Prognostic significance of treatment-induced pathologic necrosis in extremity and truncal soft tissue sarcoma after neoadjuvant chemoradiotherapy.

[liposarcoma]

Histologic response to chemotherapy has been shown to be an independent prognostic factor in patients with osteosarcoma and Ewing sarcoma . However , in patients with soft tissue sarcoma (STS ), the prognostic impact of histologic response to chemotherapy is less clear . In the current study , the authors sought to determine the prognostic significance of treatment-induced pathologic necrosis in patients receiving neoadjuvant chemoradiotherapy for STS .Between 1989 and 2011 , a total of 113 patients with grade 2 or 3 (graded according to the National Cancer Institute grading system using 3 tiers ) extremity or truncal STS were identified who received neoadjuvant interdigitated chemoradiotherapy according to protocol followed by surgery . The extent of tumor necrosis in the resected specimens was quantified and correlated with outcome .The median tumor necrosis rate was 90 %, and 103 patients (91 %) received all 3 cycles of planned neoadjuvant chemotherapy . The likelihood of achieving ≥95 % necrosis was not related to the number of preoperative cycles of chemotherapy received but was found to be related to tumor histology (62 % for malignant fibrous histiocytoma vs 0 % for synovial sarcoma [P <.001 ]; 56 % for myxoid liposarcoma vs 0 % for synovial sarcoma [P = .002 ]). At a median follow-up of 6 years , there were no statistically significant differences noted in the 5 -year local control , disease-specific survival , and overall survival rates for patients with ≥95 % necrosis (50 patients ; 44 %) and <95 % necrosis (63 patients ; 56 %), even when stratifying by histology .In a homogeneous population of patients with high -grade extremity and truncal STS who were treated with neoadjuvant chemoradiotherapy , the extent of pathologic tumor necrosis did not correlate with outcome . Cancer 2014 ;120 :3676 -3682 . © 2014 American Cancer Society .

Diseases
Validation

Diseases presenting "cancer" symptom

achondroplasia

acute rheumatic fever

adrenal incidentaloma

alpha-thalassemia

benign recurrent intrahepatic cholestasis

cadasil

canavan disease

carcinoma of the gallbladder

cholangiocarcinoma

coats disease

congenital adrenal hyperplasia

congenital diaphragmatic hernia

cowden syndrome

cushing syndrome

cutaneous mastocytosis

dedifferentiated liposarcoma

dystrophic epidermolysis bullosa

epidermolysis bullosa simplex

erdheim-chester disease

erythropoietic protoporphyria

esophageal adenocarcinoma

esophageal carcinoma

esophageal squamous cell carcinoma

familial hypocalciuric hypercalcemia

familial mediterranean fever

gm1 gangliosidosis

heparin-induced thrombocytopenia

hereditary cerebral hemorrhage with amyloidosis

hirschsprung disease

hodgkin lymphoma, classical

inclusion body myositis

junctional epidermolysis bullosa

kabuki syndrome

kallmann syndrome

kindler syndrome

lamellar ichthyosis

liposarcoma

locked-in syndrome

lymphangioleiomyomatosis

monosomy 21

neuralgic amyotrophy

oculocutaneous albinism

oligodontia

oral submucous fibrosis

papillon-lefèvre syndrome

pendred syndrome

pleomorphic liposarcoma

primary effusion lymphoma

proteus syndrome

pyomyositis

pyruvate dehydrogenase deficiency

severe combined immunodeficiency

sneddon syndrome

systemic capillary leak syndrome

triple a syndrome

von hippel-lindau disease

waldenström macroglobulinemia

well-differentiated liposarcoma

werner syndrome

wiskott-aldrich syndrome

wolf-hirschhorn syndrome

x-linked adrenoleukodystrophy

This symptom has already been validated