Does histologic grade in soft tissue sarcoma influence response rate to systemic chemotherapy?

Article Abstract:

Soft tissue sarcomas are a group of cancers affecting connective tissues, muscle, blood vessels, and related tissues. Surgery is the preferred treatment for soft tissue sarcoma, but if the cancer has already begun to spread in the body, chemotherapy may be the only alternative. Pathologists scale the appearances of cancers according to ''grade''; a low-grade cancer is closer in appearance to normal tissue while a high-grade cancer looks highly abnormal and malignant. In cases of primary soft tissue sarcoma, tumor grade is known to be an important predictor of survival. A study was conducted to determine if tumor grade might also be an important predictor of response to chemotherapy in patients with metastatic cancer. In a review of 116 cases of soft tissue sarcoma, it was found that the higher the grade of the tumor, that is, the more malignant the appearance under the microscope, the more likely the patient was to respond to chemotherapy with the drug doxorubicin. Fifty-five percent of the patients with Grade 4 cancer had objective responses to chemotherapy, in contrast with 23 percent of Grade 3 patients, 19 percent of Grade 2 patients, and none of the patients with Grade 1 soft tissue sarcoma. Among the patients who achieved responses, however, there were no significant differences by grade regarding the period of time before the cancer recurred. While the patients with the higher grade cancers were more likely to respond to treatment, their survival was shorter, Overall, the median (midpoint) survival for patients with Grades 1, 2, 3, and 4 cancer were 20, 14, 9, and 8 months, respectively. If only the patients who achieved responses to chemotherapy are considered, the median survival was about a year regardless of disease grade. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cancer, Carcinogenesis, Histology, Pathological, Pathological histology

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Soft tissue sarcoma: integration of brachytherapy, resection, and external irradiation

Article Abstract:

The effects of radiation therapy and surgery were assessed in patients with nonretroperitoneal soft tissue sarcoma, a type of cancer arising from connective tissue. The tumors did not involve tissues behind the abdominal membranes. Treatment consisted of brachytherapy, the use of radioactive implants at the site of the cancer; surgical removal (resection) of the tumor; and external beam irradiation, the delivery of radiation from outside of the body. Between December 1981 and August 1988, 63 patients with a total of 65 tumors underwent brachytherapy procedures and moderate resection. In addition, external beam irradiation was performed on 61 of 65 tumors. External irradiation was used before surgery for large lesions located near the bone, nerve, and blood vessels, and after surgery for small tumors that could be surgically removed or were inadequately resected. Forty-seven tumors were high-grade, and 34 tumors were greater than five centimeters. Lesions recurred in nine patients, including five who had prior irradiation. At 20 months follow-up, only 2 of the 56 tumors subjected to brachytherapy recurred, and three of nine recurrent tumors occurred once again. Only one of five tumors that recurred locally formed in the implant. Wound complications were observed in 2 of the 40 implants performed before irradiation, and in 4 of the 16 implants performed after external radiation. The combined treatment of brachytherapy, resection, and external irradiation did not increase disease activity and may control tumor development better than brachytherapy or external irradiation used alone or as a supplement to surgical removal of the tumor. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Methods, Radioisotope brachytherapy, Brachytherapy

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Extraosseous Ewing's sarcoma: a study of 42 cases

Article Abstract:

Ewing's sarcoma usually arises from bone cells, but an extraosseous (nonbone) type of this sarcoma has been recognized, and large series of cases have been reviewed infrequently. The disease is aggressive, with high rates of local recurrence and distant metastases (spread of tumor outside the original site). The clinical features and treatment of 42 cases are reviewed in this report. Metastases occurred in 30 patients, and were found during the original diagnosis in 6 patients, or occurred up to 11 years later in the others. Lung and bone were the most common sites for metastasis. Sixteen of the patients had local recurrence of the tumor, and overall survival at 5 years was 15 of 39 patients. Improved survival was associated with extensive surgery with cancer-free cells at the margins, local radiation therapy, and diagnosis after 1970. Decreased survival was associated with pelvic tumors, limited surgery, and metastasis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Ewing's sarcoma

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