Cryoablation and Resection Influences Patient Survival for Soft Tissue Sarcomas: Impact on Survivorship and Local Recurrence

: Myxofibrosarcoma is one of the most common soft tissue sarcomas in the elderly. It is characterized by an extremely high rate of local recurrence, higher than other soft tissue tumors, and a relatively low risk of distant metastases.Magnetic resonance imaging (MRI) is the imaging modality of choice for the assessment of myxofibrosarcoma and plays a key role in the preoperative setting of these patients.MRI features associated with high risk of local recurrence are: high myxoid matrix content (water-like appearance of the lesions), high grade of contrast enhancement, presence of an infiltrative pattern (“tail sign”). On the other hand, MRI features associated with worse sarcoma specific survival are: large size of the lesion, deep location, high grade of contrast enhancement. Recognizing the above-mentioned imaging features of myxofibrosarcoma may be helpful to stratify the risk for local recurrence and disease-specific survival. Moreover, the surgical planning should be adjusted according to the MRI features

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Is local recurrence in bone and soft tissue sarcomas just a local recurrence or does it impact the overall survival, retrospective cohort from a sarcoma referral center

Journal of Surgical Oncology ◽

10.1002/jso.26663 ◽

2021 ◽

Author(s):

Obada Hasan ◽

Momin Nasir ◽

Muneeba Jessar ◽

Mustafa Hashimi ◽

Qiang An ◽

...

Keyword(s):

Overall Survival ◽

Soft Tissue ◽

Local Recurrence ◽

Retrospective Cohort ◽

Soft Tissue Sarcomas ◽

Referral Center ◽

It Impact

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The Therapeutic Approach of Soft – Tissue Sarcomas. A 12 Cases Analysis

Romanian Journal of Orthopaedic Surgery and Traumatology ◽

10.2478/rojost-2018-0069 ◽

2018 ◽

Vol 1 (Supplement) ◽

pp. 58

Author(s):

V. Georgeanu ◽

T. Atasiei ◽

D. Gartonea ◽

B. Shazam ◽

G. Goleşteanu ◽

...

Keyword(s):

Soft Tissue ◽

Local Recurrence ◽

Synovial Sarcoma ◽

Therapeutic Approach ◽

Clear Cell ◽

Postoperative Radiotherapy ◽

Soft Tissue Sarcomas ◽

Clear Cell Sarcoma ◽

Cell Sarcoma ◽

Special Cases

Abstract Introduction. Soft Tissue Sarcomas (STS) is a group of rare malignant tumors with mesenchymal tissue origin. At present, over 50 histopathological types with typical chromosome changes are described. Treatment is multidisciplinary, centered on the surgical approach. Method. Between 2014 and 2016, 12 STS cases were treated in our clinic: 3 liposarcomas, 2 synovial sarcomas, 1 angiosarcoma, 2 rhabdomyosarcomas, 2 myxofibrosarcomas, 1 fibroblast sarcoma and 1 clear cell sarcoma. With the exception of angiosarcoma that benefited only from chemotherapy, the other cases were surgically approached, followed by radiotherapy in 7 cases, and chemotherapy in one case. Results. Patient follow-up was for a minimum of 2 years. In 3 cases (fibroblast sarcoma, clear-cell sarcoma, synovial sarcoma), a local recurrence occurred between 3 and 9 months. In 2 cases (fibroblastic sarcoma, synovial sarcoma), pulmonary metastases occurred between 6 and 18 months and the patients died at 8 months and 2 years respectively. The rest of the cases were clinically and imagistically assessed (local MRI, lung CT) at 6 months for at least 2 years and showed no signs of local recurrence or metastasis. Conclusions. The evolution of STS depends on the histological type and to the stage of diagnosis (local extension, degree of differentiation and presence of metastases). Therapeutic approach should be centered on an accurate resection, within the limits of oncological safety even with re-resection. Postoperative radiotherapy is used in most of the cases, and chemotherapy is reserved for special cases with unfavorable local evolution or metastasis.

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Treatment-Induced Pathologic Necrosis: A Predictor of Local Recurrence and Survival in Patients Receiving Neoadjuvant Therapy for High-Grade Extremity Soft Tissue Sarcomas

Journal of Clinical Oncology ◽

10.1200/jco.2001.19.13.3203 ◽

2001 ◽

Vol 19 (13) ◽

pp. 3203-3209 ◽

Cited By ~ 218

Author(s):

Fritz C. Eilber ◽

Gerald Rosen ◽

Jeffery Eckardt ◽

Charles Forscher ◽

Scott D. Nelson ◽

...

Keyword(s):

Overall Survival ◽

Soft Tissue ◽

Local Recurrence ◽

Neoadjuvant Therapy ◽

Independent Predictor ◽

Survival Rates ◽

Soft Tissue Sarcomas ◽

High Grade ◽

Recurrence Rates ◽

Pathologic Assessment

PURPOSE: To determine whether treatment-induced pathologic necrosis correlates with local recurrence and overall survival in patients who receive neoadjuvant therapy for high-grade extremity soft tissue sarcomas. PATIENTS AND METHODS: Four hundred ninety-six patients with intermediate- to high-grade extremity soft tissue sarcomas received protocol neoadjuvant therapy. All patients underwent surgical resection after neoadjuvant therapy and had pathologic assessment of tumor necrosis in the resected specimens. RESULTS: The 5- and 10-year local recurrence rates for patients with ≥ 95% pathologic necrosis were significantly lower (6% and 11%, respectively) than the local recurrence rates for patients with less than 95% pathologic necrosis (17% and 23%, respectively). The 5- and 10-year survival rates for the patients with ≥ 95% pathologic necrosis were significantly higher (80% and 71%, respectively) than the survival rates for the patients with less than 95% pathologic necrosis (62% and 55%, respectively). Patients with less than 95% pathologic necrosis were 2.51 times more likely to develop a local recurrence and 1.86 times more likely to die of their disease as compared with patients with ≥ 95% pathologic necrosis. The percentage of patients who achieved ≥ 95% pathologic necrosis increased to 48% with the addition of ifosfamide as compared with 13% of the patients in all the other protocols combined. CONCLUSION: Treatment-induced pathologic necrosis is an independent predictor of both local recurrence and overall survival in patients who receive neoadjuvant therapy for high-grade extremity soft tissue sarcomas. A complete pathologic response (≥ 95% pathologic necrosis) correlated with a significantly lower rate of local recurrence and improved overall survival.

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Radiotherapy of Soft Tissue Sarcomas

Tumori Journal ◽

10.1177/030089167005600505 ◽

1970 ◽

Vol 56 (5) ◽

pp. 297-310

Author(s):

Giovanni Crema ◽

Bruno Damascelli ◽

Renato Musumeci ◽

Carlo Uslenghi

Keyword(s):

Soft Tissue ◽

Patient Survival ◽

Radical Surgery ◽

Postoperative Radiotherapy ◽

Soft Tissue Sarcomas ◽

Lower Limbs ◽

Histologic Type ◽

Complementary Treatment ◽

Histologic Types ◽

First Time

This review series comprises 245 patients with soft tissue sarcomas of various sites and histologic types observed at this Institute between 1928 and 1966. 132 patients were men (54.2%) and 113 women (45.8%). Fibrosarcomas accounted for the largest number of cases (161 cases - 65.5%), followed by undifferentiated sarcomas (36 cases). Other histologic types accounted for a smaller number of cases. As to the site of the primary tumor, the lower limbs accounted for 32.2% and the abdomen for 26.5% of the cases. 152 of the 245 patients attended for the first time and 93 presented recurrences of the tumor sometime after receiving surgical treatment and/or radiotherapy elsewhere. 159/245 cases were subjected at this Institute to designedly radical surgery followed by postoperative radiotherapy by various techniques. In the remaining 86 cases, in which surgery was either not indicated or not possible because of the patients’ local or general condition, radiotherapy only was given, where possible curative. Radium was used in 97 cases almost always as complementary treatment in superficial tumors that had developed mainly towards the surface and been removed surgically either radically or as radically as conditions allowed. The therapeutic techniques and results are discussed in relation to patient survival by histologic type and to failures and recurrences.

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