Preoperative chemotherapy for soft-tissue sarcomas of the extremities.
Forty-six patients with extremity soft-tissue sarcomas were treated with a mean of 4.4 cycles of preoperative adriamycin-based combination chemotherapy, followed by definitive local surgery and radiotherapy. All tumors were larger than 5 cm and of histologic type having significant risk of metastasis. Eighteen patients (40%) had an objective clinical response to the chemotherapy, while 27 patients (60%) did not respond. Patients with tumors responsive to chemotherapy had significantly improved overall survival (median 60 + months versus 32.7 months; p = 0.02), continuous disease-free survival (median 60 + months versus 15.1 months; p = 0.04), and distant metastasis-free survival (median 60+ months versus 28.5 months; p = 0.006) compared to the nonresponding patients. Tumor response to preoperative chemotherapy provides strong prognostic information and identifies a subgroup of patients most likely to benefit from chemotherapy.
Pezzi
C M
CM
Department of Surgery, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Pollock
R E
RE
Evans
H L
HL
Lorigan
J G
JG
Pezzi
T A
TA
Benjamin
R S
RS
Romsdahl
M M
MM
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003606:Dacarbazine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005121:Extremities; D005260:Female; D018219:Histiocytoma, Benign Fibrous / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D006801:Humans; D008297:Male; D011300:Preoperative Care; D012189:Retrospective Studies; D012509:Sarcoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D003606:Dacarbazine; D004317:Doxorubicin; D003520:Cyclophosphamide