Metastasectomy for limited metastases from soft tissue sarcoma

Abstract

The development of metastatic soft tissue sarcoma (American Joint Committee on Cancer stage IV) is associated with a poor prognosis. Surgical resection of isolated solitary or multiple metastases is the only curative treatment; all other forms of treatment are considered palliative. As with all surgical procedures, patient selection is important to maximize the clinical benefit of metastasectomy and to minimize the risk for treatment-related morbidity. Over the past decade, nonresectional ablative approaches have been developed to manage visceral metastatic disease. These ablative procedures include cryosurgery, radiofrequency tumor ablation, and alcohol injection. All such procedures are considered investigational; outcome should be compared to that achievable with traditional surgical metastasectomy. The optimal sequence of treatments and role for perioperative (combined with metastasectomy) chemotherapy are unknown. Given the potential curative nature of metastasectomy, all patients with metastatic soft tissue sarcoma should be evaluated for the possibility of surgical resection. Patients with good performance status who have radiographically resectable disease should be considered for metastasectomy.

Lung nodules in pediatric oncology patients: a prediction rule for when to biopsy

“…However, if the predictive rule that has been developed was used, we propose that our benign biopsy rate could have been as low as 12%. Our goal is to decrease the number of negative biopsies, thereby reducing additional hospitalization and the intrinsic morbidity associated with the surgical procedure(s) and improving the overall oncologic outcome, with patients not having to undergo a surgical procedure [2,[21][22][23][24][25][26][27][28][29].…”

Cancer du sein métastatique

“…On distingue deux pré sentations cliniques diffé rentes (pouvant ê tre simultané ment associé es) : les nodules de permé ation cutané e et la lymphangite carcinomateuse cutané e. Seuls quelques articles font é tat de l'usage de la radiofré quence percutané e pour le traitement de ces lé sions [1,20].…”

Management of lung metastases from musculoskeletal sarcomas

“…18 Patients with good general status, who have resectable metastases, are potential candidates for surgery, using the same techniques described for other histotypes.…”

“…3 During the past ten years alternative non-surgical treatments such as cryotherapy, radio frequency, ablation and alcholisation, have been proposed but none have obtained results similar to surgical metastasectomy. 4 alternative therapies available, (III) good possibility of total removal of the pulmonary metastases, (IV) low surgical risk and (V) low risk of respiratory failure.…”