Soft tissue sarcomas of the hand and foot: Management and survival

Cp, Karakousis; C, De Young; Dl, Driscoll

doi:10.1007/bf02303779

Cited by 35 publications

(24 citation statements)

References 19 publications

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“…Combination chemotherapy and radiation therapy • The 5-year survival rate for sarcoma of the hand and foot is approximately 80%, better than the rate usually given for extremity STS [47][48][49]. With surgical excision and the use of adjunctive radiotherapy when the minimum surgical margin is narrow (<2 mm), limb amputation can be avoided as primary therapy in most patients, and up to two-thirds of patients can retain a normal or fairly normal extremity (Fig.…”

Section: Neoadjuvant Doxorubicin-based Chemotherapy Plus Radiation Thmentioning

confidence: 97%

Optimizing radiation therapy and post-treatment function in the management of extremity soft tissue sarcoma

DeLaney

2004

Curr. Treat. Options in Oncol.

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When treating soft tissue sarcomas (STS) of the extremities, the major therapeutic goals are survival, local tumor control, optimal function, and minimal morbidity. Surgical resection of the primary tumor is the essential component of treatment for virtually all patients. However, local control by surgery alone is poor for the majority of patients with extremity lesions unless the procedure removes large volumes of grossly normal tissue (ie, widely negative margins are attained, because sarcomas tend to infiltrate normal tissue adjacent to the evident lesion). Thus, removal of the gross lesion by a simple excision alone is followed by local recurrence in 60% to 90% of patients. Radical resections reduce the local recurrence rate to 10% to 30%, but may compromise limb function. The combination of function-sparing surgery and radiation achieves better outcomes than either treatment alone for nearly all patients with STS. Because both surgical and radiation technique are critically important for optimizing local control of tumor and functional outcome, it is important to manage these patients in dedicated multispecialty clinics comprised of physicians with expertise in sarcomas, including orthopedic and general oncologic surgeons, radiation oncologists, medical oncologists, sarcoma pathologists, and bone and soft tissue diagnostic radiologists. Radiation therapy can be given by external beam radiation therapy (EBRT) or brachytherapy (BRT) or combination thereof. External beam radiation can be given either preoperatively or postoperatively. The clinical considerations and the outcome data that must be considered in choosing the most appropriate treatment technique for the individual patient are discussed.

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Section: Neoadjuvant Doxorubicin-based Chemotherapy Plus Radiation Thmentioning

confidence: 97%

Optimizing radiation therapy and post-treatment function in the management of extremity soft tissue sarcoma

DeLaney

2004

Curr. Treat. Options in Oncol.

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“…Analog demonstrierten Karakousis et al für Weichgewebssarkome an der Hand eine normale oder weitgehend normal funktionierende Extremität bei einem 5-Jahres-Überleben von ca. 80% [33].…”

Section: Diskussionunclassified

Weichgewebssarkome der oberen Extremität

Lehnhardt

Hirche

Daigeler

et al. 2011

Chirurg

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“…Dies hat für Weichteilsarkome an Hand und Fuß die Konsequenz, dass auch bei knapp im Gesunden resezierten Befunden eine normale oder weitgehend normal funktionierende Extremität erhalten werden kann bei einem 5-Jahres-Überle-ben von etwa 80% [14,33]. Die Nachteile der adjuvanten Bestrahlung (höhere Frequenz von Wundheilungsstörungen, Gelenksteife, Ödembil-dung und reduzierte Gelenkbeweglichkeit) werden in Kauf genommen.…”

Section: > Das Therapiebedingte Lokale Komplikationsrisiko Ist Mit Deunclassified

“…Es ist jedoch nicht klar, ob das Lokalrezidiv kausal für die Verschlechterung ist oder ob es einfach einen sichtbaren Marker für eine aggressive Tumorbiologie darstellt [6,11,14,19,26,28,36,40]. Möglich wäre auch, dass beide Mechanismen unabhängig voneinander dazu beitragen.…”

Section: Lokalrezidivunclassified

“…Der Vorteil besteht darin, dass das postoperative und kosmetische Defizit durch Kombination beider Therapieformen so gering wie möglich gehalten werden kann. In der Literatur werden diesbezüglich lokale Kontrollraten von etwa 90% bei High-grade-Weichteilsarkomen und von 90-100% bei Low-gradeSarkomen angegeben, abhängig von der Tumorgröße [14,20,22,23,24,27,28,29]. [7].…”

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Chirurgie der Weichteilsarkome im Bereich der Extremitäten

Rudert

Burgkart

Gradinger

et al. 2009

Chirurg

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Treatment of soft tissue sarcomas requires an individual plan which considers interdisciplinary recommendations and the various clinical situations. Anatomical region, histological grading and typing, and tumor size necessitate adjusted methods of reconstruction. The biopsy should be performed at the institution where the patient is treated. In general surgical resection of the tumor will be the treatment of choice. Adjuvant therapies are applied according to anatomical region and size and grading of the tumor. Surgery alone is recommended only in small (<5 cm), superficial, low-grade sarcomas. Sarcomas larger than 5 cm in diameter should be treated by surgery and radiotherapy, achieving excellent results, although in high-grade sarcomas more than 50% of patients still will experience metastatic disease. In case of locally recurrent disease, surgical revision with tumor-free resection margins followed by radiotherapy should be the aim. This applies even for patients who had had radiotherapy after the first excision. In this case brachytherapy is a good modality of tissue-sparing treatment.

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Soft tissue sarcomas of the hand and foot: Management and survival

Cited by 35 publications

References 19 publications

Optimizing radiation therapy and post-treatment function in the management of extremity soft tissue sarcoma

Optimizing radiation therapy and post-treatment function in the management of extremity soft tissue sarcoma

Weichgewebssarkome der oberen Extremität

Chirurgie der Weichteilsarkome im Bereich der Extremitäten

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