2303 Long-term outcome of combined modality therapy for soft-tissue sarcomas and the prognostic validity of the 1998 AJCC stage groupings

Abstract Combined modality therapy with radiation and chemotherapy has been the standard treatment for limited-stage HL. Long-term toxicities, including cardiac and disease and secondary cancers, s have been reported in multiple series with long follow-up. Lower doses and smaller fields may be less toxic, but mediastinal/cardiac radiation is unavoidable in most cases. The Dana-Farber Cancer Institute and Massachusetts General Hospital lymphoma teams have now treated 74 patients with localized, non-bulky classical HL with chemotherapy as the only therapy. The median age of the series was 29 years (17–42). The M/F ratio was 33/41. The clinical stages were IA (10), IIA (56), IIB (9). The treatment consisted of ABVD × 6 cycles (70 pts), ABVD × 4 cycles (3 pts), and variants of ABVD (2 pts). The median F/U is 48+ months (4+–174+). One patient had primary refractory disease. Seven patients (median age 30, range 20–38) have relapsed (6, 10, 10, 11, 14, 20 and 63 months) whose original stage was IA (1), IIA (3), IIB (3). The progression-free survival at 4 years is 91%. All patients are alive. Six of seven patients received salvage RT and autologous stem cell transplantation, and only one has relapsed to date. In retrospect, all seven patients who relapsed from CR or CRu were FDG-PET negative at mid-cycle. Thus far, there has been no long-term, chemotherapy-related toxicity in the patients who remain in remission. 94% (62/66) asymptomatic patients remain in remission compared to 6/9 (67%) IIB patients. Conclusion: In young adults with non-bulky, localized HL chemotherapy alone with ABVD can achieve excellent progression-free and overall survival, especially those asymptomatic at diagnosis. These data and previously published results indicate an equivalent long-term outcome when compared to combined modality trials but without the long-term risks of radiation therapy. Avoidance of radiation therapy may be even more important in the pediatric age group.

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EP-1607 Preoperative Radiation Therapy and IORT in Retroperitoneal Soft Tissue Sarcomas. Long Term Outcome

Radiotherapy and Oncology ◽

10.1016/s0167-8140(19)32027-4 ◽

2019 ◽

Vol 133 ◽

pp. S866

Author(s):

F. Navarria ◽

S. Basso ◽

E. Palazzari ◽

R. Innocente ◽

A. Lauretta ◽

...

Keyword(s):

Radiation Therapy ◽

Soft Tissue ◽

Soft Tissue Sarcomas ◽

Preoperative Radiation ◽

Term Outcome ◽

Long Term Outcome ◽

Preoperative Radiation Therapy

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Long-Term Outcome of Patients With American Joint Committee on Cancer Stage IIB Extremity Soft Tissue Sarcomas

Journal of Clinical Oncology ◽

10.1200/jco.1999.17.9.2772 ◽

1999 ◽

Vol 17 (9) ◽

pp. 2772-2772 ◽

Cited By ~ 42

Author(s):

Jason B. Fleming ◽

Russell S. Berman ◽

Su-Chun Cheng ◽

Nancy P. Chen ◽

Kelly K. Hunt ◽

...

Keyword(s):

Soft Tissue ◽

Local Recurrence ◽

Soft Tissue Sarcomas ◽

Cancer Stage ◽

High Grade ◽

Term Outcome ◽

Long Term Outcome ◽

Adjuvant Therapies ◽

Disease Free

PURPOSE: It has been suggested that patients with small (< 5 cm), high-grade extremity soft tissue sarcomas (STS) have an excellent overall prognosis and, consequently, may not require adjuvant therapies. PATIENTS AND METHODS: A comprehensive review of all patients with extremity STS treated at a tertiary care cancer hospital over a 9-year period (January 1984 to December 1992) was performed. Prognostic factors, treatment data, and long-term outcome were evaluated in the subset of 111 patients with American Joint Committee on Cancer stage IIB (G3/4, T1a/b) disease. RESULTS: The median tumor size was 3.0 cm (range, 0.6 to 4.9 cm), and 55 tumors (50%) were deep in location. All patients underwent surgical resection; 68 (61%) received pre- or postoperative radiotherapy, and 32 (29%) received doxorubicin-based chemotherapy. The median follow-up was 76 months. Forty patients (36%) experienced 59 recurrences. First recurrences occurred at local, regional, and distant sites in 21, five, and 14 patients, respectively. The 5-year actuarial local recurrence-free, distant recurrence-free, disease-free, and overall survival rates were 82%, 83%, 68%, and 83%, respectively. The presence of a microscopically positive surgical margin was an independent adverse prognostic factor for both local recurrence (relative risk [RR] = 3.75; 95% confidence interval [CI], 1.25 to 11.25; P = .02) and disease-free survival (RR = 2.57; 95% CI, 1.33 to 4.98; P = .005). CONCLUSION: Event-free outcome for this subset of patients with high-grade STS does not seem as favorable as previously reported by other investigators. Patients who undergo maximal surgical resection with microscopically positive margins represent a subset of T1 STS patients who warrant consideration for adjuvant therapies.

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