Long-term recurrence of soft tissue sarcomas: Prognostic factors and implications for prolonged follow-up

In this retrospective study, we analysed the long-term oncological and functional results after extended ray resection for sarcoma of the hand. Recurrence-free and overall survivals were calculated using the Kaplan–Meier method. The function of the operated hand was assessed with the Michigan Hand Questionnaire and compared with the contralateral side. Extended ray resection was performed in 25 out of 168 consecutive patients with soft-tissue and bony sarcomas of the hand. The overall 5- and 10-year, disease-specific survival rates were 86% and 81%, respectively. Local recurrences were observed in two patients. The Michigan Hand Questionnaire score for the affected hand at follow-up in nine patients was 82 points versus 95 for the healthy contralateral hands. We conclude that extended ray resection of osseous sarcomas breaking through the bone into the soft tissue or for soft tissue sarcomas invading bone is a preferable alternative to hand ablation when excision can be achieved with tumour-free margins. Level of evidence: III

Download Full-text

Long-term follow-up of patients treated with neoadjuvant chemotherapy and radiotherapy for large, extremity soft tissue sarcomas

Cancer ◽

10.1002/cncr.26696 ◽

2011 ◽

Vol 118 (15) ◽

pp. 3758-3765 ◽

Cited By ~ 52

Author(s):

John T. Mullen ◽

Wendy Kobayashi ◽

Jing Jing Wang ◽

David C. Harmon ◽

Edwin Choy ◽

...

Keyword(s):

Soft Tissue ◽

Neoadjuvant Chemotherapy ◽

Soft Tissue Sarcomas ◽

Long Term Follow Up

Download Full-text

Prognostic Factors in Extremity Soft Tissue Sarcoma Patients Treated with Preoperative Radiotherapy

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol04-i03/579 ◽

2019 ◽

Vol 4 (03) ◽

Author(s):

Berrin Inanc, MD ◽

Kubilay Inanc, MD

Keyword(s):

Prognostic Factors ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Preoperative Radiotherapy ◽

Soft Tissue Sarcomas ◽

Tumor Grade ◽

Metastatic Recurrence ◽

Extremity Soft Tissue Sarcoma ◽

Metastatic Relapse

Purpose: The purpose of the study was to investigate the prognostic factors and survival after preoperative radiotherapy in Extremity Soft Tissue Sarcomas (ESTS). Materials and Methods: In this retrospective study, all patients treated for an extremity sarcoma with pre-operative radiotherapy followed by surgery. Results: The mean follow-up for all 24 ESTS patients was 15.5 (range: 10-39 months). At last follow-up, 9 patients (37%) were alive, 15 patients (62%) had died of distant disease progression. Among the patients died, there were 15 with metastatic relapse (13 lung and 2 cranial metastasis), 5 with both local and metastatic recurrence. The median OS was 16 month. The 2-years actuarial OS rate and 3-years OS rate were 39% and 26%, respectively. The median RFS was 14(12.5-15.4) month. The 2-years and 3-years RFS rate was 71%.The median MFS was 12 months. The 2-years and 3-years MFS rate were 33%, 17%, respectively. The effects of age, sex, histopathologic type, tumor size, tumor localization, tumor grade, tumor depth, radiation doses and recestion margin on OS, RFS, MFS were not observed. In univariate and multivariate model, it was observed that recurrence decreased OS time significantly (p<0.05). Conclusion: Recurrens and metastasis are strong and negative prognostic factor for survival in extremity soft tissue sarcoma patients.

Download Full-text

Long-Term Follow-Up of Patients Receiving Neoadjuvant Treatment Modalties for Soft Tissue Sarcomas of the Extremities

Cancers ◽

10.3390/cancers13205244 ◽

2021 ◽

Vol 13 (20) ◽

pp. 5244

Author(s):

Miriam Rauch ◽

Abbas Agaimy ◽

Sabine Semrau ◽

Alexander Willner ◽

Oliver Ott ◽

...

Keyword(s):

High Risk ◽

Soft Tissue ◽

Neoadjuvant Therapy ◽

Neoadjuvant Treatment ◽

Soft Tissue Sarcomas ◽

Disease Free Survival ◽

Treatment Modalities ◽

Free Survival

Background: Neoadjuvant treatment modalities in soft tissue sarcoma (STS) of the extremities have become more popular in recent years, but because of the rarity and heterogeneity of STS, there are yet few studies on the long-term impact of neoadjuvant treatment modalities, especially in terms of neoadjuvant radiochemotherapy. Methods: The study enrolled 136 patients with primary STS of the extremities who underwent surgery with curative intent or neoadjuvant therapy, followed by surgery in a 15-year period. Neoadjuvant treatment consisted of radiotherapy (RT) with 60 Gy and in most cases simultaneous chemotherapy (CTx) with ifosfamide (1.5 g/m2/d, d1–5, q28) and doxorubicine (50 mg/m2/d, d3, q28). We investigated the clinical, (post)-operative and histopathological data and the oncological follow-up as well. The median follow-up period was 82 months (range 6–202). Results: A total of 136 patients (M:F = 73:63) with a mean age of 62 years (range; 21–93) was observed. Seventy-four patients (54.4%) received neoadjuvant therapy (NT), 62 patients (45.6%) received primary surgery (PS). When receiving NT, patients with high-risk STS had a lower risk to develop distant metastasis (p = 0.025). Age, histological type, tumor size and surgical margins (R0 vs. R1) had no influence on any survival rates. There was an association between NT and the occurrence of postoperative complications (p = 0.001). The 5-year local recurrence free survival (LRFS), metastasis free survival (MFS), disease free survival (DFS) and overall survival (OS) rate of the whole cohort was 89.9%, 77.0%, 70.6% and 72.6%; whereas the 5-year LRFS, MFS, DFS and OS rate was 90.5%, 67.2%, 64.1% and 62.8% for the NT group and 89.5%, 88.3%. 78.4% and 83.8% for the PS group. Conclusion: Multimodal treatment strategies in patients with STS of extremities lead to excellent oncological outcomes. Patients with high-risk STS had a significantly better MFS when receiving NT than patients with low-risk STS. NT was associated with a higher probability of postoperative but well-manageable complications.

Download Full-text

Short, full-dose adjuvant chemotherapy (CT) in high-risk adult soft tissue sarcomas (STS): Long-term follow-up of a randomized clinical trial from the Italian Sarcoma Group and the Spanish Sarcoma Group.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.15_suppl.11045 ◽

2016 ◽

Vol 34 (15_suppl) ◽

pp. 11045-11045

Author(s):

Elena Palassini ◽

Stefano Ferrari ◽

Javier Martin Broto ◽

Paolo Verderio ◽

Antonio Lopez-Pousa ◽

...

Keyword(s):

Clinical Trial ◽

High Risk ◽

Adjuvant Chemotherapy ◽

Soft Tissue ◽

Randomized Clinical Trial ◽

Soft Tissue Sarcomas ◽

Full Dose ◽

Long Term Follow Up

Download Full-text

Short, full-dose adjuvant chemotherapy (CT) in high-risk adult soft tissue sarcomas (STS): long-term follow-up of a randomized clinical trial from the Italian Sarcoma Group and the Spanish Sarcoma Group

Annals of Oncology ◽

10.1093/annonc/mdw430 ◽

2016 ◽

Vol 27 (12) ◽

pp. 2283-2288 ◽

Cited By ~ 51

Author(s):

A. Gronchi ◽

S. Stacchiotti ◽

P. Verderio ◽

S. Ferrari ◽

J. Martin Broto ◽

...

Keyword(s):

Clinical Trial ◽

High Risk ◽

Adjuvant Chemotherapy ◽

Soft Tissue ◽

Randomized Clinical Trial ◽

Soft Tissue Sarcomas ◽

Full Dose ◽

Long Term Follow Up

Download Full-text

LONG-TERM RESULTS OF EXTREMITY SOFT TISSUE SARCOMAS LIMB-SPARING SURGERY AND RADIOTHERAPY

Acta Ortopédica Brasileira ◽

10.1590/1413-785220192704217574 ◽

2019 ◽

Vol 27 (4) ◽

pp. 207-211

Author(s):

Özlem Yetmen Dogan ◽

Didem Çolpan Oksuz ◽

Banu Atalar ◽

Fazilet Oner Dincbas

Keyword(s):

Prognostic Factors ◽

Soft Tissue ◽

Postoperative Radiotherapy ◽

Survival Rates ◽

Soft Tissue Sarcomas ◽

Disease Free Survival ◽

Long Term Results ◽

Level Of Evidence ◽

Actuarial Survival

ABSTRACT Objective: To assess the prognostic factors and results of limb sparing surgery and postoperative radiotherapy (PORT) in patients with non-metastatic soft tissue sarcomas (STS) of the extremities. Methods: Between 1980-2007, 114 extremity-located STS treated with PORT were analyzed retrospectively. Tumors were mostly localized in the lower extremities (71,9%). The median radiotherapy (RT) dose was 60.9 Gy. Chemotherapy was administered to 37.7% of the patients. Tumor sizes were between 3-26 cm (median 7 cm). The three most frequent histological types included undifferentiated pleomorphic sarcoma (26.3%), liposarcoma (25.4%), and synovial sarcoma (13.2%). The median follow-up for all patients was 60 months, and 81 months for survivors. Results: The 5- and 10-year local control (LC) rates were 77% and 70.4%, respectively; actuarial survival rates for 5 and 10 years were 71.8% and 69.1%, respectively. Increasing the dose above 60 Gy for all patients and the patients with positive margins demonstrated a clear benefit on 5-year LC (p=0.03 and p=0.04, respectively). Based on multivariate analysis, the addition of chemotherapy and RT dose were independent prognostic factors for LC. A recurrent presentation significantly affects the disease-free survival. Conclusions: PORT for STS of the extremities provides good long-term disease control with acceptable toxicity in a multidisciplinary approach. Level of evidence III, Retrospective study.

Download Full-text