Timothée Olivier1, Daniel Pop2, Amina Chouiter Djebaili3, Alexander Tuan Falk4, Antoine Iannessi5, Esma Saada6, Willy Nettekoven3, Jean-Yves Blay7, Patrick Baque8, Didier Cupissol9, Antoine Thyss6, Juliette Thariat10. 1. Hôpital neuchâtelois, Département d'Oncologie, Chasseral 20, 2300 La Chaux-de-Fonds, Switzerland; Institut régional du Cancer de Montpellier, Parc Euromédecine, 208 rue des Apothicaires, 34298 Montpellier Cedex 5, France. 2. Centre Hospitalo-Universitaire Pasteur, Service de Chirurgie Thoracique, 30 Avenue de la Voie Romaine, 06000 Nice, France. 3. Hôpital neuchâtelois, Département d'Oncologie, Chasseral 20, 2300 La Chaux-de-Fonds, Switzerland. 4. Centre Antoine Lacassagne, Département d'oncologie, Département de radiothérapie, 227, Avenue de la Lanterne, 06200 Nice, France. 5. Centre Antoine Lacassagne, Département de radiologie, 33, Avenue Valombrose, 06189 Nice, France. 6. Centre Antoine Lacassagne, Département d'oncologie médicale, 33, Avenue Valombrose, 06189 Nice, France. 7. Département d'Oncologie, Centre Léon Bérard, 28 Rue Laennec, 69008 Lyon, France. 8. Centre Hospitalo-Universitaire Saint Roch, Service de Chirurgie, 06000 Nice, France. 9. Institut régional du Cancer de Montpellier, Parc Euromédecine, 208 rue des Apothicaires, 34298 Montpellier Cedex 5, France. 10. Centre Antoine Lacassagne, Département d'oncologie, Département de radiothérapie, 227, Avenue de la Lanterne, 06200 Nice, France. Electronic address: jthariat@hotmail.com.
Abstract
PURPOSE: The mainstay of first line treatment in metastatic sarcomas is chemotherapy with response rates of ≈25% but the optimal management of further events is debated. We assessed the benefit of local metastatic treatment in metastatic sarcomas. RESULTS: Local control of local treatment strategies (≈85%) is excellent but highly institution-dependent and subject to selection biases. Formal evidence of an improvement of survival with local ablative treatments has been limited to retrospective studies. On the other hand, some chemotherapy trials are inconclusive because about 20% of patients receive local metastatic ablation as it is considered unethical to omit local treatment in these patients. Further, technology has made surgery, stereotactic irradiation and radiofrequency ablation highly effective on local control with limited morbidity. CONCLUSION: The benefit on survival of metastatic ablation deserves prospective studies integrating quality of life, cost effectiveness and patient-reported outcomes assessment.
PURPOSE: The mainstay of first line treatment in metastatic sarcomas is chemotherapy with response rates of ≈25% but the optimal management of further events is debated. We assessed the benefit of local metastatic treatment in metastatic sarcomas. RESULTS: Local control of local treatment strategies (≈85%) is excellent but highly institution-dependent and subject to selection biases. Formal evidence of an improvement of survival with local ablative treatments has been limited to retrospective studies. On the other hand, some chemotherapy trials are inconclusive because about 20% of patients receive local metastatic ablation as it is considered unethical to omit local treatment in these patients. Further, technology has made surgery, stereotactic irradiation and radiofrequency ablation highly effective on local control with limited morbidity. CONCLUSION: The benefit on survival of metastatic ablation deserves prospective studies integrating quality of life, cost effectiveness and patient-reported outcomes assessment.
Authors: Loïc Chaigneau; Anna Patrikidou; Isabelle Ray-Coquard; Thibaud Valentin; Claude Linassier; Jacques Olivier Bay; Laurence Moureau Zabotto; Emmanuelle Bompas; Sophie Piperno-Neumann; Nicolas Penel; Thierry Alcindor; Maryline Laigre; Cecile Guillemet; Sebastien Salas; Anne Hugli; Julien Domont; Marie Pierre Sunyach; Axel Lecesne; Jean Yves Blay; Virginie Nerich; Nicolas Isambert Journal: Oncologist Date: 2018-06-22
Authors: Jennifer le Guevelou; Colin Debaigt; Esma Saada-Bouzid; Julien Viotti; Nazim Khalladi; David Thibouw; Nicolas Penel; Marie Pierre Sunyach; Laurence Moureau-Zabotto; Mohamed Benchalal; Ovidiu Veresezan; Anne Ducassou; Cecile le Pechoux; Maria Jolnerovski; Celine Bazille; Dominique Vaur; Alexandre Escande; Raphael Serre; Christine Lovera; Juliette Thariat Journal: BMJ Open Date: 2020-09-23 Impact factor: 2.692