="left" valign="top" charoff="50"><italic>Local relapse</italic></td></tr><tr><td align="left" valign="top" charoff="50"> - In patients with positive margins and treatment with radiotherapy</td><td align="char" valign="top" char="(" charoff="50">4/8 (50%)</td><td align="char" valign="top" char="(" charoff="50">7/21 (33%)</td><td align="char" valign="top" char="." charoff="50">0.433</td></tr><tr><td align="left" valign="top" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="(" charoff="50"> </td><td align="char" valign="top" char="." charoff="50"> </td></tr><tr><td colspan="4" align="left" valign="top" charoff="50"><italic>Local relapse</italic></td></tr><tr><td align="left" valign="top" charoff="50"> - In patients with positive margins and no radiotherapy</td><td align="char" valign="top" char="(" charoff="50">14/17 (82%)</td><td align="char" valign="top" char="(" charoff="50">6/19 (32%)</td><td align="char" valign="top" char="." charoff="50">0.003</td></tr></tbody></table><table-wrap-foot><fn id="t4-fn1"><label>a</label><p>RIS=radiation-induced sarcoma.</p></fn><fn id="t4-fn2"><label>b</label><p>Controls=sporadic sarcoma.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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