Chemotherapy Influences the Pseudocapsule Composition in Soft Tissue Sarcomas

O’Donnell, Patrick W.; Cheng, Edward Y.; Clohisy, Denis R.

doi:10.1007/s11999-013-3022-7

Cited by 20 publications

(8 citation statements)

References 13 publications

(16 reference statements)

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“…In one European trial, adjuvant chemotherapy in the form of cyclophosphamide, vincristine, doxorubicin, and dacarbazine (CYVADIC) reduced local recurrence but not overall survival, similar to our study [4]. 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].…”

Section: Discussionsupporting

confidence: 83%

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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Section: Discussionsupporting

confidence: 83%

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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“…Peritumoral PC is a layer of fibrous connective tissue surrounding the cancer. A complete PC can prevent tumor cells from infiltrating adjacent renal parenchyma and facilitate the smooth implementation of TE surgery (9). In contrast, patients with disrupted PC or infiltrated parenchyma are recommended to receive standardized NSS to avoid positive surgical margin.…”

Section: Original Articlementioning

confidence: 99%

A preoperative nomogram predicting the pseudocapsule status in localized renal cell carcinoma

Hu¹,

Chen²,

Li³

et al. 2020

Transl Androl Urol

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Background: Tumor enucleation (TE) surgery for localized renal cell carcinoma (RCC) relies on a complete peritumoral pseudocapsule (PC). Study objective was to develop a preoperative model to predict PC status.Methods: The prediction model was developed in a cohort that consisted of 170 patients with localized RCC, and data was gathered from 2010 to 2015. Multivariable logistic regression analysis and R were used to generate this prediction model. The statistical performance was assessed with respect to the calibration, discrimination, and clinical usefulness.Results: The prediction model incorporated the systemic inflammatory markers [neutrophil-lymphocyte ratio (NLR); albumin-globulin ratio (AGR)], CT imaging features (tumor size and necrosis), and clinical risk factors (BMI). The model showed good discrimination, with a C-index of 0.85 (0.78-0.91), and good calibration (P=0.60). The sensitivity and specificity were 62% and 94% respectively. Decision curves and clinical impact curve demonstrated that the current model was clinically useful. Conclusions:We constructed a model that incorporated both the systematic inflammatory markers and clinical risk factors. It can be conveniently used to preoperatively predict the individualized risk of PC invasion and identify the best candidates to receive TE surgery.

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“…The local recurrence of marginally excised subcutaneous STSs is variable and difficult to predict. STSs are commonly surrounded by a pseudo capsule that may contain or be confluent with tumor cells [ 30 ]. The resemblance to complete margins [ 31 , 32 ] does not predict recurrence.…”

Section: Discussionmentioning

confidence: 99%

Proposing Clinicopathological Staging and Mitotic Count as Prognostic Factors for Canine Soft Tissue Sarcomas

Moreira

Franzoni

Anjos³

et al. 2023

Veterinary Sciences

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Soft tissue sarcomas (STSs) are a heterogeneous group of malignant mesenchymal tumors with similar histological features and biological behaviors. They are characterized by a low to moderate local recurrence rate and low metastasis, affecting approximately 20% of patients. Although this tumor set is vital in veterinary medicine, no previous unified staging system or mitotic count has been associated with patient prognosis. Therefore, this study proposed a new clinicopathological staging method and evaluated a cut-off value for mitosis related to the survival of dogs affected by STS. This study included 105 dogs affected by STS, treated only with surgery, and a complete follow-up evaluation. The new clinicopathological staging system evaluated tumor size (T), nodal involvement (N), distant metastasis (M), and histological grading criteria (G) to categorize the tumor stage into four groups (stages I, II, III, and IV). The proposed tumor staging system was able to differentiate patients’ prognoses, with dogs with stage IV disease experiencing the lowest survival time and dogs with stage I disease having the highest survival time (p < 0.001). Moreover, we assessed the median mitosis (based on mitotic count) and its association with overall survival. Our study’s median mitosis was 5, and patients with ≤5 mitoses had a higher survival time (p = 0.006). Overall, the proposed staging system and mitotic count seemed promising in the prediction of patient prognosis.

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Chemotherapy Influences the Pseudocapsule Composition in Soft Tissue Sarcomas

Abstract: Background Soft tissue sarcomas are a heterogeneous group of malignant tumors. Standard treatment for soft tissue sarcoma of the extremity is surgical excision and adjuvant therapy; however, the role of neoadjuvant chemotherapy is controversial.

Cited by 20 publications

References 13 publications

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

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

A preoperative nomogram predicting the pseudocapsule status in localized renal cell carcinoma

Proposing Clinicopathological Staging and Mitotic Count as Prognostic Factors for Canine Soft Tissue Sarcomas

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