DOI QR코드

DOI QR Code

Long-Term Treatment Results in Soft Tissue Sarcomas of the Thoracic Wall Treated with Pre-or-Postoperative Radiotherapy - a Single Institution Experience

  • Oksuz, Didem Colpan (Department of Radiation Oncology, Istanbul University Cerrahpasa Medical Faculty) ;
  • Ozdemir, Sevim (Department of Radiation Oncology, Istanbul University Cerrahpasa Medical Faculty) ;
  • Kaydihan, Nuri (Department of Radiation Oncology, Istanbul University Cerrahpasa Medical Faculty) ;
  • Dervisoglu, Sergulen (Department of Pathology, Istanbul University Cerrahpasa Medical Faculty) ;
  • Hiz, Murat (Department of Orthopedic Surgery, Istanbul University Cerrahpasa Medical Faculty) ;
  • Tuzun, Hasan (Department of Cardiovascular Surgery, Istanbul University Cerrahpasa Medical Faculty) ;
  • Mandel, Nil Molinas (Department of Medical Oncology, Istanbul University, Cerrahpasa Medical Faculty) ;
  • Koca, Sedat (Department of Radiation Oncology, Istanbul University Cerrahpasa Medical Faculty) ;
  • Dincbas, Fazilet Oner (Department of Radiation Oncology, Istanbul University Cerrahpasa Medical Faculty)
  • 발행 : 2014.12.18

초록

Objective: To evaluate the long term results among patients with soft tissue sarcoma of the thoracic wall. Materials and Methods: Twenty-six patients who were treated with pre-or postoperative radiotherapy between December 1980-December 2007, with a diagnosis of soft tissue sarcoma of the thoracic wall were retrospectively evaluated. Results: The median age was 44 years (14-85 years) and 15 of them were male. A total of 50% of patients were grade 3. The most common histologic type of tumor was undifferentiated pleomorphic sarcoma (26.9%). Tumor size varied between 2-25 cm (median 6.5 cm). Seventeen of the cases had marginal and 9 had wide local resection. Four cases received preoperative radiotherapy and 22 postoperative radiotherapy. Six of the patients with large and high grade tumors received chemotherapy. Median follow-up time was 82 months (9-309 months). Local recurrence and metastasis was detected in 34.6% and 42.3% of patients, respectively. Five-year local control (LC), disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS) were 62%, 38%, 69%, and 76% respectively. On univariate analysis, the patients with positive surgical margins had a markedly lower 5-year LC rate than patients with negative surgical margin, but the difference was not significant (43% vs 78%, p=0.1). Five-year DFS (66% vs 17%) and DSS (92% vs 60%) rates were significantly worse for the patients who had high grade tumors (p=0.01, p=0.008 respectively). Conclusions: Tumor grade and surgical margin are essential parameters for determining the prognosis of thoracic wall soft tissue sarcoma both in our series and the literature.

키워드

참고문헌

  1. Anderson BO, Burt ME (1994). Chest wall neoplasms and their management. Ann Thorac Surg, 58, 1774-81. https://doi.org/10.1016/0003-4975(94)91691-8
  2. Athanassiadi K, Kalavrouziotis G, Rondogianni D, et al (2001). Primary chest wall tumors: early and long-term results of surgical treatment. Eur J Cardiothorac Surg, 19, 589-93. https://doi.org/10.1016/S1010-7940(01)00655-8
  3. Berna BD, Meral G, Vehbi E, et al (2012). Retrospective analysis of 498 primary soft tissue sarcomas in a single Turkish centre. Asian Pacific J Cancer Prev, 13, 4125-8. https://doi.org/10.7314/APJCP.2012.13.8.4125
  4. Burt A, Berriochoa J, Korpak A, et al (2013). Treatment of chest wall sarcomas a single-institution experience over 20 years. Am J Clin Oncol, [Epub ahead of print].
  5. Coindre JM, Terrier P, Bui NB, et al (1996). Prognostic factors in adult patients with locally controlled soft tissue sarcoma: A study of 546 patients from French federation cancer center sarcoma group. J Clin Oncol, 14, 869-77.
  6. Coindre JM, Terrier P, Guillou L, et al (2001). Predictive value of grade for metastasis development in the main histologic types of adult soft tissue sarcomas: a study of 1240 patients from the French Federation of cancer centers sarcoma group. Cancer, 91, 1914-26. https://doi.org/10.1002/1097-0142(20010515)91:10<1914::AID-CNCR1214>3.0.CO;2-3
  7. Gordon MS, Hajdu SI, Bains MS, Burt ME (1991). Soft tissue sarcomas of the chest wall. Results of surgical resection. J Thorac Cardiovasc Surg, 101, 843-54.
  8. Greager JA, Patel MK, Briele HA, et al (1987). Soft tissue sarcomas of the adult thoracic wall. Cancer, 59, 370-73. https://doi.org/10.1002/1097-0142(19870115)59:2<370::AID-CNCR2820590234>3.0.CO;2-L
  9. Gronchi A, Verderio P, De Paoli A, et al (2013). Quality of surgery and neoadjuvant combined therapy in the ISG-GEIS trial on soft tissue sarcomas of limbs and trunk wall. Ann Oncol, 24, 817-23. https://doi.org/10.1093/annonc/mds501
  10. Gross JL, Younes RN, Haddad FJ, et al (2005). Soft-tissue sarcomas of the chest wall: prognostic factors. Chest, 127, 902-8. https://doi.org/10.1378/chest.127.3.902
  11. Italiano A, Delva F, Mathoulin-Pelissier S, et al (2010). Effect of adjuvant chemotherapy on survival in FNCLCC grade 3 soft tissue sarcomas: a multivariate analysis of the French Sarcoma Group Database. Ann Oncol, 21, 2436-41. https://doi.org/10.1093/annonc/mdq238
  12. Jamal A, Siegel R, Xu J, Ward E (2010). Cancer statistics, 2010. CA Cancer J Clin, 60, 277-300. https://doi.org/10.3322/caac.20073
  13. Kachroo P, Pak PS, Sandha HS, et al (2012). Single-institution, multidisciplinary experience with surgical resection of primary chest wall sarcomas. J Thorac Oncol, 7, 552-8. https://doi.org/10.1097/JTO.0b013e31824176df
  14. Kraybill WG, Harris J, Spiro IJ, et al (2010). Long-term results of a phase 2 study of neoadjuvant chemotherapy and radiotherapy in the management of high-risk, high-grade, soft tissue sarcomas of the extremities and body wall: radiation therapy oncology group trial 9514. Cancer, 116, 4613-21. https://doi.org/10.1002/cncr.25350
  15. Lindberg RD, Martin RG, Romsdahl MM, Barkley HT Jr (1981). Conservative surgery and postoperative radiotherapy in 300 adults with soft-tissue sarcomas. Cancer, 47, 2392-7.
  16. Pairolero PC, Arnold PG (1985). Chest wall tumor: experience with 100 consecutive patients. J Thorac Cardiovasc Surg, 90, 367-72
  17. Pairolero PC (2000). Chest wall tumors. in "general thoracic surgery" eds. Shields TW, Lo Cicero J, Ponn RB. Philadelphia: Lippincott Williams & Wilkins; 2000. pp.599-608.
  18. Pervaiz N, Colterjohn N, Farrokhyar F, et al (2008). A systematic meta-analysis of randomized controlled trials of adjuvant chemotherapy for localized resectable soft-tissue sarcoma. Cancer, 113, 573-81. https://doi.org/10.1002/cncr.23592
  19. Roger N, Edward W, David P, et al (2013). Soft-tissue sarcomas in the asia-pacific region: a systematic review. Asian Pac J Cancer Prev, 14, 6821-32. https://doi.org/10.7314/APJCP.2013.14.11.6821
  20. Sabaratnan S, Shah R, Mearns AJ (1997). Surgical treatment of treatment of primary malignant chest wall tumours. Eur J Cardiothorac Surg, 11, 1011-6. https://doi.org/10.1016/S1010-7940(97)00090-0
  21. Salas S, Bui B, Stoeckle E, et al (2009). Soft tissue sarcomas of the trunk wall (STS-TW): A study of 343 patients from the French Sarcoma Group (FSG) database. Ann Oncol, 20, 1127-35. https://doi.org/10.1093/annonc/mdn757
  22. Shah AA, D'Amico TA (2010). Primary chest wall tumors. J Am Coll Surg, 210, 360-6. https://doi.org/10.1016/j.jamcollsurg.2009.11.012
  23. Singer S, Corson JM, Demetri GD,et al (1995). Prognostic factors predictive of survival for truncal and retroperitoneal soft-tissue sarcoma. Ann Surg, 221, 185-95. https://doi.org/10.1097/00000658-199502000-00009
  24. Tsukushi S, Nishida Y, Sugiura H, Nakashima H, Ishiquro N (2009). Soft tissue sarcomas of the chest wall. J Thorac Oncol, 4, 834-7. https://doi.org/10.1097/JTO.0b013e3181a97da3
  25. Van Geel AN, Wouters MW, Lans TE, Schmitz PI, Verhoef C (2011). Chest wall resection for adult soft tissue sarcomas and chondrosarcomas: analysis of prognostic factors. World J Surg, 35, 63-9. https://doi.org/10.1007/s00268-010-0804-x
  26. Walsh GL, Davis BM, Swisher SG, et al (2001). A singleinstitutional, multidisciplinary approach to primary sarcomas involving the chest wall requiring full-thickness resections. J Thorac Cardiovasc Surg, 121, 48-60. https://doi.org/10.1067/mtc.2001.111381
  27. Warzelhan J, Stoelben E, Imdahl A, Hasse J (2001). Results in surgery for primary and metastatic chest wall tumors. Eur J Cardiothorac Surg, 19, 584-8. https://doi.org/10.1016/S1010-7940(01)00638-8
  28. Wouters MW, Van Geel AN, Nieuwenhuis L, et al (2008). Outcome after surgical resections of recurrent chest wall sarcomas. J Clin Oncol, 26, 5113-8. https://doi.org/10.1200/JCO.2008.17.4631

피인용 문헌

  1. Radiation-Induced Sarcoma following Prolonged Coronary Stent Placement vol.2018, pp.2090-6919, 2018, https://doi.org/10.1155/2018/2903801