title: Primary mediastinal sarcoma: surgical outcomes of 21 cases.
abstract: OBJECTIVE
  Primary sarcomas of the mediastinum are relatively rare. This article reviews the surgical outcomes of 21 cases diagnosed with localized mediastinal sarcomas receiving multidisciplinary treatment modalities in Sichuan province, China, from January 1996 to January 2011.
  
  
  METHODS
  Twenty-one cases of histologically diagnosed primary mediastinal sarcoma undergoing surgical treatment were reviewed retrospectively. Disease-free survival (DFS) and overall survival (OS) were statistically analysed. All the patients presented with localized tumours consisting of 5 females and 16 males with a median age of 41.0 years (range: 9.0-68.0 years). Among all cases, 17 (81.0%) had an Eastern Cooperative Oncology Group performance status score of ≤1 at diagnosis. Eight (38.1%) underwent macroscopically complete resection (R0-R1) and 13 (61.9%) had incomplete resection (R2). Ten (47.6%) received postoperative radiotherapy and 7 (33.3%) postoperative chemotherapy.
  
  
  RESULTS
  The median DFS was 17 months (range: 0.4-79.8 months) and the median OS was 27.2 months (range: 0.4-79.8 months). Patients receiving complete resection showed significantly improved DFS (P = 0.031) and OS (P = 0.035) compared with those with incomplete resection. Neither postoperative radiotherapy nor chemotherapy significantly improved DFS (P = 0.770, P = 0.756) or OS (P = 0.905, P = 0.738). However, 7 patients (R2) and 2 (R0-R1 and grade 3) had improved local control with a local recurrence-free survival of 28.9 months (range: 7.6-73.2 months).
  
  
  CONCLUSIONS
  Complete resection should be preferentially attempted compared with incomplete resection and postoperative radiotherapy might yield good local control.
authors.affiliation: West China School of Medicine, Sichuan University, Chengdu, China.
authors.forename: Da-Xian
authors.initials: DX
authors.lastname: Luo
authors.forename: Mei-Juan
authors.initials: MJ
authors.lastname: Huang
authors.forename: Bo
authors.initials: B
authors.lastname: Xiong
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.forename: Ke
authors.initials: K
authors.lastname: Xie
authors.forename: Fu-Rong
authors.initials: FR
authors.lastname: Chen
authors.forename: Guo-Wei
authors.initials: GW
authors.lastname: Che
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.forename: Yong
authors.initials: Y
authors.lastname: Xu
authors.forename: Xiao-Juan
authors.initials: XJ
authors.lastname: Zhou
authors.forename: You
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D002648:Child; D002681:China; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008479:Mediastinal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D018365:Neoplasm, Residual; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D019616:Thoracic Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Chemotherapy; Mediastinum; Radiotherapy; Sarcoma; Surgery
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