BACKGROUND: Treatment of radiation-induced sarcoma (RIS) remains an unsolved problem. To provide more insight into the disease process, its characteristics, outcome, and potential outcome determinants were defined. METHODS: From 1978 to 2003, 27 patients--20 females (74%) and 7 males (26%) with a median age 44 years (range, 1-73 years) at the time of diagnosis of the primary tumor--developed an RIS after a median interval of 8 years (range, 3-41 years). The histology of the RIS was 10 (37%) undifferentiated high-grade pleomorphic sarcomas, 7 (26%) angiosarcomas, 6 (22%) fibrosarcomas, 2 (7%) osteosarcomas, 1 (4%) pleomorphic rhabdomyosarcoma, and 1 (4%) pleomorphic leiomyosarcoma. Surgical resection was performed in 21 patients: 13 (62%) R0 (microscopically radical), 4 (19%) R1 (microscopically irradical), 2 (9.5%) R2 (macroscopically irradical), and 2 (9.5%) RX (unknown radicality). Six (22%) patients underwent no resection. RESULTS: The 5-year disease-free and overall survival rates were 27% and 30%, respectively. The local failure rate after R0 resection was 54%. The distant failure rate for the entire group was 41%. Patients with an R0 resection had a significantly better survival rate (P < .05) than patients with an R1, R2, or no resection. CONCLUSIONS: RISs are aggressive malignancies with a high tendency for local recurrence and distant metastases. Previously applied treatment often hampers adequate resection. Therefore, radical surgical resection is the only chance to improve disease-free and overall survival, but it may also have a palliative role. Still, the overall prognosis remains poor.
BACKGROUND: Treatment of radiation-induced sarcoma (RIS) remains an unsolved problem. To provide more insight into the disease process, its characteristics, outcome, and potential outcome determinants were defined. METHODS: From 1978 to 2003, 27 patients--20 females (74%) and 7 males (26%) with a median age 44 years (range, 1-73 years) at the time of diagnosis of the primary tumor--developed an RIS after a median interval of 8 years (range, 3-41 years). The histology of the RIS was 10 (37%) undifferentiated high-grade pleomorphic sarcomas, 7 (26%) angiosarcomas, 6 (22%) fibrosarcomas, 2 (7%) osteosarcomas, 1 (4%) pleomorphic rhabdomyosarcoma, and 1 (4%) pleomorphic leiomyosarcoma. Surgical resection was performed in 21 patients: 13 (62%) R0 (microscopically radical), 4 (19%) R1 (microscopically irradical), 2 (9.5%) R2 (macroscopically irradical), and 2 (9.5%) RX (unknown radicality). Six (22%) patients underwent no resection. RESULTS: The 5-year disease-free and overall survival rates were 27% and 30%, respectively. The local failure rate after R0 resection was 54%. The distant failure rate for the entire group was 41%. Patients with an R0 resection had a significantly better survival rate (P < .05) than patients with an R1, R2, or no resection. CONCLUSIONS: RISs are aggressive malignancies with a high tendency for local recurrence and distant metastases. Previously applied treatment often hampers adequate resection. Therefore, radical surgical resection is the only chance to improve disease-free and overall survival, but it may also have a palliative role. Still, the overall prognosis remains poor.
Authors: Sean P Dineen; Christina L Roland; Rachel Feig; Caitlin May; Shouhao Zhou; Elizabeth Demicco; Ghadah Al Sannaa; Davis Ingram; Wei-Lein Wang; Vinod Ravi; Ashleigh Guadagnolo; Dina Lev; Raphael E Pollock; Kelly Hunt; Janice Cormier; Alex Lazar; Barry Feig; Keila E Torres Journal: Ann Surg Oncol Date: 2015-03-06 Impact factor: 5.344
Authors: Christopher Conlon; Lauren Pupa; Edward M Reece; Carrie K Chu; Jessie Z Yu; Joshua Vorstenbosch; Sebastian Winocour Journal: Semin Plast Surg Date: 2021-07-06 Impact factor: 2.195
Authors: Alexander L Lazarides; Zachary D C Burke; Manit K Gundavda; Rostislav Novak; Michelle Ghert; David A Wilson; Peter S Rose; Philip Wong; Anthony M Griffin; Peter C Ferguson; Jay S Wunder; Matthew T Houdek; Kim M Tsoi Journal: Cancers (Basel) Date: 2022-04-27 Impact factor: 6.575