title: Impact of extensive surgery in multidisciplinary approach of pterygopalatine/infratemporal fossa soft tissue sarcoma.
abstract: BACKGROUND
  To evaluate a strategy whereby extensive surgery ± external radiotherapy (RT) could improve local control in pterygopalatine/infratemporal fossa (PIF) sarcoma.
  
  
  METHODS
  Forty-one patients with a diagnosis of sarcoma involving the PIF and referred to our Institute from 1984 to 2009 were included in the analysis. Patients received multidrug chemotherapy and radiotherapy ± surgery, depending on the period of treatment.
  
  
  RESULTS
  The median age at diagnosis was 7.6 years (range: 0.1-22 years). There were 36 RMS, 3 undifferentiated sarcoma and 2 other soft-tissue sarcomas. Sixty-eight percent of patients had meningeal risk factors at diagnosis. Local treatment consisted of RT alone in 19 patients, surgery in combination to RT in 19 patients and surgery alone in 3 patients. The local progression rate (LPR) at 5 years was 45% for the entire population, 59% for the 19 patients treated with RT alone and 34% for the 22 patients who had surgery as part of their treatment. All locoregional failures after extensive surgery occurred at the skull base and/or in leptomeningeal spaces.
  
  
  CONCLUSIONS
  Multidisciplinary approach including extensive surgery for PIF sarcoma is feasible and yields good local control with 15/22 patients in local complete remission. Future studies are warranted to confirm these promising results, to evaluate the possibility of avoiding RT or limiting the RT field, and to extend the indication for extensive surgery to other "worse" sites of PM sarcoma such as the paranasal sinuses.
authors.affiliation: Institut Gustave Roussy (IGR), Villejuif, France. veronique.minard@igr.fr
authors.forename: Véronique
authors.initials: V
authors.lastname: Minard-Colin
authors.forename: Frédéric
authors.initials: F
authors.lastname: Kolb
authors.forename: Christian
authors.initials: C
authors.lastname: Saint-Rose
authors.forename: Florence
authors.initials: F
authors.lastname: Fayard
authors.forename: François
authors.initials: F
authors.lastname: Janot
authors.forename: Annie
authors.initials: A
authors.lastname: Rey
authors.forename: Sandra
authors.initials: S
authors.lastname: Canale
authors.forename: Morbize
authors.initials: M
authors.lastname: Julieron
authors.forename: Nadège
authors.initials: N
authors.lastname: Corradini
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Raquin
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Habrand
authors.forename: Jacques
authors.initials: J
authors.lastname: Grill
authors.forename: Bernard
authors.initials: B
authors.lastname: George
authors.forename: Patrice Tran
authors.initials: PT
authors.lastname: Ba Huy
authors.forename: Vincent
authors.initials: V
authors.lastname: Couloignier
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: Terrier-Lacombe
authors.forename: Bernard
authors.initials: B
authors.lastname: Luboinski
authors.forename: Dominique
authors.initials: D
authors.lastname: Valteau-Couanet
authors.forename: Odile
authors.initials: O
authors.lastname: Oberlin
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D002648:Child; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D049691:History, Medieval; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D056739:Pterygopalatine Fossa / Q000473:pathology; D011878:Radiotherapy; D012509:Sarcoma / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult