BLOOD SUPPLY FEATURES OF SOFT TISSUE SARCOMAS OF THE EXTREMITIES

Surgical removal of tumor remains the only one radical treatment for patients with soft tissue sarcomas of the extremities. However, the parameters of total and disease-free survival after this type of treatment cannot be considered satisfactory. Currently the active search and introduction into clinical practice of additional impact methods that can improve the immediate and long-term results of treatment of such patients is being conducted. In the article there are presented results of the analysis of preoperative angiographic studies of 94 patients with primary and recurrent sarcomas of soft tissues of the extremities. The features of blood supply and internal angioarchitectonics of tumor were revealed depending on the size, histological type and localization. The features of blood supply of tumors in patients with primary and recurrent sarcomas of soft tissues of extremities were described in detail. The results of further surgical treatment of patients included in the study showed that information on the number and size of blood supply sources of the tumor zone, supplemented by selective embolization of vessels, made it possible to select the optimal plan and minimize trauma, reduce intraoperative hemorrhage, and perform organ-preserving and functionally beneficial operations.

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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.

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RESULTS OF TREATMENT OF LOCALLY RECURRING SOFT TISSUES SARCOMAS OF EXTREMITIES

Problems in oncology ◽

10.37469/0507-3758-2018-64-3-408-413 ◽

2018 ◽

Vol 64 (3) ◽

pp. 408-413

Author(s):

Grigoriy Zinovev ◽

Georgiy Gafton ◽

Sergey Novikov ◽

Ivan Gafton ◽

Yekaterina Busko ◽

...

Keyword(s):

Radiation Therapy ◽

Soft Tissues ◽

Cox Regression ◽

Disease Free Survival ◽

Tumor Location ◽

Long Term Results ◽

Clinical Feature ◽

National Medical ◽

Results Of Treatment ◽

Kaplan Meier

Background: The most striking clinical feature of soft tissues sarcomas (STS) is their ability to recur. At present disputes about the clinical and morphological factors of STS recurrence such as the degree of malignancy, size, location, depth of tumor location, patient’s age and the presence of previous relapses in the anamnesis do not subside. It also requires clarification of the effect of the volume of tissues removed on the long-term results of treatment of STS as well as indications for the application of various regimes of remote radiation therapy. Materials and methods: Of 1802 registered cases of STS of extremities at the N.N. Petrov National Medical Research Center of Oncology from 2004 to 2016 there were selected data on 213 patients who suffered from at least one relapse of the disease. There was performed an assessment of overall, non-metastatic and disease-free survival using a single-factor (the Kaplan-Meier method) and multivariate analysis (the Cox regression model). Conclusion: The detection of various prognostic factors of locally recurrent STS allows determining the necessary treatment tactics (the vastness and traumatism of surgery and the advisability of radiation therapy).

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Re-excision after unplanned excision of soft tissue sarcomas: Long-term results

Surgical Oncology ◽

10.1016/j.suronc.2020.04.026 ◽

2020 ◽

Vol 34 ◽

pp. 212-217

Author(s):

Guido Scoccianti ◽

Matteo Innocenti ◽

Filippo Frenos ◽

Francesco Muratori ◽

Federico Sacchetti ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcomas ◽

Long Term Results ◽

Unplanned Excision

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Long-term Results following Postoperative Radiotherapy for Soft Tissue Sarcomas of the Extremity

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2010.07.1432 ◽

2010 ◽

Vol 78 (3) ◽

pp. S615-S616

Author(s):

L.A. McGee ◽

R. Dagan ◽

C.G. Morris ◽

J. Knapik ◽

J. Reith ◽

...

Keyword(s):

Soft Tissue ◽

Postoperative Radiotherapy ◽

Soft Tissue Sarcomas ◽

Long Term Results

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Immediate results of electrochemotherapy for malignant tumors of the skin and soft tissues, cutaneous and subcutaneous metastases of melanoma

Oncologia i radiologia Kazakhstana ◽

10.52532/2521-6414-2020-2-56-31-34 ◽

2020 ◽

Vol 56 (2) ◽

pp. 31-34

Author(s):

D. A. Tuleuova ◽

G. A. Serikbaev ◽

A. K. Kurmanaliev ◽

J. U. Pysanova ◽

Sh. P. Najibulo ◽

...

Keyword(s):

Skin Cancer ◽

Soft Tissue ◽

Malignant Tumors ◽

Cell Membrane Permeability ◽

Long Term Results ◽

Temporary Increase ◽

Surgical Removal ◽

Term Survival ◽

Subcutaneous Metastases

Relevance: Surgical removal of locally advanced forms of skin cancer and multiple cutaneous and subcutaneous metastases of melanoma does not always provide satisfactory aesthetic, functional, and long-term results. The treatment outcomes depend on the size, shape, location, and some other characteristics of the tumor. The relapse rate after surgical removal of locally advanced skin cancer is 12.5-34%, and the long-term survival of patients with cutaneous and subcutaneous metastases of melanoma does not exceed 30%. Cutaneous and subcutaneous metastases of melanoma and some superficial tumors are usually initially inoperable. Their complications such as bleeding, infection, pain, and pitting cause serious clinical problems and often require local therapy even at the 4th stage of the disease. Electrochemotherapy (ECT) is one of the modern treatment methods for skin cancer, soft tissue sarcoma, and metastatic melanoma. ECT is a treatment of choice in the presence of contraindications to surgical and radiation therapy. ECT combines the physical properties of current-induced electroporation with the chemical properties of chemotherapeutic drugs. In this method, an electric current affecting the tissue causes a temporary increase in cell membrane permeability, thereby providing free access to the cell of large molecules, including cytostatics, which are not initially transferred to the cytosol. This significantly increases the potential toxicity of cytostatics. The purpose of this study was to demonstrate the immediate results of ECT in patients with malignant tumors of the skin, soft tissue, cutaneous, and subcutaneous melanoma metastases. Results: Since 2017, 27 patients were treated by ECT at the Centre for bone and soft tissue tumors and melanomas of Kazakh Institute of Oncology and Radiology (Almaty, Kazakhstan). After two months, 67% of patients had a complete response (CR), 26% – a partial response (PR), and 7% had progression of the tumor. Side effects included local edema (n=13, 40%) which independently disappeared within several days to 2 weeks, local pains (12%) which disappeared within six months after treatment in 3% and within a month in 11% of patients, and hyperthermia in the early postoperative period in 6% of patients which was stopped within 10-15 min after the procedure

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Long-term Results With Resection of Radiation-Induced Soft Tissue Sarcomas

Annals of Surgery ◽

10.1097/01.sla.0000128686.51815.8b ◽

2004 ◽

Vol 239 (6) ◽

pp. 903-910 ◽

Cited By ~ 112

Author(s):

Charles Cha ◽

Christina R. Antonescu ◽

May Lynn Quan ◽

Sandip Maru ◽

Murray F. Brennan

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcomas ◽

Long Term Results ◽

Radiation Induced

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Apatinib with doxorubicin and ifosfamide as neoadjuvant therapy for high-risk soft tissue sarcomas: a retrospective cohort study

Investigational New Drugs ◽

10.1007/s10637-021-01139-w ◽

2021 ◽

Author(s):

Zhichao Tian ◽

Jiaqiang Wang ◽

Jinpo Yang ◽

Peng Zhang ◽

Xin Wang ◽

...

Keyword(s):

Soft Tissue ◽

Neoadjuvant Therapy ◽

Objective Response ◽

Soft Tissue Sarcomas ◽

Disease Free Survival ◽

Lesion Size ◽

Target Lesion ◽

Free Survival ◽

Treatment Groups

Summary Background There is a need to establish an effective neoadjuvant therapy for soft tissue sarcomas (STSs). We previously showed that apatinib, administered in combination with doxorubicin-based chemotherapy, improves the efficacy of treatment. This study aimed to clarify the effectiveness and safety of apatinib combined with doxorubicin and ifosfamide (AI) neoadjuvant chemotherapy for STSs. Methods This retrospective study included patients with STS who received neoadjuvant therapy and surgery between January 2016 and January 2019. The patients were divided into two treatment groups: AI + apatinib group and AI group (doxorubicin + ifosfamide). Results The study included 74 patients (AI + apatinib: 26, AI: 48) with STS. There were significant between-group differences in objective response rates (53.85% vs. 29.17%, p = 0.047) and the average change in target lesion size from baseline (-40.46 ± 40.30 vs. -16.31 ± 34.32, p = 0.008). The R0 rate (84.62% vs. 68.75%; p = 0.170) and 2-year disease-free survival (73.08% vs. 62.50%, p = 0.343) were similar across groups. Finally, the rates of neoadjuvant therapy-related adverse effects and postoperative complications were similar in both groups (p > 0.05). Conclusion Apatinib plus doxorubicin and ifosfamide regimen is safe and effective as neoadjuvant therapy for patients with STS. However, the significantly improved preoperative ORR observed after neoadjuvant therapy did not translate into a significantly improved R0 rate and 2-year DFS. Prospective, well-powered studies are warranted to determine the long-term efficacy and optimal application of these protocols.

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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.

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