The sequential combination of limited surgery and tumor bed brachytherapy with or without external radiotherapy has been established as an effective alternative to more ablative procedures like amputation. Histologic grade has proven to be a significant factor determining local control.
Twenty-nine patients with high-grade nonmetastatic osteogenic sarcoma of the extremities were treated with adjuvant chemotherapy following definitive surgery. Chemotherapy consisted of systemic intravenous Adriamycin and cisplatin in a sequential fashion given for six courses. Nineteen out of 29 patients are alive and continuously disease free over a follow-up period ranging from 9+ to 30+ months. The relapse-free survival was 72%, and overall survival for the entire group was 69%. Median survival is not reached yet. Six out of 29 patients relapsed, of which 1 patient is alive for 6+ months after relapse. Three patients died of chemotherapy toxicity. The results were superior to historical controls treated with surgery alone. The need for more aggressive treatment approaches is discussed.
Extraskeletal myxoid chondrosarcoma is a rare soft-tissue sarcoma of the extremities that is considered to be indolent, but yet it has a capacity for multiple recurrences and lung metastasis. In a 23-year period, 10 cases of this rare tumor were reported in this institute. The authors studied the clinicopathologic features, including histochemical and immunohistochemical reactions, of these 10 cases, with a view to evaluate whether any constant pattern emerged. The histologic features include a lobular or nodular growth pattern, periodic acid-Schiff's stain positivity, diastase sensitivity, alcian blue positivity with and without pretreatment by testicular hyaluronidase, lack of epithelial markers, and positivity for S-100 protein and vimentin. The purpose of this article is to stress that the above-mentioned features are of immense help in delineating this rare tumor from other tumors associated with myxoid and chondroid differentiation. The authors did not find any consistent relationship between site, cellularity, and development of lung metastasis. Int J Surg Pathol 5(3/4): [77][78][79][80][81][82] 1997
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