Neoadjuvant and adjuvant therapy for extremity soft tissue sarcomas.
Despite the overall good prognosis in patients who have localized soft tissue sarcoma (STS) of the extremities, approximately half of those who have high-risk features ultimately will die from metastatic disease that was present as microscopic foci at the time of diagnosis. The principal role of adjuvant and neoadjuvant chemotherapy is to improve the "cure" rate through eradication of these microscopic foci. Over the last 30 years there have been numerous studies attempting to determine whether adjuvant or neoadjuvant systemic chemotherapy does lead to an improvement in disease-specific survival in patients who have localized STS. It is still unclear whether there may be a role for systemic chemotherapy in patients who have high-risk localized STS of the extremities. This article discusses some of the issues surrounding this most controversial area in the management of STS.
Scurr
Michelle
M
Cancer Research-UK Centre for Cancer Therapeutics, Institute of Cancer Research, Sycamore House, Downs Road, Sutton, Surrey SM2 5PT, UK. michelle.scurr@icr.ac.uk
Judson
Ian
I
D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005121:Extremities / Q000473:pathology; D006801:Humans; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D012983:Soft Tissue Neoplasms / Q000188:drug therapy* / Q000473:pathology