Background and purpose: High-grade soft tissue sarcomas are a series of life-threatening malignant tumors. This study aimed to share our ten-year clinical experience in treating high-grade soft tissue sarcoma to identify prognostic factors and probe further into the appropriate therapeutic strategies. Methods: We retrospectively reviewed the clinical features and outcome of 473 patients with high-grade soft tissue sarcoma treated at Musculoskeletal Tumor Center of Peking University People’s Hospital from July 2000 to July 2014. The patients were followed-up and their clinical characteristics were analyzed. Results: Four hundred patients received limb salvages. One hundred and three patients developed local recurrence while 148 patients had evidence of distal metastases in lung or other bones. 419 (88.58%) patients received tumor resection with wide margin. Three hundred and seventy patients had adjuvant chemotherapies while 153 patients had radiation. The mean follow-up time was 46.9 months (ranging from 8 to 127 months). The 3-year

5-year and 10-year overall survival rates were 82.6%

69.0% and 58.7% respectively. The statistical analysis showed histologic subtype

chemotherapy and distant metastasis had significant relevance to prognosis. Conclusion: All the patients with high risk should receive adjuvant treatments

which have been demonstrated to contribute to overall survival improvements. Radiotherapy is helpful with local control

while chemotherapy is conducive to reduce metastatic risk.