Local control and survival in soft tissue sarcomas of the limbs, trunk walls and head and neck: A study of 113 cases

Abbatucci, J.S.; Boulier, N.; Ranieri, J. De; Mandard, A.M.; Tanguy, Alain; Vernhes, J.C.; Lozier, J.C.; Busson, A

doi:10.1016/0360-3016(86)90066-0

Cited by 48 publications

(5 citation statements)

References 19 publications

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“…According to Brant (personal communication), 56 patients treated with preoperative radiation and surgical excision were examined with attention to surgical niargins. Resections were classed as intracapsular (9), marginal with margins within the reactive zone (24), or wide, (24), wide excision with a "safe margin of healthy tissue" (84), or marginal excision if the resection was close to the tumor or through the pseudocapsule or reactive zone (40). Twenty-one resections were considered marginal, and the patients subsequently received postoperative radiation therapy; 19 were scored as marginal due to reclassification based on review of operative and pathologic notes, and these patients did not receive radiation, Local recurrence results were: O%, amputation; 4%, compartmental resection; 892, wide excision; 1 O%, marginal excision with radiation; and 37% marginal excision without radiation.…”

Section: Discussionmentioning

confidence: 99%

Preoperative radiation, surgical margins, and local control of extremity sarcomas of soft tissues

Sadoski

Suit

Rosenberg

et al. 1993

Journal of Surgical Oncology

254

108

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The relationship between status of the surgical margin and local control of soft tissue sarcoma of the extremities by preoperative radiation therapy has been assessed in 132 consecutive patients from 1974 to 1988. The 5-year actuarial local control rate was 94% for all patients; the rates were 97% and 82% for the 104 tumors with negative margins and the 28 tumors with positive margins, respectively. The local control rate was independent of the extent of the negative margin. For primary sarcomas, the local control rates were 96%, 97%, and 100%, respectively, for margins that were negative at < or = 1 mm or > 1 mm, or the specimens were negative for tumor; for positive margins the result was 83%. The overall local control rate was lower (not significant) for recurrent than for primary sarcomas: 88% vs. 94%. On the other hand, when stratifying by margin status, no difference was observed in local control results, i.e.: (1) 97% and 91% for primary and recurrent tumors with negative margins, respectively, and (2) 83% and 80% for primary and recurrent tumors with positive margins, respectively. Local control was not significantly higher in those patients who were treated by surgical resection (S), radiation (RT), and re-excision of the previous tumor bed than in those whose radiation therapy was started after the biopsy and followed by one surgical resection. For primary sarcomas that were resected with negative margins the results were: 100% of 15 patients treated by S-RT-S and 96% of 75 patients treated by RT-S.

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Section: Discussionmentioning

confidence: 99%

Preoperative radiation, surgical margins, and local control of extremity sarcomas of soft tissues

Sadoski

Suit

Rosenberg

et al. 1993

Journal of Surgical Oncology

254

108

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“…This analysis suggests that only patients with negative margins and welldifferentiated lesions can be effectively treated with surgery alone for sinonasal sarcomas. The importance of resection margins in sarcomas was emphasized by Abbatucci et al 16 In their study of local control following resection of sarcomas of all sites, they found that local control was 98% at 5 and 10 years in patients with negative margins, and only 56% among patients with positive margins.…”

Section: Initial Outcome No Evidence Ofdisease Failed Salvaged Totalmentioning

confidence: 97%

Sarcomas of the Nasal Cavity and Paranasal Sinuses

Sercarz¹,

Mark²,

Storper³

et al. 1994

Ann Otol Rhinol Laryngol

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Sarcomas of the nose and paranasal sinuses are rare malignancies. Key issues remain unresolved in the management of these tumors, particularly with regard to the role of radiotherapy. To help clarify these issues, 48 consecutive cases of nasal and paranasal sinus sarcomas treated at the University of California, Los Angeles, between 1958 and 1988 were retrospectively reviewed. Six of 16 patients managed initially with surgery alone were cured. All had negative surgical margins and 5 of the 6 had low-grade tumors. Of 5 patients with high-grade lesions treated with surgery only, 1 was rendered free of disease. Twelve patients with positive surgical margins were treated with adjuvant radiotherapy; 5 were cured with this approach. Grade and surgical margin status were found to be significantly related to outcome for sinonasal sarcoma. There were 14 patients with rhabdomyosarcoma; 3 were cured with modern combined-modality therapy. Patients with positive surgical margins should be treated with adjuvant radiotherapy. Surgical therapy is effective for low-grade lesions that are completely excised.

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“…Mantravardi et al [3] and Denton et al 141, using slightly different protocols, did not experience this problem, although their numbers were small. Although preoperative irradiation was associated with a high rate of pathological fracture (16%) in the study reported by Enneking et al [25], this complication was not encountered in 2 other similar studies [21,22]. Lindberg et al Two cases of lymphoedema and "no other serious complications" is a remarkable achievement associated with such high rates of limb salvage (96%) and local control (87%).…”

Section: Commentsmentioning

confidence: 94%

“…Contemporary results achieved with radiotherapy, given pre-or postoperatively are presented in Table I11 [ 19,22,25,26]. The study reported by Enneking et al [25] using preoperative irradiation is small, as is the IA ADR study described by Goodnight et al [6].…”

Section: Commentsmentioning

confidence: 99%

“…Lindberg et al Two cases of lymphoedema and "no other serious complications" is a remarkable achievement associated with such high rates of limb salvage (96%) and local control (87%). Abbatucci et al [22] used pre-and postoperative radiotherapy, again with high rates of limb salvage (93 %) and local control (86%) but no mention of complications. They do admit to a 9% "poor functional result."…”

Section: Commentsmentioning

confidence: 99%

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Intraarterial chemotherapy of soft‐tissue sarcomas

Bramwell

1988

Seminars in Surgical Oncology

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This review compares the results of preoperative intraarterial chemotherapy delivered by various methods, such as intraarterial injection/infusion, tourniquet infusion, and isolation perfusion, with the results achieved by pre- and postoperative radiotherapy. The histological heterogeneity of soft tissue sarcomas adds to the inherent difficulties of comparing results across studies. There is a clear need for randomized studies to directly compare these treatment modalities in similar patient populations. Patients with these rare tumors would benefit from the expertise of multidisciplinary teams available at the larger centers. Metastatic spread, which even with the highest rates of local control, occurs in approximately 30% of high grade soft tissue sarcomas, represents a continuing challenge, and innovative approaches are needed to control systemic disease.

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Local control and survival in soft tissue sarcomas of the limbs, trunk walls and head and neck: A study of 113 cases

Cited by 48 publications

References 19 publications

Preoperative radiation, surgical margins, and local control of extremity sarcomas of soft tissues

Preoperative radiation, surgical margins, and local control of extremity sarcomas of soft tissues

Sarcomas of the Nasal Cavity and Paranasal Sinuses

Intraarterial chemotherapy of soft‐tissue sarcomas

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