title: Long-term survivor of relapsed MFH on the thigh treated with autologous formalin-fixed tumor vaccine (AFTV) combined with limb-sparing surgery and radiotherapy.
abstract: Malignant fibrous histiocytoma (MFH) is an aggressive spindle cell cancer of soft-tissue sarcoma type in the elderly, mostly affecting the extremities. Lesions > 5 cm, positive margins, and local recurrence are significant poor prognostic indicators. The strongest predictor for distant metastasis was tumor size (> 5 cm), and for overall survival, presence of local recurrence. Limb-sparing extensive tumor resection is preferred to achieve negative surgical margins. However, in some circumstances, amputation is inevitable. Recent studies demonstrated that adjuvant radiotherapy for microscopically positive surgical margins significantly improved local control and disease-free survival rates. Therefore, effective therapeutic strategies against locally relapsed high grade MFH are required to prevent distant metastasis and to achieve long-term disease-free survival. Here, we report local relapse of high grade MFH treated by successive application of autologous formalin-fixed tumor vaccination (AFTV) with limb-sparing surgery and postoperative radiotherapy. The patient is alive and well, disease-free and with no functional impairment, more than five years after treatment.
authors.affiliation: Department of Surgery, Tsukuba Central Hospital, Ushiku-shi 300-121, Japan. todorokit@sound.ocn.ne.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Todoroki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kondo
authors.forename: Shinji
authors.initials: S
authors.lastname: Sugahara
authors.forename: Yukio
authors.initials: Y
authors.lastname: Morishita
authors.forename: Kensaku
authors.initials: K
authors.lastname: Mori
authors.forename: Tadao
authors.initials: T
authors.lastname: Ohno
mesh_terms: D000368:Aged; D019496:Cancer Vaccines / Q000627:therapeutic use*; D005404:Fixatives; D005500:Follow-Up Studies; D005557:Formaldehyde; D051677:Histiocytoma, Malignant Fibrous / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local; D049268:Positron-Emission Tomography; D018714:Radiotherapy, Adjuvant; D012983:Soft Tissue Neoplasms; D013848:Thigh; D013997:Time Factors
chemical_list: D019496:Cancer Vaccines; D005404:Fixatives; D005557:Formaldehyde