Long‐term follow‐up of patients receiving neoadjuvant treatment modalties for soft tissue sarcomas of the extremities
Rauch M, Agaimy A, Semrau S, Willner A, Ott O, Fietkau R, Hohenberger W, Croner RS, Grützmann R, Fechner K, Vassos N (2021)
Publication Type: Journal article
Publication year: 2021
Journal
Book Volume: 13
Article Number: 5244
Journal Issue: 20
Abstract
Background: Neoadjuvant treatment modalities in soft tissue sarcoma (STS) of the extremities have become more popular in recent years, but because of the rarity and heterogeneity of STS, there are yet few studies on the long‐term impact of neoadjuvant treatment modalities, especially in terms of neoadjuvant radiochemotherapy. Methods: The study enrolled 136 patients with primary STS of the extremities who underwent surgery with curative intent or neoadjuvant therapy, followed by surgery in a 15‐year period. Neoadjuvant treatment consisted of radiotherapy (RT) with 60 Gy and in most cases simultaneous chemotherapy (CTx) with ifosfamide (1.5 g/m2/d, d1–5, q28) and doxorubicine (50 mg/m2/d, d3, q28). We investigated the clinical, (post)‐operative and histopathological data and the oncological follow‐up as well. The median follow‐up period was 82 months (range 6–202). Results: A total of 136 patients (M:F = 73:63) with a mean age of 62 years (range; 21–93) was observed. Seventy‐four patients (54.4%) received neoadjuvant therapy (NT), 62 patients (45.6%) received primary surgery (PS). When receiving NT, patients with high‐risk STS had a lower risk to develop distant metastasis (p = 0.025). Age, histological type, tumor size and surgical margins (R0 vs. R1) had no influence on any survival rates. There was an association between NT and the occurrence of postoperative complications (p = 0.001). The 5‐year local recurrence free survival (LRFS), metastasis free survival (MFS), disease free survival (DFS) and overall survival (OS) rate of the whole cohort was 89.9%, 77.0%, 70.6% and 72.6%; whereas the 5‐year LRFS, MFS, DFS and OS rate was 90.5%, 67.2%, 64.1% and 62.8% for the NT group and 89.5%, 88.3%. 78.4% and 83.8% for the PS group. Conclusion: Multimodal treatment strategies in patients with STS of extremities lead to excellent oncological outcomes. Patients with high‐risk STS had a significantly better MFS when receiving NT than patients with low‐risk STS. NT was associated with a higher probability of postoperative but well‐manageable complications.
Authors with CRIS profile
Miriam Rauch
Medizinische Fakultät
Abbas Agaimy
Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie
Sabine Semrau
Medizinische Fakultät
Alexander Willner
Medizinische Fakultät
Oliver Ott
Medizinische Fakultät
Rainer Fietkau
Lehrstuhl für Strahlentherapie
Werner Hohenberger
Department of Surgery
Robert Grützmann
Department of Surgery
Katja Fechner
Department of Surgery
Nikolaos Vassos
Medizinische Fakultät
Involved external institutions
Germany (DE)How to cite
APA:
Rauch, M., Agaimy, A., Semrau, S., Willner, A., Ott, O., Fietkau, R.,... Vassos, N. (2021). Long‐term follow‐up of patients receiving neoadjuvant treatment modalties for soft tissue sarcomas of the extremities. Cancers, 13(20). https://doi.org/10.3390/cancers13205244
MLA:
Rauch, Miriam, et al. "Long‐term follow‐up of patients receiving neoadjuvant treatment modalties for soft tissue sarcomas of the extremities." Cancers 13.20 (2021).
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