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December 1993

Management of Small Soft-Tissue Sarcoma of the Extremity in Adults

Author Affiliations

Los Angeles, Calif

Arch Surg. 1993;128(12):1399. doi:10.1001/archsurg.1993.01420240107020

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I am writing in regard to the article by Geer et al,1 published in the November 1992 issue of the Archives. This article has been used by clinicians to suggest that postoperative irradiation might not be appropriate in high-grade soft-tissue sarcomas of the extremity in adults.

It is the responsibility of the Archives to ensure that articles published do not lead to unjustified changes in treatment protocol. Owing to the fact that the tabulated data in the article do not compare high-grade tumors undergoing irradiation with high-grade tumors that do not, the conclusions stated in the article and in the abstract are misleading and run counter to previous evidence supporting radiation treatment for sarcomas of the head and neck.2

The authors instead tabulate and graph survival curves of tumors with and without postoperative irradiation and claim no significant difference, but this does not address the efficacy of irradiation

Geer RJ, Woodruff J, Casper ES, Brennan MF.  Management of small soft-tissue sarcoma of the extremity in adults . Arch Surg . 1992;127:1285-1289.Article
Tran LM, Mark R, Meier R, Calcaterra TC, Parker RG.  Sarcomas of the head and neck: prognostic factors and treatment stategies . Cancer . 1992;70:169-176.Article