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1. Lewis JJ, Leung D, Espat J, Woodruff JM, Brennan MF: Effect of reresection in extremity soft tissue sarcoma. Ann Surg; 2000 May;231(5):655-63
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  • [Title] Effect of reresection in extremity soft tissue sarcoma.
  • OBJECTIVE: To determine whether reresection affects survival in patients with inadequately resected, primary extremity soft tissue sarcoma.
  • SUMMARY BACKGROUND DATA: Soft tissue sarcomas are rare neoplasms, with an incidence of approximately 6,000 per year in the United States.
  • Because these tumors are rare and benign soft tissue tumors are common, many are initially thought to be benign and are excised without wide margins.
  • METHODS: Patients who underwent treatment for primary tumors from July 1982 to June 1999 at a single institution were the subject of study.
  • Two groups of patients were analyzed: those who underwent one definitive resection (one operation) and those whose tumors were previously resected and who were then referred for subsequent reresection (two operations).
  • Patients were given adjuvant radiation or chemotherapy according to the standard of care.
  • RESULTS: Of 1,092 patients with primary extremity soft tissue sarcoma underwent resection, 685 underwent definitive radical resection and 407 underwent reresection after undergoing excisional resection elsewhere.
  • The 5-year disease-free survival rate of the definitive resection (one operation) group was 70%; that of the reresection (two operations) group was 88%.
  • To determine whether this difference was stage- or referral-biased, the patient population was divided by AJCC stage.
  • In all stages there was a trend toward improved outcome; this was most marked for those with stage III disease (>5 cm, high-grade, and deep).
  • CONCLUSIONS: Patients with extremity soft tissue sarcoma who undergo reresection with two "primary" operations have an improved survival compared with those who undergo one operation.
  • The most plausible explanation, referral and selection bias, is questionable given the significance of reresection as a variable after adjusting for stage and other risk factors.
  • This suggests that where indicated and possible, reresection should be liberally applied in patients with primary extremity soft tissue sarcoma.

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  • (PMID = 10767786.001).
  • [ISSN] 0003-4932
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P01 CA047179; United States / NCI NIH HHS / CA / CA47179
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC1421052
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2. Takeuchi A, Tsuchiya H, Yamamoto N, Hayashi K, Yamauchi K, Kawahara M, Miyamoto K, Tomita K: Caffeine-potentiated chemotherapy for patients with high-grade soft tissue sarcoma: long-term clinical outcome. Anticancer Res; 2007 Sep-Oct;27(5B):3489-95
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  • [Title] Caffeine-potentiated chemotherapy for patients with high-grade soft tissue sarcoma: long-term clinical outcome.
  • BACKGROUND: Caffeine, which has a DNA-repair inhibiting effect, enhances the cytocidal effects of anticancer drugs and radiation.
  • The present study was performed to assess the efficacy of caffeine-potentiated chemotherapy for high-grade soft tissue sarcoma (STS).
  • PATIENTS AND METHODS: A non-randomised prospective clinical trial was initiated for 90 patients with non-metastatic (stages II and III) or metastatic (stage IV) STS.
  • A radiographic and histological response to chemotherapy was assessed.
  • The local recurrence rate was 23.7% in stages II and III and 13.6% in stage IV.
  • Lung metastases newly developed in 21 (35.6%) patients at stages II and III.
  • With a median follow-up period of 52 months, the overall 5-year cumulative survival rate at stages II and III was 80.7%.
  • Local recurrence-free survival for the histological responders and distant metastasis-free survival for the radiographic responders at stages II and III were significantly improved compared to the non-responders (p=0.004 and p=0.034).
  • CONCLUSION: Caffeine-potentiated chemotherapy resulted in a favourable radiographic response and prolonged overall survival of the patients at all stages.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Caffeine / therapeutic use. Sarcoma / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Disease-Free Survival. Drug Synergism. Female. Humans. Kaplan-Meier Estimate. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Staging. Preoperative Care. Time Factors. Treatment Outcome

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  • (PMID = 17972506.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 3G6A5W338E / Caffeine
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3. Bramwell V: When to consider adjuvant/neoadjuvant therapy for adult soft-tissue sarcoma. Oncology (Williston Park); 2007 Apr;21(4):511-4
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  • [Title] When to consider adjuvant/neoadjuvant therapy for adult soft-tissue sarcoma.
  • In patients with adult soft-tissue sarcoma (ASTS), the use and timing of adjuvant chemotherapy or chemoradiotherapy remains controversial.
  • The appropriate target population is generally accepted as International Union Against Cancer (UICC)/American Joint Committee on Cancer (AJCC) stage III extremity or trunk sarcomas (i.e., >5 cm, grade 3/4, located deep to the superficial fascia, with no evidence of metastases).
  • After definitive local treatment, the 5-year disease-free and overall survival rates in this population are approximately 52% and 56%.
  • [MeSH-major] Neoadjuvant Therapy. Neoplasm Recurrence, Local. Sarcoma / drug therapy. Sarcoma / radiotherapy
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Humans. Meta-Analysis as Topic. Randomized Controlled Trials as Topic. Retrospective Studies

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  • (PMID = 17474349.001).
  • [ISSN] 0890-9091
  • [Journal-full-title] Oncology (Williston Park, N.Y.)
  • [ISO-abbreviation] Oncology (Williston Park, N.Y.)
  • [Language] eng
  • [Publication-type] Congresses
  • [Publication-country] United States
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4. Leidinger B, Heyse T, Schuck A, Buerger H, Mommsen P, Bruening T, Fuchs S, Gosheger G: High incidence of metastatic disease in primary high grade and large extremity soft tissue sarcomas treated without chemotherapy. BMC Cancer; 2006;6:160
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  • [Title] High incidence of metastatic disease in primary high grade and large extremity soft tissue sarcomas treated without chemotherapy.
  • BACKGROUND: The risk of metastasis and the survival in patients with primary extremity soft tissue sarcomas is worse when tumour size is large and the grade of malignancy is high.
  • Such tumours may receive chemotherapy and/or radiation therapy (RTX) for optimising local control.
  • The question arises if the kind of RTX in the absence of chemotherapy influences the outcome concerning local control, metastatic disease, survival and complications.
  • METHODS: We retrospectively reviewed the clinical outcome of 233 patients with a primary extremity soft tissue sarcoma treated between 1990 - 2000 with a mean follow-up of 35.8 (4-120) months in our institute.
  • 41 patients had high grade, deep and large tumours (>8 cm), an AJCC stage III (no evidence of metastasis prior to treatment) and were treated with limb salvage surgery and irradiation but stayed without additional chemotherapy.
  • RESULTS: 56% (23/41) of the population developed metastatic disease, 24% (10/41) local recurrence.
  • Wound infections and other combined therapy related complications were equally distributed (p = 0.22).
  • CONCLUSION: Without chemotherapy there remains a high risk of metastasis in AJCC grade 3 patients.
  • In high risk patients treated without chemotherapy the elapsed time to tumour resection after preoperative radiation might contribute to the development of metastasis.
  • This outcome may support the thesis that a combination of RTX and offensive multimodal treatment protocols is advantageous in such a subset of patients.
  • [MeSH-major] Sarcoma / pathology. Sarcoma / therapy

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  • (PMID = 16780601.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1550254
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5. Meric F, Hess KR, Varma DG, Hunt KK, Pisters PW, Milas KM, Patel SR, Benjamin RS, Plager C, Papadopoulos NE, Burgess MA, Pollock RE, Feig BW: Radiographic response to neoadjuvant chemotherapy is a predictor of local control and survival in soft tissue sarcomas. Cancer; 2002 Sep 1;95(5):1120-6
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  • [Title] Radiographic response to neoadjuvant chemotherapy is a predictor of local control and survival in soft tissue sarcomas.
  • BACKGROUND: Downstaging of large soft tissue sarcomas can be accomplished by the use of neoadjuvant chemotherapy (NeoCT).
  • METHODS: The authors reviewed the medical records of 65 patients with Stage II or III soft tissue sarcoma (42 extremity, 23 retroperitoneal) who were treated with doxorubicin or ifosfamide-based NeoCT from January 1991 to December 1996.
  • Radiographic response and impact on surgical therapy were determined retrospectively by comparing imaging studies obtained before and after chemotherapy.
  • CONCLUSIONS: The NeoCT regimens used in this study resulted in tumor shrinkage sufficient to impact surgical therapy in a few patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoadjuvant Therapy. Neoplasm Recurrence, Local. Retroperitoneal Neoplasms / drug therapy. Sarcoma / drug therapy. Soft Tissue Neoplasms / drug therapy

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  • [Copyright] Copyright 2002 American Cancer Society.
  • (PMID = 12209699.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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6. Oda Y, Saito T, Tateishi N, Ohishi Y, Tamiya S, Yamamoto H, Yokoyama R, Uchiumi T, Iwamoto Y, Kuwano M, Tsuneyoshi M: ATP-binding cassette superfamily transporter gene expression in human soft tissue sarcomas. Int J Cancer; 2005 May 10;114(6):854-62
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  • [Title] ATP-binding cassette superfamily transporter gene expression in human soft tissue sarcomas.
  • However, their expression levels and distribution within soft tissue sarcomas remain controversial.
  • In 86 cases of surgically resected soft tissue sarcoma, intrinsic mRNA levels of MDR1, MRP1, MRP2 and MRP3 were assessed using a quantitative reverse transcriptase-PCR (RT-PCR) method.
  • Among the various histologic types, malignant peripheral nerve sheath tumor (MPNST) showed significantly high levels of MDR1 (p=0.017) and MRP3 (p=0.0384) mRNA expression, compared to the other tumor types.
  • P-gp expression was significantly correlated with large tumor size (> or =5 cm, p=0.041) and high AJCC stage (stages III and IV) (p=0.0365).
  • Our results suggest that MDR1/P-gp expression may have an important role to play in tumor progression in the cases of soft tissue sarcoma, and p53 may be one of the active regulators of the MDR1 transcript.
  • In addition, the high levels of both MDR1 and MRP3 mRNA expression in MPNST may help to explain the poor response of this tumor to anticancer-drugs.
  • [MeSH-major] ATP-Binding Cassette Transporters / biosynthesis. ATP-Binding Cassette Transporters / genetics. Drug Resistance, Multiple. Gene Expression Regulation, Neoplastic. Genes, p53. Sarcoma / drug therapy. Sarcoma / genetics
  • [MeSH-minor] Adolescent. Adult. Disease Progression. Drug Resistance, Neoplasm / genetics. Female. Gene Expression Profiling. Humans. Immunohistochemistry. Male. Reverse Transcriptase Polymerase Chain Reaction

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  • (PMID = 15609299.001).
  • [ISSN] 0020-7136
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / ATP-Binding Cassette Transporters
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7. Ray-Coquard I, Biron P, Blay JY: [High-dose chemotherapy in soft tissue sarcomas of adults]. Bull Cancer; 2001 Sep;88(9):858-62
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  • [Title] [High-dose chemotherapy in soft tissue sarcomas of adults].
  • [Transliterated title] Chimiothérapie à hautes doses dans les sarcomes des tissus mous de l'adulte.
  • Few cytotoxic agents are active for the treatment of soft tissue sarcomas of adults: drugs active in monotherapy are doxorubicin, ifosfamide, dacarbazine and ET743.
  • In patients with advanced stage soft tissue sarcomas (ASTS), a dose-response relationship has been established for doxorubicin and ifosfamide.
  • Intensive combination chemotherapy regimens at conventional doses (MAID, or AI) yield higher objective response rates than monochemotherapy regimens, ranging between 25% and 44%, but failed improve survival rates as comparted to less intensive regimens.
  • Recently, several phase I or II studies have investigated the use of high dose chemotherapy regimens as consolidation therapy in ASTS in response to conventional regimens.
  • Some of these patients with ASTS achieved long term complete remission, in particular in the subgroup of patients in complete remission after conventional chemotherapy in advanced phase.
  • Phase III studies are required to confirm that survival may be improved by HDCT in subgroups of patients with ASTS.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Sarcoma / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Clinical Trials, Phase I as Topic. Clinical Trials, Phase II as Topic. Dacarbazine / administration & dosage. Dioxoles / administration & dosage. Dose-Response Relationship, Drug. Doxorubicin / administration & dosage. Hematopoietic Stem Cell Transplantation. Humans. Ifosfamide / administration & dosage. Isoquinolines / administration & dosage. Tetrahydroisoquinolines

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  • (PMID = 11604358.001).
  • [ISSN] 0007-4551
  • [Journal-full-title] Bulletin du cancer
  • [ISO-abbreviation] Bull Cancer
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Dioxoles; 0 / Isoquinolines; 0 / Tetrahydroisoquinolines; 114899-77-3 / trabectedin; 7GR28W0FJI / Dacarbazine; 80168379AG / Doxorubicin; UM20QQM95Y / Ifosfamide
  • [Number-of-references] 40
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8. Papanastassiou I, Ioannou M, Magoulas D, Lalos S, Athanassiou AE, Ziras N, Thanopoulou E, Demertzis N: Chemoembolization facilitates limb salvage surgery in stage III soft tissue sarcoma. J BUON; 2009 Jul-Sep;14(3):507-10
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  • [Title] Chemoembolization facilitates limb salvage surgery in stage III soft tissue sarcoma.
  • A 26 year-old male was referred to our unit because of a stage III soft tissue sarcoma in the shoulder girdle-axillary area and reduced forearm-distal arm strength.
  • The patient received adjuvant chemotherapy (ifosfamide/mesna, adriamycin, and dacarbazine/MAID) and finally radiation therapy (RT; 6500 cGy total dose).
  • In stage III soft tissue sarcomas, especially in proximity with major nerve/arterial bundles, a multimodality approach is mandatory; chemoembolization is very effective in shrinking the tumor and defining its margins so as to make feasible a LSS.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Embolization, Therapeutic. Limb Salvage. Sarcoma / drug therapy. Soft Tissue Neoplasms / drug therapy
  • [MeSH-minor] Adult. Antibiotics, Antineoplastic / therapeutic use. Antineoplastic Agents, Alkylating / therapeutic use. Antineoplastic Agents, Phytogenic / therapeutic use. Chemotherapy, Adjuvant. Cyclophosphamide / therapeutic use. Doxorubicin / therapeutic use. Humans. Male. Neoplasm Staging. Radiotherapy, Adjuvant. Vincristine / therapeutic use

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  • (PMID = 19810146.001).
  • [ISSN] 1107-0625
  • [Journal-full-title] Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • [ISO-abbreviation] J BUON
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antineoplastic Agents, Alkylating; 0 / Antineoplastic Agents, Phytogenic; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide
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9. Cormier JN, Huang X, Xing Y, Thall PF, Wang X, Benjamin RS, Pollock RE, Antonescu CR, Maki RG, Brennan MF, Pisters PW: Cohort analysis of patients with localized, high-risk, extremity soft tissue sarcoma treated at two cancer centers: chemotherapy-associated outcomes. J Clin Oncol; 2004 Nov 15;22(22):4567-74
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  • [Title] Cohort analysis of patients with localized, high-risk, extremity soft tissue sarcoma treated at two cancer centers: chemotherapy-associated outcomes.
  • PURPOSE: Patients with American Joint Committee on Cancer stage III soft tissue sarcoma (STS) have high risks of distant recurrence and death.
  • The role of chemotherapy for these patients remains controversial despite several randomized trials and a meta-analysis.
  • METHODS: We reviewed the treatments and outcomes of 674 consecutive adult patients presenting with primary stage III extremity STS between 1984 and 1999.
  • Pre- or postoperative doxorubicin-based chemotherapy was used in a nonrandomized fashion in approximately half of this high-risk population.
  • The objective of this review was to evaluate the impact of chemotherapy while accounting for known prognostic variables.
  • RESULTS: Among 674 patients, 338 (50%) were treated with local therapy only, and 336 (50%) were treated with local therapy plus chemotherapy.
  • Cox regression analyses showed a time-varying effect associated with chemotherapy.
  • During the first year, the hazard ratio associated with DSS for patients treated with chemotherapy versus no chemotherapy was 0.37 (95% CI, 0.20 to 0.69; P = .002).
  • CONCLUSION: It seems that the clinical benefits associated with doxorubicin-based chemotherapy in patients with high-risk extremity STS are not sustained beyond 1 year.
  • These results suggest that caution should be used in the interpretation of randomized clinical trials of adjuvant chemotherapy that seem to demonstrate clinical benefits with relatively short-term follow-up.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Sarcoma / drug therapy. Sarcoma / pathology. Soft Tissue Neoplasms / drug therapy. Soft Tissue Neoplasms / pathology

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  • (PMID = 15542808.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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10. Verma S, Bramwell V: Dose-intensive chemotherapy in advanced adult soft tissue sarcoma. Expert Rev Anticancer Ther; 2002 Apr;2(2):201-15
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Dose-intensive chemotherapy in advanced adult soft tissue sarcoma.
  • The treatment of metastatic soft tissue sarcomas in adults is one of the most challenging areas in oncology.
  • While multidisciplinary management of early-stage, localized disease has led to a number of improved outcomes, therapy of unresectable or advanced disease remains problematic.
  • Adriamycin and ifosfamide are the only chemotherapeutic drugs to have consistently produced response rates of over 20% when given as single agents and these two drugs have been exhaustively studied alone or in combination.
  • In this article, the status of dose-intensive chemotherapy in advanced adult soft tissue sarcomas (excluding pediatric histologies, such as Ewing's sarcoma and rhabdomyosarcoma) will be discussed.
  • Emphasis will be placed on data from randomized Phase III trials but information from Phase I/II studies will also be reviewed and recommendations will be made on a systematic analysis of the data.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Sarcoma / drug therapy
  • [MeSH-minor] Clinical Trials as Topic / methods. Clinical Trials as Topic / statistics & numerical data. Clinical Trials as Topic / trends. Dose-Response Relationship, Drug. Drug Administration Schedule. Humans. Lung Neoplasms / secondary. Lung Neoplasms / surgery

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  • (PMID = 12113242.001).
  • [ISSN] 1473-7140
  • [Journal-full-title] Expert review of anticancer therapy
  • [ISO-abbreviation] Expert Rev Anticancer Ther
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 103
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11. Phan A, Patel S: Advances in neoadjuvant chemotherapy in soft tissue sarcomas. Curr Treat Options Oncol; 2003 Dec;4(6):433-9
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  • [Title] Advances in neoadjuvant chemotherapy in soft tissue sarcomas.
  • The use of adjuvant chemotherapy in soft tissue sarcomas (STS) continues to be an area of controversy; however, the group of investigators favoring the use of an anthracycline- and ifosfamide-based regimen for high-risk (American Joint Committee on Cancer stage III) extremity STS is steadily increasing.
  • The historic 5-year survival rate of approximately 50% in this high-risk group treated with local therapy alone represents a poor standard of care, thus there is a need to incorporate systemic therapy early in the management of these patients.
  • Published data from the meta-analysis of doxorubicin-based adjuvant chemotherapy trials and the prospective randomized data with epirubicin and ifosfamide from the Italian Sarcoma Group are frequently used as rationale for this approach.
  • In a rare and heterogenous group of diseases, such as STS, physicians run into negative studies for various reasons that have little to do with the efficacy of the treatment being tested.
  • It is appropriate to acknowledge that the chemotherapeutic agents have limited efficacy and are toxic, especially when used at full therapeutic doses.
  • Selecting patients in whom there is some evidence of benefit, justifying the poor quality of life from receiving chemotherapy, becomes very important.
  • This rationale, with the lessons learned from osteosarcoma research, forms the basis for neoadjuvant chemotherapy for STS.
  • Until we reach the day when we have identified critical tumorigenic targets and their effective inhibitors for most of these tumors, we are obligated to use the available therapeutic armamentarium in the best possible sequence.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoadjuvant Therapy. Sarcoma / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Combined Modality Therapy. Disease-Free Survival. Humans. Prognosis. Risk Factors. Treatment Outcome

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  • (PMID = 14585224.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 26
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12. Manoso MW, Frassica DA, Deune EG, Frassica FJ: Outcomes of re-excision after unplanned excisions of soft-tissue sarcomas. J Surg Oncol; 2005 Sep 1;91(3):153-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Outcomes of re-excision after unplanned excisions of soft-tissue sarcomas.
  • BACKGROUND AND OBJECTIVES: Unplanned excisions of soft-tissue sarcomas of the extremities occur commonly.
  • Our goal was to evaluate the presence of residual disease, the treatment outcomes as they relate to local and distant recurrence and 5-year survival, and the limb functional outcomes in patients with unplanned sarcoma excision who were treated with re-excision and adjuvant therapy.
  • METHODS: Between 1993 and 1999, 42 patients presented to our institution after unplanned excision of soft-tissue sarcomas.
  • All 38 patients underwent revision wide excision; most (31) also received adjuvant therapy (radiation and/or chemotherapy).
  • Univariate analysis showed that stage-III disease (American Joint Committee on Cancer classification of soft-tissue sarcomas), lesions below the fascia, a histologic high-grade, and the development of organ metastasis were statistically significant factors for mortality.
  • Stage-III disease also was significant for mortality on multivariate analysis.
  • Only stage-III disease was significant for the development of local recurrence.
  • CONCLUSIONS: Re-excision with adjuvant therapy proved to be a safe and effective method for treating the disease and preserving limb function.
  • [MeSH-major] Neoplasm Recurrence, Local / surgery. Neoplasm, Residual / surgery. Sarcoma / surgery. Soft Tissue Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Baltimore / epidemiology. Combined Modality Therapy. Female. Humans. Logistic Models. Male. Middle Aged. Multivariate Analysis. Proportional Hazards Models. Reoperation. Survival Rate. Treatment Outcome

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  • [Copyright] Copyright 2005 Wiley-Liss, Inc.
  • (PMID = 16118773.001).
  • [ISSN] 0022-4790
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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13. Lejeune FJ, Pujol N, Liénard D, Mosimann F, Raffoul W, Genton A, Guillou L, Landry M, Chassot PG, Chiolero R, Bischof-Delaloye A, Leyvraz S, Mirimanoff RO, Bejkos D, Leyvraz PF: Limb salvage by neoadjuvant isolated perfusion with TNFalpha and melphalan for non-resectable soft tissue sarcoma of the extremities. Eur J Surg Oncol; 2000 Nov;26(7):669-78
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  • [Title] Limb salvage by neoadjuvant isolated perfusion with TNFalpha and melphalan for non-resectable soft tissue sarcoma of the extremities.
  • AIMS: Patients with non-resectable soft tissue sarcomas of the extremities do not live longer if they are treated by amputation or disarticulation.
  • In order to avoid major amputations, we tested isolated limb perfusion (ILP) with tumour necrosis factor alpha (TNF)+melphalan+/-interferon-gamma (IFN) as a pre-operative, neoadjuvant limb salvage treatment.
  • The AJCC stage was IIA in four patients, III in seven and IV in 11.
  • Thirteen cases were recurrent or progressive after previous therapy; five tumours had a diameter >/=20 cm, and four were multiple or regionally metastatic.
  • All patients had fever for 24 hours but only one developed a reversible grade 3 distributive shock syndrome with no sequelae.
  • Seventeen patients (77%) underwent limb-sparing resection of the tumour remnants after a median time of 3.4 months: 10 resections were intracompartmental and seven extracompartmental.
  • Adjuvant chemotherapy was given to eight patients and radiotherapy to six.
  • The median disease free and overall survival times have been >12.5 and 18.7 months respectively: this is similar to the outcome after primary amputations for similar cases.
  • CONCLUSION: ILP with TNF and chemotherapy is an efficient limb sparing neoadjuvant therapy for a priori non-resectable limb soft tissue sarcomas.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Leg / surgery. Sarcoma / drug therapy. Sarcoma / surgery. Soft Tissue Neoplasms / drug therapy. Soft Tissue Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Chemotherapy, Cancer, Regional Perfusion. Disease-Free Survival. Doxorubicin / administration & dosage. Female. Humans. Ifosfamide / administration & dosage. Interferon-gamma / administration & dosage. Interferon-gamma / adverse effects. Male. Melphalan / administration & dosage. Melphalan / adverse effects. Middle Aged. Neoadjuvant Therapy. Neoplasm Recurrence, Local / surgery. Radiotherapy, Adjuvant. Salvage Therapy. Survival Analysis. Tumor Necrosis Factor-alpha / administration & dosage. Tumor Necrosis Factor-alpha / adverse effects

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  • [Copyright] Copyright 2000 Harcourt Publishers Ltd.
  • (PMID = 11078614.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0 / Tumor Necrosis Factor-alpha; 80168379AG / Doxorubicin; 82115-62-6 / Interferon-gamma; Q41OR9510P / Melphalan; UM20QQM95Y / Ifosfamide
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14. Stevens M, Rey A, Bouvet N, Ellershaw C, Sanchez de Toledo J, Oberlin O: SIOP MMT 95: Intensified (6 drug) versus standard (IVA) chemotherapy for high risk non metastatic rhabdomyosarcoma (RMS). J Clin Oncol; 2004 Jul 15;22(14_suppl):8515

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] SIOP MMT 95: Intensified (6 drug) versus standard (IVA) chemotherapy for high risk non metastatic rhabdomyosarcoma (RMS).
  • Principal study objectives were: low and standard risk patients, to maintain excellent survival with limited chemotherapy and very selective use of local therapy.
  • ; high risk patients, to explore survival advantage for an intensified chemotherapy strategy in a randomised trial.
  • METHODS: Eligibility for randomisation included age ≥ 6 months ≤18 years, no distant metastases, diagnosis within previous 8 weeks without prior treatment except surgery, pathology available for central review, written consent according to institutional requirement.
  • From July 1995 to July 2003, 456 high risk patients (incompletely resected embryonal RMS, undifferentiated sarcoma and soft tissue PNET at all sites except paratesticular, vagina and uterus, and all alveolar RMS) were randomised to receive IVA (ifosfamide, vincristine, actinomycin D) or a 6 drug combination (IVA + carboplatin, epirubicin, etoposide) both delivered over 27 weeks.
  • Cumulative dose / m<sup>2</sup> = ifosfamide 54g (both arms), epirubicin 450 mg, etoposide 1350 mg (6 drug).
  • Delivery of radiotherapy was determined according to site and / or response to chemotherapy ± surgery.
  • Non randomised exceptions were: orbital tumours (allocated IVA); SIOP stage III (node positive) and young (age < 3yr) parameningeal tumours (allocated 6 drugs).
  • RESULTS: Data given only for randomised patients [Figure: see text] Toxicity was significantly greater (infection, myelosuppression, mucositis) for the 6 drug arm.
  • CONCLUSIONS: Intensification of chemotherapy provides no overall advantage for non metastatic RMS / other chemosensitive STS, and adds toxicity.

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  • (PMID = 28013776.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Tanaka K, Kawamoto H, Saito I, Yoshimura K, Fukuda H, Iwamoto Y: Preoperative and postoperative chemotherapy with ifosfamide and adriamycin for adult high-grade soft-tissue sarcomas in the extremities: Japan Clinical Oncology Group Study JCOG0304. Jpn J Clin Oncol; 2009 Apr;39(4):271-3
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  • [Title] Preoperative and postoperative chemotherapy with ifosfamide and adriamycin for adult high-grade soft-tissue sarcomas in the extremities: Japan Clinical Oncology Group Study JCOG0304.
  • This phase II clinical trial aims to evaluate the efficacies and toxicities of pre- and postoperative chemotherapy with adriamycin plus ifosfamide on the patients with soft-tissue high-grade sarcomas.
  • Patients who have operable, non-round cell soft-tissue sarcomas [French Federation of Cancer Center (FNCLCC) Grades 2 and 3] arising in the extremities [T2bN0M0, i.e.
  • American Joint Committee on Cancer (AJCC) stage III] are treated by three courses of preoperative chemotherapy consisting of adriamycin and ifosfamide followed by complete resection and additional two courses of the same chemotherapy regimen.
  • The Bone and Soft Tissue Tumor Study Group (BSTTSG) in the Japan Clinical Oncology Group (JCOG) including 26 specialized institutes will accrue 75 patients.
  • The primary endpoint of the study is the 2-year progression-free survival rate, and secondary endpoints are response rate of the preoperative chemotherapy, 3-year progression-free survival rate, progression-free survival, overall survival and adverse events.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Doxorubicin / administration & dosage. Ifosfamide / administration & dosage. Sarcoma / drug therapy

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  • (PMID = 19155282.001).
  • [ISSN] 1465-3621
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 80168379AG / Doxorubicin; UM20QQM95Y / Ifosfamide
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16. Kazanowska B, Mikołajewska A, Balcerska A, Balwierz W, Bodalski J, Dłuzniewska A, Drozyńska E, Kurylak A, Reich A, Stencel D, Szewczyk B, Wachowiak J, Wysocki M, Chybicka A: [Soft tissue sarcoma of the bladder and prostate. A report of the Polish Paediatric Solid Tumour Group (PPSTG)]. Med Wieku Rozwoj; 2004 Oct-Dec;8(4 Pt 2):1091-8
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  • [Title] [Soft tissue sarcoma of the bladder and prostate. A report of the Polish Paediatric Solid Tumour Group (PPSTG)].
  • Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children younger then 15 years of age.
  • The treatment of RMS localized in bladder or prostate still remains controversial.
  • The aim of this study was analysis of treatment results in children with soft tissue sarcoma of bladder and prostate.
  • From 1993 to 2001 the PPSTG has used three protocols to treat soft tissue sarcomas in children.
  • The CWS-91 regimen has been served to treat stage I-III and SIOP-IV Intergroup study in stage IV.
  • Since 1996 the CWS-96 protocol for all patients in stage I-IV has been used.
  • After biopsy confirmation of the diagnosis patients were treated with chemotherapy and subsequent surgery.
  • The median follow-up time was 42 months.
  • RMS-embryonal was diagnosed in 11 patients, RMS-alveolare in 4 and others types in 4.
  • Sixteen patients presented clinical stage III and 3 stage IV The tumours were primarily localised in bladder in 16 patients and prostate in 3.
  • After induction chemotherapy two patients received partial cystectomy, 5 complete cystectomy and 3 complete cystectomy with genitourinary reconstructive.
  • The most common treatment failure was isolated, local relapse in 8 children particularly in patients with any second surgery.
  • Significant prognostic factors are the initial tumours volume, the lymph nodes infiltration and the response to the first chemotherapy cycle.
  • Surgery is the most important procedure in local control of soft tissue sarcoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Prostatic Neoplasms. Rhabdomyosarcoma. Urinary Bladder Neoplasms
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Cystectomy / methods. Female. Follow-Up Studies. Humans. Infant. Male. Neoplasm Staging. Poland. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 15951604.001).
  • [Journal-full-title] Medycyna wieku rozwojowego
  • [ISO-abbreviation] Med Wieku Rozwoj
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
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17. Pisters PW, O'Sullivan B, Maki RG: Evidence-based recommendations for local therapy for soft tissue sarcomas. J Clin Oncol; 2007 Mar 10;25(8):1003-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evidence-based recommendations for local therapy for soft tissue sarcomas.
  • There has been a gradual migration in the local treatment of soft tissue sarcomas from amputation and similar radical resectional approaches to more conservative, function-preserving surgery combined with radiotherapy.
  • In the new millennium, attention has shifted to defining subsets of patients who might be adequately treated by surgery alone and defining the optimal sequence of surgery and radiation for patients who require both types of local therapy.
  • There remains considerable discussion and debate surrounding the issue of pre- and postoperative chemotherapy for patients with localized soft tissue sarcomas.
  • Adjuvant chemotherapy is a standard of care for adults who have the subtypes of soft tissue sarcomas that typically occur in pediatric patients (Ewing sarcoma, rhabdomyosarcoma), and just as clearly, adjuvant chemotherapy is not warranted in patients with low- and intermediate-risk disease (stages I and II).
  • For patients with higher risk disease (stage III), the available randomized trials do not convincingly demonstrate a clinical benefit to adjuvant chemotherapy.
  • As such, a complete accounting of potential risks and benefits is appropriate when discussing adjuvant chemotherapy with patients who have stage III disease.
  • [MeSH-major] Sarcoma / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Combined Modality Therapy. Evidence-Based Medicine. Humans. Randomized Controlled Trials as Topic

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  • (PMID = 17350950.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 37
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18. Zawitkowska-Klaczyńska J, Katski K, Woźniak M, Kowalczyk JR: Characteristics and outcome of children with primary soft tissue sarcomas of extremities. Med Wieku Rozwoj; 2004 Apr-Jun;8(2 Pt 1):169-74
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  • [Title] Characteristics and outcome of children with primary soft tissue sarcomas of extremities.
  • OBJECTIVES: To determine the characteristics and outcome or patients with primary soft tissue sarcomas of extremities in children.
  • MATERIAL AND METHODS: Thirty-six patients treated for soft tissues sarcomas were enrolled into the study.
  • Features analysed: the incidence of soft tissues sarcoma of extremities, the time from first clinical symptoms to making the diagnosis, the primary site of tumour; histopathologic type of tumour, stage of disease, methods and results of the treatment.
  • RESULTS: The time From first symptoms to making the diagnosis was 5.4 months (mean).
  • Histopathologic types: synovial sarcoma in 4 patients, malignant haemangiopericytoma in 2, rhabdomyosarcoma in 2, sarcoma myogenes in 1, primitive neuroectodermal tumour in l.
  • Stage of disease: III deg.
  • Patients underwent treatment according to the soft tissue sarcoma protocols.
  • Results of treatment: first complete remission was observed in 7 patients; second complete remission in 1, one patient is on postoperative treatment.
  • Combined treatment achieves full remission in the majority of patients with soft tissues sarcomas localized within the limbs.
  • 2. In patients with large tumours (>5 cm) the treatment should to be started with inductive chemotherapy, and the surgery should be postponed.
  • 3. Early excision of the tumour should be considered in cases of small tumours (< 5 cm), when resection with wide margin of healthy tissues is possible, without deteriorating the function of the limb or cosmetic damage.
  • [MeSH-major] Arm. Leg. Sarcoma / diagnosis. Sarcoma / therapy
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Disease-Free Survival. Female. Hemangiopericytoma / diagnosis. Hemangiopericytoma / therapy. Humans. Incidence. Male. Myosarcoma / diagnosis. Myosarcoma / therapy. Neoplasm Staging. Neuroectodermal Tumors / diagnosis. Neuroectodermal Tumors / therapy. Poland / epidemiology. Retrospective Studies. Rhabdomyosarcoma / diagnosis. Rhabdomyosarcoma / therapy. Sarcoma, Synovial / diagnosis. Sarcoma, Synovial / therapy. Survival Analysis. Time Factors. Treatment Outcome

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  • (PMID = 15738590.001).
  • [Journal-full-title] Medycyna wieku rozwojowego
  • [ISO-abbreviation] Med Wieku Rozwoj
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Poland
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19. Khanfir K, Alzieu L, Terrier P, Le Péchoux C, Bonvalot S, Vanel D, Le Cesne A: Does adjuvant radiation therapy increase loco-regional control after optimal resection of soft-tissue sarcoma of the extremities? Eur J Cancer; 2003 Sep;39(13):1872-80
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  • [Title] Does adjuvant radiation therapy increase loco-regional control after optimal resection of soft-tissue sarcoma of the extremities?
  • Adjuvant radiotherapy (RT) is routinely recommended for most soft-tissue sarcomas (STS) of the extremities.
  • The median tumour size was 6 cm (range 1-20 cm) with 28, 44 and 28% of stage I, II and III lesions, respectively.
  • Other patient characteristics (age, tumour size, stage, deep-seated lesion, histoprognostic grade, adjuvant chemotherapy) were similar in both the RT and no-RT groups.
  • Adjuvant RT is indicated after mR resection and for residual tumour after definitive surgery, but its role after oR resection (primary resection or no residual tumour after re-excision) should be evaluated in a prospective randomised trial.
  • [MeSH-major] Sarcoma / radiotherapy. Soft Tissue Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Extremities. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Recurrence, Local. Neoplasm Staging. Postoperative Care / methods. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Time Factors

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  • (PMID = 12932665.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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20. Sun L, Wu LY, Li XG, Bai P, Zhang HT: [Clinical characterization of vulvar epithelioid sarcoma]. Zhonghua Zhong Liu Za Zhi; 2010 Dec;32(12):935-8
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  • [Title] [Clinical characterization of vulvar epithelioid sarcoma].
  • OBJECTIVE: Vulvar epithelioid sarcoma is a rare, undifferentiated soft-tissue sarcoma, with a high rate of local relapse, regional nodal spread and distant metastases.
  • The aim of this study was to investigate the clinical features, diagnosis, treatment and prognosis of this malignancy.
  • METHODS: We studied the clinicopathologic features of 20 cases of vulvar epithelioid sarcoma, of which 4 cases were admitted to our hospital from 1999 to 2009.
  • Seven patients were treated without adjuvant therapy.
  • Seven patients received postoperative radiotherapy only and three underwent chemotherapy.
  • Chemotherapy plus radiotherapy were given postoperatively in three.
  • 2 patients developed lymph node metastases but alive.
  • Survival of the early stage (I-II) patients was significantly longer than those in the advanced stage (III-IV) (median, 21 vs. 6 months, P < 0.01).
  • Radical local excision with adequate margin (at least 2 cm) and bilateral inguinofemoral lymphadenectomy is effective for the treatment of vulvar epithelioid sarcoma.
  • The role of adjuvant therapy, chemotherapy and radiation remains unclear but merits consideration.
  • [MeSH-major] Sarcoma / pathology. Sarcoma / surgery. Soft Tissue Neoplasms / pathology. Soft Tissue Neoplasms / surgery. Vulvar Neoplasms / pathology. Vulvar Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Female. Follow-Up Studies. Humans. Keratins / metabolism. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Mucin-1 / metabolism. Neoplasm Staging. Radiotherapy, Adjuvant. Retrospective Studies. Survival Rate. Vimentin / metabolism. Vulva / surgery. Young Adult


21. Orbach D, Rey A, Oberlin O, Sanchez de Toledo J, Terrier-Lacombe MJ, van Unnik A, Quintana E, Stevens MC: Soft tissue sarcoma or malignant mesenchymal tumors in the first year of life: experience of the International Society of Pediatric Oncology (SIOP) Malignant Mesenchymal Tumor Committee. J Clin Oncol; 2005 Jul 1;23(19):4363-71
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  • [Title] Soft tissue sarcoma or malignant mesenchymal tumors in the first year of life: experience of the International Society of Pediatric Oncology (SIOP) Malignant Mesenchymal Tumor Committee.
  • Sixty-four patients had rhabdomyosarcoma (RMS), 26 had undifferentiated sarcoma, and 12 had other histology.
  • Clinical TNM stage was stage I (41%), II (39%), III (6%), and IV (14%).
  • First-line treatment was ifosfamide, vincristine, dactinomycin, whereas the second-line combination consisted of either cisplatin and doxorubicin (in MMT 84) or vincristine, carboplatin, etoposide/teniposide (in MMT 89).
  • Chemotherapy doses were adapted to age.
  • Local therapy was conservative surgery as often as possible.
  • Only two of 13 stage IV patients survived.
  • CONCLUSION: OS was satisfactory even when local treatment was not aggressive, although the prognosis was poor for infants with alveolar RMS or metastatic tumors.
  • Chemotherapy toxicity was manageable with appropriate dose modification.
  • [MeSH-major] Sarcoma / drug therapy
  • [MeSH-minor] Age Factors. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Cyclophosphamide / therapeutic use. Dactinomycin / therapeutic use. Doxorubicin / administration & dosage. Epirubicin / therapeutic use. Etoposide / administration & dosage. Humans. Ifosfamide / therapeutic use. Infant. Infant, Newborn. Neoplasm Metastasis. Neoplasm Recurrence, Local. Rhabdomyosarcoma / drug therapy. Survival Analysis. Teniposide / administration & dosage. Vincristine / therapeutic use

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  • (PMID = 15994146.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 1CC1JFE158 / Dactinomycin; 3Z8479ZZ5X / Epirubicin; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; 957E6438QA / Teniposide; UM20QQM95Y / Ifosfamide; CEV protocol; IVA protocol
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22. MacDermed DM, Miller LL, Peabody TD, Simon MA, Luu HH, Haydon RC, Montag AG, Undevia SD, Connell PP: Primary tumor necrosis predicts distant control in locally advanced soft-tissue sarcomas after preoperative concurrent chemoradiotherapy. Int J Radiat Oncol Biol Phys; 2010 Mar 15;76(4):1147-53
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  • [Title] Primary tumor necrosis predicts distant control in locally advanced soft-tissue sarcomas after preoperative concurrent chemoradiotherapy.
  • PURPOSE: Various neoadjuvant approaches have been evaluated for the treatment of locally advanced soft-tissue sarcomas.
  • This retrospective study describes a uniquely modified version of the Eilber regimen developed at the University of Chicago.
  • METHODS AND MATERIALS: We treated 34 patients (28 Stage III and 6 Stage IV) with locally advanced soft-tissue sarcomas of an extremity between 1995 and 2008.
  • All patients received preoperative therapy including ifosfamide (2.5 g/m2 per day for 5 days) with concurrent radiation (28 Gy in 3.5-Gy daily fractions), sandwiched between various chemotherapy regimens.
  • Postoperatively, 47% received further adjuvant chemotherapy.
  • Of the resected tumor specimens, 50% exhibited high (> or =90%) treatment-induced necrosis and 11.8% had a complete pathologic response.
  • The 5-year survival rate was 42.3% for all patients and 45.2% for Stage III patients.
  • The 5-year freedom-from-distant metastasis rate was 53.4% (Stage IV patients excluded), and freedom from distant metastasis was superior if treatment-induced tumor necrosis was 90% or greater (84.6% vs. 19.9%, p = 0.02).
  • The resulting treatment-induced necrosis rates are predictive of subsequent metastatic risk, and this information may provide an opportunity to guide postoperative systemic therapies.

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
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  • (PMID = 19577863.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA124557-01A1; United States / NCI NIH HHS / CA / R21 CA124557; United States / NCI NIH HHS / CA / R21 CA124557-01A1
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
  • [Other-IDs] NLM/ NIHMS230212; NLM/ PMC2931332
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23. Kazanowska B, Mikołajewska A, Kołodziej A, Dorobisz U, Reich A, Chybicka A: [Role of total bladder resection and reconstructive surgery in children with soft tissue sarcomas--three clinical cases)]. Pol Merkur Lekarski; 2004 Jul;17(97):64-9
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  • [Title] [Role of total bladder resection and reconstructive surgery in children with soft tissue sarcomas--three clinical cases)].
  • Soft tissue tumors of the lower genitourinary tract in children require a multidisciplinary treatment.
  • The international CWS-91 and CWS-96 protocols established the second-look operation as a control procedure.
  • The article presents a short characteristic of the reconstructive method modo Studer, advantages connected with this procedure, possible complications as well as description of three clinical cases of children treated from 1994 to 2001 in the Department of Hematology and Pediatric Oncology in Wrocław.
  • All patients were qualified as the clinical stage III and treated with primary chemotherapy and/or radiotherapy, followed by total cystectomy and subsequent genitourinary reconstruction modo Studer.
  • This procedure led in all cases to the complete remission, which is present up to date.
  • The regular clinical and diagnostic controls as well as the patients' compliance enable the immediate detection of any possible complication as well as the nearly unchanged life activity.
  • [MeSH-major] Cystectomy. Reconstructive Surgical Procedures. Sarcoma / surgery. Urogenital Neoplasms / surgery
  • [MeSH-minor] Adolescent. Female. Humans. Male. Neoplasm Staging. Treatment Outcome

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  • (PMID = 15559616.001).
  • [ISSN] 1426-9686
  • [Journal-full-title] Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
  • [ISO-abbreviation] Pol. Merkur. Lekarski
  • [Language] pol
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Poland
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24. Brigman BE, Hornicek FJ, Gebhardt MC, Mankin HJ: Allografts about the Knee in Young Patients with High-Grade Sarcoma. Clin Orthop Relat Res; 2004 Apr;(421):232-9
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  • [Title] Allografts about the Knee in Young Patients with High-Grade Sarcoma.
  • Reconstruction after resections for high-grade sarcomas about the knee in children and adolescents is a challenging problem because of the large soft tissue and skeletal defects, the effects of adjuvant therapy, and the potential for long-term use of the limb.
  • One hundred sixteen patients, all 18 years or younger, with osteosarcoma or Ewing's sarcoma located between the middle femur and middle tibia, were treated with chemotherapy, resection, and allograft reconstruction.
  • One hundred three patients with osteosarcoma and 13 patients with Ewing's sarcoma had 105 Stage II and 11 Stage III tumors.
  • Reconstruction of large bone defects about the knee in young patients who are being treated with chemotherapy is difficult.
  • [MeSH-major] Bone Neoplasms / surgery. Bone Transplantation. Knee Joint / surgery. Sarcoma, Ewing / surgery
  • [MeSH-minor] Adolescent. Child. Female. Follow-Up Studies. Humans. Male. Recovery of Function / physiology. Time Factors. Transplantation, Homologous. Treatment Outcome

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  • (PMID = 15123953.001).
  • [ISSN] 0009-921X
  • [Journal-full-title] Clinical orthopaedics and related research
  • [ISO-abbreviation] Clin. Orthop. Relat. Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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25. Pappo AS, Devidas M, Jenkins J, Rao B, Marcus R, Thomas P, Gebhardt M, Pratt C, Grier HE: Phase II trial of neoadjuvant vincristine, ifosfamide, and doxorubicin with granulocyte colony-stimulating factor support in children and adolescents with advanced-stage nonrhabdomyosarcomatous soft tissue sarcomas: a Pediatric Oncology Group Study. J Clin Oncol; 2005 Jun 20;23(18):4031-8
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  • [Title] Phase II trial of neoadjuvant vincristine, ifosfamide, and doxorubicin with granulocyte colony-stimulating factor support in children and adolescents with advanced-stage nonrhabdomyosarcomatous soft tissue sarcomas: a Pediatric Oncology Group Study.
  • PURPOSE: To describe the response rate and survival of children and adolescents with unresected or metastatic nonrhabdomyosarcomatous soft tissue sarcomas (NRSTS) treated with vincristine, ifosfamide, and doxorubicin.
  • Granulocyte colony-stimulating factor was administered daily (5 mug/kg) after each cycle of chemotherapy.
  • RESULTS: The median patient age at diagnosis was 11.7 years; the most common primary tumor site was lower extremity (36%); and synovial sarcoma was the predominant histology.
  • Patients with clinical group III disease had significantly better 3-year and progression-free survival rates compared with patients who presented with metastatic disease.
  • Patients with synovial sarcoma had higher response rates than other patients, and patients with unresected disease had improved outcomes.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Sarcoma / drug therapy. Soft Tissue Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Child. Combined Modality Therapy. Doxorubicin / administration & dosage. Female. Granulocyte Colony-Stimulating Factor / administration & dosage. Humans. Ifosfamide / administration & dosage. Male. Mesna / administration & dosage. Neoadjuvant Therapy. Protective Agents / administration & dosage. Survival Analysis. Treatment Outcome. Vincristine / administration & dosage

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  • [CommentIn] J Clin Oncol. 2005 Jun 20;23(18):4003-5 [15767649.001]
  • (PMID = 15767644.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Protective Agents; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; NR7O1405Q9 / Mesna; UM20QQM95Y / Ifosfamide
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26. García-Aceituno L, Villarreal-Garza C, Perfecto M, León-Rodríguez E: Retroperitoneal soft tissue sarcomas: experience at a single institution in Mexico. World J Surg; 2010 Jul;34(7):1511-6
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  • [Title] Retroperitoneal soft tissue sarcomas: experience at a single institution in Mexico.
  • BACKGROUND: Retroperitoneal soft tissue sarcomas (RSTS) are a rare and uncommon entity with a poor 5-year overall survival (OS) of approximately 50%, even though they rarely metastasize.
  • Variables analyzed were age, sex, histological type, TNM stage, tumor size, grade of differentiation, and treatment (surgery, chemotherapy only, radiotherapy only, adjuvant radiotherapy, and best supportive care).
  • Overall survival, recurrence-free survival (RFS), cancer-specific survival (CSS), and survival comparison by stage, grade, and type of resection were analyzed.
  • The median CSS for resected patients was 102 months; the 5-year OS for stages I, III, and IV was 83, 37, and 0%, respectively; the 5-year OS for low histological grade disease and high histological grade disease was 82 and 35%, respectively; and for R0, R1, and R2 resection, the 5-year OS was 81, 56, and 14%, respectively.
  • CONCLUSIONS: Incomplete surgical resection, unresectable disease, high histological grade, and advanced TNM stage are associated with a poor survival in patients with RSTS.
  • Complete resection is still the treatment of choice.
  • [MeSH-major] Retroperitoneal Neoplasms / mortality. Sarcoma / mortality
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Female. Humans. Kaplan-Meier Estimate. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Staging. Retrospective Studies. Tomography, X-Ray Computed. Young Adult

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  • (PMID = 20162280.001).
  • [ISSN] 1432-2323
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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27. Tiwari A, Gupta H, Jain S, Kapoor G: Outcome of multimodality treatment of Ewing's sarcoma of the extremities. Indian J Orthop; 2010 Oct;44(4):378-83

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Outcome of multimodality treatment of Ewing's sarcoma of the extremities.
  • BACKGROUND: The management of Ewing's sarcoma family of tumors (ESFT, Ewing's sarcoma/primitive neuroectodermal tumor) has been established as a multimodality treatment.
  • Advances in imaging and diagnostics, chemotherapy, surgical techniques, radiotherapy and prosthetic technology have resulted in drastic changes in the outcome of this disease, with most of the recent studies having 5-year survival rates of more than 60%.
  • The Indian patients present at a more advanced stage and the compliance of treatment is suboptimal.
  • While there is plenty of data in the world literature on the outcome of Ewing's sarcoma, there is paucity of data in Indian patients.
  • Therefore, we conducted the present study to analyze the outcome of multimodality treatment of ESFT of the extremities at a tertiary nonprofit institute over a decade.
  • MATERIALS AND METHODS: 34 patients who had histopathologically proven diagnosis of Ewing's sarcoma of the extremities and had received treatment at our institute from 1997 through 2007 were included for analysis.
  • The majority of patients had involvement of the femur (35%), followed by tibia (17%), fibula and foot (15% each), humerus (12%) and soft tissue of thigh (6%).
  • Twenty-nine patients presented with localized disease (Enneking stage II B) while five patients presented with metastases (Enneking stage III).
  • All patients received Vincristine, Actinomycin D, Cyclofosfamide + Ifosfamide and Etoposide (VAC+IE)-based chemotherapy and local treatment was offered to all but three patients having multicentric disease.
  • The local treatment offered were, radiation (n= 15), surgery (n= 12) both surgery and radiation (n=4).
  • These outcomes were correlated with age, sex, size of tumor, stage at presentation, modality of local treatment and site of relapse.
  • On correlation with age, sex, size of tumor, stage at presentation, modality of local treatment and site of relapse, no correlation of survival was seen with any of the variables except event-free survival with size of the tumor.
  • CONCLUSION: Although the demographic profile, stage at presentation and the local and systemic treatment regimen followed in our study was similar to the world literature, the outcome of Ewing's sarcoma in Indian patients were found to be inferior to that reported in the western literature.

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  • (PMID = 20924477.001).
  • [ISSN] 1998-3727
  • [Journal-full-title] Indian journal of orthopaedics
  • [ISO-abbreviation] Indian J Orthop
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Other-IDs] NLM/ PMC2947723
  • [Keywords] NOTNLM ; Ewing’s sarcoma / extremity / multimodal chemotherapy
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28. Fanucchi M: Update on the management of connective tissue malignancies. Semin Oncol; 2004 Apr;31(2 Suppl 4):16-9
MedlinePlus Health Information. consumer health - Soft Tissue Sarcoma.

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  • [Title] Update on the management of connective tissue malignancies.
  • Approximately 11,000 new cases of connective tissue malignancies are anticipated in 2004.
  • These diseases can be divided into soft-tissue sarcomas, sarcomas of bone, and gastrointestinal stromal tumors.
  • Optimal management of these diseases requires a multidisciplinary team with expertise in surgery, pathology, radiotherapy, and chemotherapy.
  • Over half of patients with stage III soft tissue and bone sarcomas are cured, as are some patients with metastatic disease.
  • Imatinib mesylate has been an important advance in the treatment of gastrointestinal stromal tumors.
  • [MeSH-major] Sarcoma / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Bone Neoplasms / therapy. Combined Modality Therapy. Gastrointestinal Neoplasms / therapy. Humans. Soft Tissue Neoplasms / therapy

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  • (PMID = 15124129.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 27
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29. Guo W, Ji T, Yant Y: [Endoprosthetic reconstruction after wide resection of sarcoma in lower extremities]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2006 Oct;20(10):970-4
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  • [Title] [Endoprosthetic reconstruction after wide resection of sarcoma in lower extremities].
  • OBJECTIVE: To assess the clinical outcome of the limb salvage surgery and complications occurring in the lower extremities after a wide resection of sarcoma.
  • METHODS: A total of 167 patients underwent a limb-sparing procedure by means of the implantation of a custom-made or modular tumor endoprosthesis from July 1997 to July 2004.
  • In 5 patients, a proximal femur prosthesis was implanted; in 57 patients, a distal femur prosthesis was implanted; and in 38 patients, a proximal tibia prosthesis was implanted.
  • According to the Enneking staging, 3 patients were grouped in the stage of II A, 85 in I B, and 12 in III.
  • All the patients received chemotherapy for 1-2 courses and 3-5 courses before operation and after operation, respectively.
  • Local recurrence developed in 7 patients within 6 months to 2 years after operation.
  • Of the 7 patients, 4 had a recurrence of the soft tissue tumor for which resection was performed; the other 3 patients underwent amputation of the diseased limb.

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  • (PMID = 17140065.001).
  • [ISSN] 1002-1892
  • [Journal-full-title] Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery
  • [ISO-abbreviation] Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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30. Karakousis CP: Surgical treatment of locally progressive stage IIIB carcinoma of the cervix: use of the inverted "T" incision. Eur J Obstet Gynecol Reprod Biol; 2004 Aug 10;115(2):216-8
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  • [Title] Surgical treatment of locally progressive stage IIIB carcinoma of the cervix: use of the inverted "T" incision.
  • Stage III carcinoma of the cervix is treated usually, and often effectively, with the combination of radiation and chemotherapy.
  • The described surgical technique derives from soft tissue sarcoma pelvic surgery.

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  • (PMID = 15262359.001).
  • [ISSN] 0301-2115
  • [Journal-full-title] European journal of obstetrics, gynecology, and reproductive biology
  • [ISO-abbreviation] Eur. J. Obstet. Gynecol. Reprod. Biol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Ireland
  • [Number-of-references] 7
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31. Meza JL, Anderson J, Pappo AS, Meyer WH, Children's Oncology Group: Analysis of prognostic factors in patients with nonmetastatic rhabdomyosarcoma treated on intergroup rhabdomyosarcoma studies III and IV: the Children's Oncology Group. J Clin Oncol; 2006 Aug 20;24(24):3844-51
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  • [Title] Analysis of prognostic factors in patients with nonmetastatic rhabdomyosarcoma treated on intergroup rhabdomyosarcoma studies III and IV: the Children's Oncology Group.
  • PURPOSE: The outcome for localized rhabdomyosarcoma (RMS) or undifferentiated sarcoma (UDS) is affected by age, histology, primary anatomic site, extent of disease, and therapy.
  • PATIENTS AND METHODS: We evaluated patient and disease characteristics for their ability to predict outcome for patients with nonmetastatic RMS or UDS treated on Intergroup Rhabdomyosarcoma Study (IRS) -III (1984 to 1991) or IRS-IV (1991 to 1997).
  • RESULTS: The estimated 5-year failure-free survival (FFS) rate was 90% for patients with embryonal RMS (ERMS) stage 1, group I or IIa; stage 2, group I; or group III orbit.
  • The estimated 5-year FFS rate was 87% for patients with ERMS stage 1, group IIb or IIc; stage 1, group III nonorbit; stage 2, group II; and stage 3, group I or II; and 73% for patients with ERMS stage 2 or 3, group III.
  • The estimated 5-year FFS rate was poor for patients with stage 2 or 3, group III ERMS with invasive (T2) tumors who were age younger than 1 year or 10 years or older (56%) and patients with stage 2 or 3, group III extremity primary tumors (43%).
  • However, the 5-year FFS rate was good for patients with ARMS/UDS at favorable sites with group I or II (80%) or group III (76%) disease.
  • The FFS rate was poorer for patients with ARMS/UDS at unfavorable sites with group I or II (66%) or group III (45%) disease.
  • The estimated 5-year FFS rate was 31% for patients with group III ARMS/UDS at unfavorable sites with regional lymph node disease, which is similar to metastatic RMS.
  • CONCLUSION: Patient and disease characteristics identify distinct subsets with different outcomes, allowing the Soft Tissue Sarcoma Committee of the Children's Oncology Group to refine risk-adapted therapy assignment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Rhabdomyosarcoma / therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Dactinomycin / administration & dosage. Disease-Free Survival. Doxorubicin / administration & dosage. Drug Administration Schedule. Etoposide / administration & dosage. Female. Humans. Ifosfamide / administration & dosage. Infant. Infusions, Intravenous. Male. Neoplasm Staging. Predictive Value of Tests. Prognosis. Risk Assessment. Risk Factors. Survival Analysis. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 16921036.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA-24507; United States / NCI NIH HHS / CA / CA-72989
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 1CC1JFE158 / Dactinomycin; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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32. Demiralp B, Ozdemir MT, Erler K, Basbozkurt M: Type 1 neurofibromatosis and adult extremity sarcoma. A report of two cases. Acta Orthop Belg; 2007 Jun;73(3):403-7
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  • [Title] Type 1 neurofibromatosis and adult extremity sarcoma. A report of two cases.
  • We report two cases of malignant soft-tissue tumours--one myxoid malignant fibrous histiocytoma and one pleomorphic rhabdomyosarcoma--which were diagnosed in two young adult patients with type 1 neurofibromatosis (NF 1).
  • The tumours were stage II and III respectively.
  • Both patients were treated with radiotherapy or chemotherapy and surgical intervention.
  • Thus detection of subtypes of rhabdomyosarcoma and malignant fibrous histiocytoma with immunohistochemistry may be helpful for the management of these tumours among other pleomorphic sarcomas that may occur in type 1 Neurofibromatosis.
  • [MeSH-major] Histiocytoma, Malignant Fibrous / complications. Neoplasms, Multiple Primary. Neurofibromatosis 1 / complications. Rhabdomyosarcoma / complications. Soft Tissue Neoplasms

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  • (PMID = 17715736.001).
  • [ISSN] 0001-6462
  • [Journal-full-title] Acta orthopaedica Belgica
  • [ISO-abbreviation] Acta Orthop Belg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Belgium
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33. Polish Paediatric Solid Tumours Study Group, Bień E, Stachowicz-Stencel T, Kazanowska B, Balcerska A, Balwierz W, Chybicka A, Dłuzniewska A, Drozyńska E, Kurylak A, Matysiaks M, Krawczuk-Rybak M, Rychłowska M, Solarz E, Sopyło B, Stencels D, Wachowiaks J, Wieczorek M, Woźniak W, Wysocki M: [Genitourinary soft tissue sarcomas located outside bladder and prostate in children treated according to the CWS-96 protocol--report from the Polish Paediatric Solid Tumours Study Group]. Med Wieku Rozwoj; 2005 Jul-Sep;9(3 Pt 2):507-15
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  • [Title] [Genitourinary soft tissue sarcomas located outside bladder and prostate in children treated according to the CWS-96 protocol--report from the Polish Paediatric Solid Tumours Study Group].
  • AIM: Analysis of therapy efficacy in non-bladder/prostate genitourinary sarcomas in children treated from I'1997 to VI'2003 with CWS-96 protocol in Poland.
  • 63% presented with low stage neoplasm (I - 7, II - 5).
  • Primary tumour exceeded 5cm and/or invaded surrounding tissues in 7 patients (37%).
  • Six of 7 patients with macroscopic tumour residues responded to chemotherapy (CR-4, GR-2).
  • One patient (stage III triton tumour of uterus) did not, respond but obtained complete remission after mutilating delayed surgery.
  • Radiotherapy (23,5-54 Gy) was given to 8 patients.
  • 3 children developed local relapse, 3 patients died (16%): 2 due to neoplasm progression, 1 of neutropenia-related sepsis.
  • 2) chemotherapy and radiotherapy were accompanied by severe but transient myelosupression in the HR group.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Rhabdomyosarcoma / diagnosis. Rhabdomyosarcoma / drug therapy. Sarcoma / diagnosis. Sarcoma / drug therapy. Urogenital Neoplasms / diagnosis. Urogenital Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Humans. Infant. Lymphatic Metastasis. Male. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Treatment Outcome

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  • (PMID = 16719163.001).
  • [Journal-full-title] Medycyna wieku rozwojowego
  • [ISO-abbreviation] Med Wieku Rozwoj
  • [Language] pol
  • [Publication-type] Clinical Trial; English Abstract; Journal Article
  • [Publication-country] Poland
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34. Hensley ML: Update on gemcitabine and docetaxel combination therapy for primary and metastatic sarcomas. Curr Opin Oncol; 2010 Jul;22(4):356-61
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  • [Title] Update on gemcitabine and docetaxel combination therapy for primary and metastatic sarcomas.
  • PURPOSE OF REVIEW: The combination of fixed-dose-rate gemcitabine and docetaxel has become an established treatment option for advanced uterine leiomyosarcoma and has demonstrated efficacy in nonleiomyosarcoma histology soft-tissue sarcomas.
  • The activity of this regimen in advanced uterine leiomyosarcoma, other soft-tissue sarcomas, and pediatric sarcomas is discussed.
  • RECENT FINDINGS: Fixed-dose-rate gemcitabine and docetaxel achieved high objective response rates in three prospective phase II studies as first-line or second-line therapy for advanced uterine leiomyosarcoma.
  • In a randomized trial, the combination of gemcitabine and docetaxel was superior to gemcitabine alone in terms of objective response, progression-free, and overall survival among patients with soft-tissue sarcoma, most of whom had received at least one prior cytotoxic regimen.
  • In a small, prospective phase II trial for women with completely resected stage I, II, III, or IV high-grade uterine leiomyosarcoma, adjuvant treatment with gemcitabine-docetaxel was associated with a 2-year progression-free survival rate that appears superior to that of historical controls.
  • SUMMARY: Fixed-dose-rate gemcitabine and docetaxel is a reasonable treatment option for patients with advanced soft-tissue sarcoma.
  • The regimen is a good choice as first-line or second-line therapy for advanced uterine leiomyosarcoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Sarcoma / drug therapy. Soft Tissue Neoplasms / drug therapy
  • [MeSH-minor] Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Disease-Free Survival. Humans. Taxoids / administration & dosage. Treatment Outcome

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  • (PMID = 20520541.001).
  • [ISSN] 1531-703X
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Taxoids; 0W860991D6 / Deoxycytidine; 15H5577CQD / docetaxel; B76N6SBZ8R / gemcitabine
  • [Number-of-references] 34
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35. Turcotte RE, Ferrone M, Isler MH, Wong C: Outcomes in patients with popliteal sarcomas. Can J Surg; 2009 Feb;52(1):51-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: Soft-tissue sarcoma involving the popliteal fossa remains challenging because it is difficult to achieve wide margins with limb salvage in this location.
  • Adjuvant therapy is frequently necessary, and limb function can be adversely affected.
  • Frequent histologic diagnoses were liposarcoma (n = 6), synovial sarcoma (n = 4) and leiomyosarcoma (n = 3).
  • American Joint Committee on Cancer staging was as follows: 4 patients had stage IIa disease, 3 patients had stage IIb, 10 patients had stage III and 1 patient had stage IV disease.
  • Treatment consisted of limb salvage in 15 patients and amputation in 3.
  • Fourteen patients had radiotherapy, 4 had chemotherapy, and 3 needed partial sciatic nerve resection.
  • [MeSH-major] Knee. Outcome Assessment (Health Care). Sarcoma / therapy. Soft Tissue Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Amputation / statistics & numerical data. Chemotherapy, Adjuvant. Databases, Factual. Female. Humans. Limb Salvage. Lung Neoplasms / secondary. Male. Middle Aged. Prospective Studies. Radiotherapy, Adjuvant. Retrospective Studies. Sciatic Nerve / surgery. Surgical Wound Dehiscence / etiology. Surgical Wound Infection / etiology. Thrombophlebitis / etiology. Young Adult

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  • (PMID = 19234652.001).
  • [ISSN] 1488-2310
  • [Journal-full-title] Canadian journal of surgery. Journal canadien de chirurgie
  • [ISO-abbreviation] Can J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Canada
  • [Other-IDs] NLM/ PMC2637647
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36. McCarter MD, Lewis JJ, Antonescu CR, Brennan MF: Extraskeletal osteosarcoma: analysis of outcome of a rare neoplasm. Sarcoma; 2000;4(3):119-23
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  • Purpose. Extraskeletal osteosarcoma represents an unusual soft-tissue sarcoma that historically is reported to carry an exceptionally poor prognosis.The objectives of this study were to use a prospectively gathered sarcoma database to test the prevailing clinical bias and more accurately describe the natural history, characterize the prognostic features, estimate survival and evaluate treatment strategies for this unusual sarcoma.Patients and methods.
  • Use of adjuvant chemotherapy or radiation therapy did not appear to influence survival, but an effect may have been missed by the relatively low numbers in each group.When matched to a comparable group of patients with stage III extremity sarcomas, there was no significant difference in overall or disease-specific survival between groups.
  • Treatment for extraskeletal osteosarcoma should follow established guidelines for treatment of soft-tissue sarcomas, with the decision regarding adjuvant therapy to be based on individual risk factors.

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  • (PMID = 18521290.001).
  • [ISSN] 1357-714X
  • [Journal-full-title] Sarcoma
  • [ISO-abbreviation] Sarcoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
  • [Other-IDs] NLM/ PMC2395433
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37. Edmonson JH, Ryan LM, Falkson CI, Hicks DG, Blum RH: Phase II Study of Ifosfamide+Doxorubicin in Patients With Advanced Synovial Sarcomas (E1793): A Trial of the Eastern Cooperative Oncology Group. Sarcoma; 2003;7(1):9-11

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Purpose Because we had observed in the synovial sarcoma subgroup of a broad phase III advanced soft tissue sarcoma study a significantly greater objective regression rate from ifosfamide+doxorubicin (88%) than from doxorubicin alone (20%) (P = 0.02), the Eastern Cooperative Oncology Group (ECOG) decided to further assess this two drug combination in a subsequent Phase II study.Patients Between 1994 and 1999, twelve adult patients with advanced synovial sarcomas were enrolled to receive, as their initial chemotherapy, ifosfamide 7.5 gm/m(2) plus doxorubicin 60 mg/m(2), given intravenously over two consecutive days every 3 weeks.Methods Each day for 2 days doxorubicin 30 mg/m(2) was infused over 5 min through a running i.v., followed by ifosfamide 3750 mg/m(2) over 4 h.
  • Continuous i.v. fluid was infused at 300 mL/h for 3 h on day 1, before chemotherapy was begun; then the infusion was continued at 100 mL/h for a total of 3 days.
  • Mesna 750 mg/m(2) was given 15 min before ifosfamide and at 4 and 8 h after ifosfamide on days 1 and 2 of each treatment cycle.
  • Filgrastim (G-CSF) 5 mug/kg was given subcutaneously each day for 14 days beginning on day 3 of each treatment cycle to limit the severity of neutropenia.Results Five of our 12 patients (42%) experienced partial regression of their advanced synovial sarcomas; however, this first stage result was borderline for proceeding to the second planned stage of accrual and our case accrual was quite poor.
  • Thus, the study was closed after stage one accrual.
  • Our patients received a median of four cycles of chemotherapy (range: 1 to 6).
  • All patients experienced at least grade 3 neutropenia (grade 4 in nine of them), and one patient died of treatment-related sepsis following the initial cycle of chemotherapy.

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  • (PMID = 18521363.001).
  • [ISSN] 1357-714X
  • [Journal-full-title] Sarcoma
  • [ISO-abbreviation] Sarcoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
  • [Other-IDs] NLM/ PMC2395511
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38. Nag S, Tippin D, Ruymann FB: Intraoperative high-dose-rate brachytherapy for the treatment of pediatric tumors: the Ohio State University experience. Int J Radiat Oncol Biol Phys; 2001 Nov 1;51(3):729-35
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  • [Title] Intraoperative high-dose-rate brachytherapy for the treatment of pediatric tumors: the Ohio State University experience.
  • PURPOSE: To determine whether intraoperative high-dose-rate brachytherapy (IO-HDRBT) can be used to decrease the dose of external beam radiotherapy (EBRT) in the treatment of children with soft-tissue sarcomas and, thereby, reduce morbidity without compromising local control.
  • METHODS AND MATERIALS: From March 1992 through April 1999, 13 pediatric patients were treated with IO-HDRBT, low-dose EBRT, chemotherapy, and radical surgery at 21 sites that were not amenable to intraoperative electron beam therapy.
  • The IO-HDRBT dose at 5 mm depth was 10 to 12.5 Gy for close margins/microscopic disease at 14 sites and 12.5 to 15 Gy for gross disease at 7 sites.
  • The treatment volumes ranged from 4 to 96 cm(3) (mean 27).
  • The EBRT dose was limited to 27-30 Gy in most cases to minimize growth retardation and preserve normal organ function.
  • Of the 2 who died, 1 had Stage III pulmonary blastoma with a sacral recurrence; the other had Stage IV undifferentiated synovial sarcoma with a pulmonary recurrence.
  • One local failure occurred in a patient with gross residual disease after incomplete resection for Stage IV pulmonary blastoma.
  • One patient developed impaired orbital growth with mild ptosis.
  • CONCLUSIONS: IO-HDRBT allowed for reduction in EBRT without compromising local control or disease-free survival in children with soft-tissue sarcomas.
  • [MeSH-major] Brachytherapy / methods. Sarcoma / radiotherapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Intraoperative Period. Male. Survival Rate. Treatment Outcome

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  • (PMID = 11597815.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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39. Wiener ES, Anderson JR, Ojimba JI, Lobe TE, Paidas C, Andrassy RJ, Raney RB, Qualman SJ, Donaldson SS, Maurer HM, Link MP, Crist WM, Grier HE: Controversies in the management of paratesticular rhabdomyosarcoma: is staging retroperitoneal lymph node dissection necessary for adolescents with resected paratesticular rhabdomyosarcoma? Semin Pediatr Surg; 2001 Aug;10(3):146-52
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  • The Intergroup Rhabdomyosarcoma Study Group (IRSG) required ipsilateral RPLND (IRPLND) for all patients with PTRMS treated on IRS-III (1984-91), but changed to clinical evaluation of RPLNs using computerized tomography (CT) in IRS-IV (1991 through 1997).
  • Nodal radiation therapy was administered only to patients with RPLNs recognized as positive; such patients received more intensive chemotherapy as well.
  • METHODS: Eligible patients with group I or II PTRMS who were treated on IRS III (n = 100) or IRS IV (n = 134) were analyzed.
  • RESULTS: There was a significant change in the distribution of patients with group I versus II tumors from IRS-III to IRS-IV (group I, 68% in IRS-III versus 82% in IRS-IV).
  • This was the result of decreased node recognition when CT was used to stage RPLNs in IRS-IV and was most notable for adolescents (>10 years of age).
  • Overall, 3-year FFS was 92% for patients treated on IRS-III and 86% for those treated on IRS-IV (P =.10), whereas survival estimates were 96% and 92%, respectively (P =.30).
  • Furthermore, adolescents with recognized group II tumors experienced better 3-year FFS than those with group I tumors on IRS-IV (100% versus 68%, P =.06), most likely as a result of receiving radiotherapy and intensified chemotherapy.
  • CONCLUSIONS: Use of only CT scan evaluation of RPLN in IRS-IV led to a decrease in identification of RPLN involvement in boys who present with localized PTRMS, and a higher rate of regional relapse as compared with IRS-III.
  • Furthermore, adolescent boys with group I tumors experienced worse FFS than those with Group II tumors on IRS-IV, probably because some patients with group II tumors were not identified by CT imaging and thus received less effective therapy.
  • These data suggest that adolescents should have ipsilateral RPLN dissection as part of their routine staging, and those with positive lymph nodes require intensified chemotherapy as well as nodal irradiation.
  • [MeSH-major] Lymph Node Excision. Neoplasm Staging. Retroperitoneal Space / surgery. Rhabdomyosarcoma / drug therapy. Rhabdomyosarcoma / surgery
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Humans. Male. Survival Rate / trends. Testicular Neoplasms. Treatment Outcome

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  • [Copyright] Copyright 2001 by W.B. Saunders Company
  • (PMID = 11481652.001).
  • [ISSN] 1055-8586
  • [Journal-full-title] Seminars in pediatric surgery
  • [ISO-abbreviation] Semin. Pediatr. Surg.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA24507; United States / NCI NIH HHS / CA / CA72989
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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40. Donaldson SS, Meza J, Breneman JC, Crist WM, Laurie F, Qualman SJ, Wharam M, Children's Oncology Group Soft Tissue Sarcoma Committee (formely Intergroup Rhabdomyosarcoma Group) representing the Children's Oncology Group and the Quality Assurance Review Center: Results from the IRS-IV randomized trial of hyperfractionated radiotherapy in children with rhabdomyosarcoma--a report from the IRSG. Int J Radiat Oncol Biol Phys; 2001 Nov 1;51(3):718-28
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: To evaluate the outcome and toxicity of hyperfractionated radiotherapy (HFRT) vs. conventionally fractionated radiotherapy (CFRT) in children with Group III rhabdomyosarcoma (RMS).
  • METHODS AND MATERIALS: Five hundred fifty-nine children were enrolled into the Intergroup Rhabdomyosarcoma Study IV with Group III RMS.
  • Of the 490 remaining, 239 were randomized to HFRT (59.4 Gy in 54 1.1-Gy twice daily fractions) and 251 to CFRT (50.4 Gy in 28 1.8-Gy daily fractions).
  • All patients received chemotherapy.
  • RT began at Week 9 after induction chemotherapy for all but those with high-risk parameningeal tumors who received RT during induction chemotherapy.
  • RESULTS: Analysis by randomized treatment assignment (intent to treat) revealed an estimated 5-year failure-free survival (FFS) rate of 70% and overall survival (OS) of 75%.
  • In the univariate analysis, the factors associated with the best outcome were age 1-9 years at diagnosis; noninvasive tumors; tumor size <5 cm; uninvolved lymph nodes; Stage 1 or 2 disease; primary site in the orbit or head and neck; and embryonal histologic features (p = 0.001 for all factors).
  • No differences in the FFS or OS between the two RT treatment methods and no differences in the FFS or OS between HFRT and CFRT were found when analyzed by age, gender, tumor size, tumor invasiveness, nodal status, histologic features, stage, or primary site.
  • Treatment compliance differed by age.
  • Of the children >or=5 years, 88% assigned to both HFRT and CFRT received their assigned treatment.
  • The reasons for not receiving the appropriate randomized treatment were progressive disease, early death, parent or physician refusal, young age, or surgery.
  • The analysis by treatment actually received revealed a 5-year FFS rate of 73% and OS rate of 77%, with no difference between CFRT and HFRT.
  • As well, there was no difference in FFS or OS between CFRT and HFRT when analyzed by age, gender, tumor size, tumor invasiveness, modal status, histology, stage or site of primary.
  • The risk of local/regional failure was comparable to that of distant failure in children with Group III RMS.
  • The standard of care for Group III RMS continues to be CFRT with chemotherapy.
  • [MeSH-minor] Adolescent. Adult. Analysis of Variance. Child. Child, Preschool. Female. Humans. Infant. Male. Patient Compliance. Radiation Injuries / classification. Radiation Injuries / pathology. Remission Induction. Treatment Outcome

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2002 Dec 1;54(5):1579-80; author reply 1580 [12459396.001]
  • (PMID = 11597814.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA-24507
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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41. Terenziani M, D'Angelo P, Bisogno G, Boldrini R, Cecchetto G, Collini P, Conte M, De Laurentis T, Ilari I, Indolfi P, Inserra A, Piva L, Siracusa F, Spreafico F, Tamaro P, Lo Curto M: Teratoma with a malignant somatic component in pediatric patients: the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) experience. Pediatr Blood Cancer; 2010 Apr;54(4):532-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PROCEDURE: The Associazione Italiana Ematologia Oncologia Pediatrica identified 14 cases of TMSC.
  • RESULTS: The series (9 female, 5 male) showed the following disease: testis (2), sacrococcygeal (3), ovary (3), retroperitoneum (3), mediastinum (2), and foot soft tissue (1).
  • Distribution of the somatic component was: carcinoma (4), pancreatic neuroendocrine tumor (1), neuroblastoma (3), rhabdomyosarcoma (3), rhabdomyosarcoma plus liposarcoma, chondrosarcoma, neurogenic sarcoma (1), chondrosarcoma plus neuroectodermal sarcoma (1), malignant peripheral nerve sheath tumor (1).
  • Three patients were in stage I, four in stage II, three in stage III, and four in stage IV.
  • Chemotherapy optimized for histology should include reagents directed to the somatic malignancy, if chemosensitive.
  • Malignant GCT warrants GCT-directed chemotherapy.
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Humans. Infant. Infant, Newborn. Italy. Male. Neoplasm Staging. Prognosis. Retrospective Studies. Treatment Outcome

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  • (PMID = 20049928.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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42. Bramwell VH: Controversies in surgical oncology: routine anthracycline-based adjuvant chemotherapy for stage III extremity soft tissue sarcoma. Ann Surg Oncol; 2007 Apr;14(4):1254-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Controversies in surgical oncology: routine anthracycline-based adjuvant chemotherapy for stage III extremity soft tissue sarcoma.
  • [MeSH-major] Anthracyclines / therapeutic use. Antineoplastic Agents / therapeutic use. Sarcoma / drug therapy. Soft Tissue Neoplasms / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Clinical Trials as Topic. Humans. Medical Oncology

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  • (PMID = 17103260.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anthracyclines; 0 / Antineoplastic Agents
  • [Number-of-references] 29
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