Adjuvant Chemotherapy for Adult Soft Tissue Sarcomas of the Extremities and Girdles: Results of the Italian Randomized Cooperative Trial

Frustaci, S.; Gherlinzoni, F.; Paoli, Antonino De; Bonetti, Marco; Azzarelli, Alberto; Comandone, Alessandro; Olmi, Patrizia; Buonadonna, Angela; Pignatti, G.; Barbieri, Enza; Apice, Gaetano; Zmerly, Hassan; Serraino, Diego; Picci, Piero

doi:10.1200/jco.2001.19.5.1238

Cited by 612 publications

(367 citation statements)

References 22 publications

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“…In our series, the 5-year survival rate of patients who had received adjuvant chemotherapy was 44.45 %. We believe that adjuvant chemotherapy may be useful in the treatment of patients with high-grade RPS [24,25].…”

Section: Discussionmentioning

confidence: 99%

Challenges in the Surgical Treatment of Retroperitoneal Sarcomas

et al. 2015

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The objective of this study is to assess long-term prognosis and patterns of failure in patients with retroperitoneal sarcoma who underwent surgery with curative intent at a single institution. We also provide a thorough review of the literature including several series and widely variable data regarding local and distant failure. During a 25-year period , 45 consecutive patients who underwent surgery for retroperitoneal sarcoma at a single referral center were reviewed retrospectively. We recorded and analyzed the presenting symptoms, type of surgical excision, and the 5-year survival rate as well as the local recurrence rate of patients with complete tumor resection. Overall survival is significantly diminished in patients in whom resection margins are not adequate. In our series, 5-year recurrence rate for patients with complete and incomplete resection of the tumor was 30.76 and 68.42 %, respectively. The 5-year survival rate was 51.12 %, and the 5-year survival rate according to type of resection was 76.93 % for complete and 15.79 % for incomplete resections. Local recurrence after first surgery and high-grade malignancy are associated with poor survival. The role of radiation therapy and chemotherapy in the treatment of retroperitoneal sarcoma (RPS) should be investigated further. Complete en bloc resection of the tumor mass and adjacent structures is the single most important factor that improves survival.

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Section: Discussionmentioning

confidence: 99%

Challenges in the Surgical Treatment of Retroperitoneal Sarcomas

et al. 2015

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“…[11][12][13][14][15][16][17][18][19][20] This novel approach is interesting, but it remains experimental. With re- gard to adjuvant chemotherapy, recent data point to its possible benefit in the treatment of adult STS, provided full doses are employed and high-risk patients are selected: 22,23 If so, then patients with highgrade nonliposarcomas may benefit from chemotherapy for distant metastases. However, this remains to be demonstrated formally.…”

Section: Discussionmentioning

confidence: 99%

“…Novel radiation therapy techniques have been explored, [11][12][13][14][15][16][17][18][19][20][21] and the role of adjuvant chemotherapy still is debated. 22,23 However, efforts to improve treatment results should be based on the patterns in which these tumors currently fail. Thus, the objective of this retrospective analysis was to assess long-term prognosis and patterns of failure in a large cohort of patients with retroperitoneal STS who underwent surgery with curative intent at a single institution over 20 years.…”

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confidence: 99%

Retroperitoneal soft tissue sarcomas

Gronchi

Casali

Fiore

et al. 2004

Cancer

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BACKGROUNDThe objective of this study was to assess long‐term prognosis and patterns of failure in patients with retroperitoneal soft tissue sarcoma who underwent surgery with curative intent at a single institution. Several series of patients with retroperitoneal sarcoma were reported, providing widely variable data regarding local and distant failure.METHODSOverall, 167 consecutive patients who underwent surgery for retroperitoneal soft tissue sarcoma over a 20 year span at a single referral center were reviewed retrospectively. Eighty‐two patients presented with primary disease, whereas 85 patients had recurrent locoregional tumors. Surgical resection was considered macroscopically complete in 147 of 167 patients (88%).RESULTSOverall survival at 10 years after definitive surgery was approximately 27%, and the disease‐free survival was approximately 16%. Only a minority of patients developed distant metastases. The risk of recurrence was correlated with whether patients underwent surgery for primary disease or for recurrent disease; the 10 year disease‐free survival rate was 27% in the former group and 4.6% in the latter group. Histotype and malignancy grade were other prognostic factors, with the former found to be predictive of the pattern of failure and the latter predictive of overall survival.CONCLUSIONSLocal recurrence after primary surgery and high‐grade malignancy were associated with the worst survival. Histologic subtype appeared to influence the pattern of recurrence, which mainly was local for patients with liposarcoma but was both local and distant for patients with the other histotypes. Cancer 2004. © 2004 American Cancer Society.

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“…One theory regarding how chemotherapy might affect local control is that chemotherapy may affect actively dividing cells at the margins of tumors [19]. Although controversy remains regarding the topic with several articles failing to show an effect on local control [6,7,18], other studies have shown that chemotherapy could benefit patients with sarcoma in terms of better local relapse-free survival and overall survival [9,10,13,21]. The effects could be dependent on the exact agents and dosages.…”

Section: Discussionmentioning

confidence: 99%

Should High-grade Extraosseous Osteosarcoma Be Treated With Multimodality Therapy Like Other Soft Tissue Sarcomas?

Fan

Patel

Lewis

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Extraosseous osteosarcoma is rare, and the most appropriate therapy is unclear because there are few studies regarding its treatment. The effectiveness of radiation and chemotherapy remains uncertain owing to conflicting results in previous reports. Questions/purposes To review our experience with contemporary multimodality treatment, we asked: (1) What is the disease-specific survival and local relapse-free survival? (2) Does American Joint Commission on Cancer (AJCC) stage, tumor size, or location relate to disease outcome? (3) Does radiation therapy improve local control or survival? (4) Do doxorubicin and ifosfamide improve local control or survival? Methods Between 1990 and 2012, we treated 40 patients for localized, high-grade extraosseous osteosarcoma. In this retrospective study, we could determine the status of 36 patients (90%) either to death or for a minimum of 24 months of followup; four (10%) were lost to followup before 24 months. There were 11 patients with AJCC Stage IIA and 25 with Stage III disease. All patients underwent wide surgical excision. Of the patients with Stage IIA disease, four received radiation and none received chemotherapy. Of the patients with Stage III disease, six received radiation, seven were treated with chemotherapy, and six received radiation and chemotherapy. During the study period, high-dose doxorubicin and ifosfamide was the preferred chemotherapy regimen for patients younger than 60 years with normal cardiac and renal function. Local relapse-free survival and disease-specific survival were determined by Kaplan-Meier analysis using a prospectively maintained institutional database supplemented by information from the institutional tumor registry. The Cox proportional hazard model was used to determine the effect of various factors on local recurrence and patient survival.One of the authors certifies that he (SP), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount of less than USD 10,000 from CytRx (Los Angeles, CA, USA), an amount of less than 10,000 USD from Janssen Pharmaceuticals/Johnson & Johnson (Titusville, NJ, USA), and an amount of USD 10,000-USD 100,000 from Novartis (Basel, Switzerland). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. Results At 5 years, local relapse-free survival was 47% (95% CI, 27%-64%), and disease-spe...

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Adjuvant Chemotherapy for Adult Soft Tissue Sarcomas of the Extremities and Girdles: Results of the Italian Randomized Cooperative Trial

Cited by 612 publications

References 22 publications

Challenges in the Surgical Treatment of Retroperitoneal Sarcomas

Challenges in the Surgical Treatment of Retroperitoneal Sarcomas

Retroperitoneal soft tissue sarcomas

Should High-grade Extraosseous Osteosarcoma Be Treated With Multimodality Therapy Like Other Soft Tissue Sarcomas?

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