| Title | Tumor Necrosis Has no Prognostic Value in Neoadjuvant Chemotherapy for Soft Tissue Sarcoma. | | Author(s) | Menendez LR, Ahlmann ER, Savage K, Cluck M, Fedenko AN | | Institution | From the *Department of Orthopaedic Oncology, University of Southern California Keck School of Medicine, University Hospital, Los Angeles, CA; the †Department of Orthopaedic Oncology and the ‡Department of Orthopaedic Surgery, Los Angeles County-University of Southern California Medical Center, Los Angeles, CA; and the §Department of Pathology, University of Southern California Keck School of Medicine University Hospital, Los Angeles, CA. | | Source | Clin Orthop Relat Res 2006 Sep 28. | | Abstract | Neoadjuvant chemotherapy for treatment of soft tissue sarcomas is controversial, and the correlation between local recurrence and survival is unclear. Histologic necrosis is a well-documented predictor of survival in patients with malignant bone tumors; however, the association is unknown in patients with soft tissue sarcomas. We assessed the prognostic significance of tumor necrosis for treatment of soft tissue sarcomas. We retrospectively collected data from 82 patients who received neoadjuvant chemotherapy for treatment of soft tissue sarcomas of the extremities. Patients had wide resections if tumors were high-grade, deep to the investing fascia, and had clear margins. We quantified the amount of necrosis and analyzed the relationship with local recurrence and overall survival. At an average followup of 65 months (range, 24-154 months), the 5-year local recurrence rates for patients with less than 95% and 95% or greater necrosis were 20% and 33%, respectively. The overall 5-year survivorship rates for patients with less than 95% necrosis and 95% or greater necrosis were 82% and 78%, respectively. There was no difference in recurrence-free survival or overall patient survival based on the amount of histologic necrosis. Tissue necrosis from neoadjuvant chemotherapy does not seem to predict outcome in soft tissue sarcomas.Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 17016226 |
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