Objective: The authors identified prognostic factors relevant to clinical outcomes (especially survival) in truncal and retroperitoneal soft tissue sarcoma. Summary Background Data: These results can be used to optimize surgical management and select patients most likely to benefit from novel therapeutic strategies in future trials. Methods: A retrospective analysis was performed of a prospectively compiled database of 183 consecutive patients with truncal and retroperitoneal sarcomas seen at the Brigham and Women's Hospital and the Dana Farber Cancer Institute between 1970 to 1994. Conclusions: The histologic grade and the margin of resection are prognostic for survival in both truncal and retroperitoneal soft tissue sarcoma. Tumor size was an independent prognostic factor for truncal sarcoma, but not for retroperitoneal sarcoma. Postoperative adjuvant radiation was beneficial to overall survival for truncal sarcoma. In this series of patients receiving a heterogeneous mixture of chemotherapeutic regimens either as preoperative 'neoadjuvant' therapy or as postoperative 'adjuvant' therapy, there were no beneficial effects on survival compared with nonrandomized patients not receiving chemotherapy.