Thank you for allowing me to comment on the letter by Frankel. The other authors and I are unaware that clinicians have used our report to suggest that postoperative irradiation might not be appropriate in high-grade soft-tissue sarcoma of the extremities in adults. In fact, our group has demonstrated in a prospective randomized study that there is a value in adjuvant brachytherapy in limiting local recurrence of soft-tissue sarcoma.1
What our present report describes is our experience in terms of local and systemic recurrence in patients with small (smaller than 5 cm) primary (ie, not previously treated) soft-tissue sarcoma of the extremity. Historically, such patients with high-grade lesions (smaller than 5 cm) would be included in the American Joint Committee on Cancer stage III group. The implication is that survival in this patient group would be approximately 30% at 5 years. What the present article demonstrates is
Brennan MF. Management of Small Soft-Tissue Sarcoma of the Extremity in Adults-Reply. Arch Surg. 1993;128(12):1399. doi:10.1001/archsurg.1993.01420240107021
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