Impact of Recurrence on Survival Prognosis and Key Risk Factors in Myxofibrosarcoma: A Single-Center Retrospective Study.

Objective: Myxofibrosarcoma (MFS) is a rare malignant fibrogenic soft tissue tumor with high propensity for recurrence. This study retrospectively analyzed the surgical treatment outcomes of patients with myxofibrosarcoma (MFS) at a single center to evaluate the impact of recurrence on survival prognosis. Methods: Clinical data from 80 patients who underwent surgical treatment for MFS between January 2015 and January 2023 were reviewed retrospectively. Postoperative follow-up was conducted to assess recurrence and overall survival. Kaplan-Meier survival analysis was used to estimate overall survival (OS) and compare survival curves. Patients were stratified into recurrence and recurrence-free groups based on recurrence status. Oncological prognosis, prognostic factors influencing survival and recurrence, and the association between recurrence and survival prognosis were examined. Results: Over a median follow-up period of 40.6 months, recurrence was observed in 38 patients (47.5%), including 16 patients with multiple recurrences. A total of 17 patients (21.3%) died, and the 5-year OS rate was 70.1%. Independent prognostic factors for OS included age, tumor size, and chemotherapy. The presence of a tumor adjacent to a major vessel or nerve, as well as involvement of the upper extremity, were identified as independent risk factors for recurrence. No statistically significant differences in survival prognosis were observed between patients with and without recurrence. Additionally, survival outcomes did not differ significantly between patients with a single recurrence and those with multiple recurrences. Conclusion: MFS exhibits a high recurrence rate, with multiple recurrences frequently occurring within three years postoperatively. However, both single and multiple recurrences, when managed with aggressive surgical intervention, may not had an adverse effect on overall survival. For tumors located near major vessels or nerves, achieving complete surgical resection and maintaining vigilant postoperative surveillance are essential to mitigate the risk of recurrence.