Eilber, F. C., Eilber, F. R., Eckardt, J., Rosen, G., Riedel, E., Maki, R. G., Brennan, M. F., Singer, S. (October 2004) The impact of chemotherapy on the survival of patients with high-grade primary extremity liposarcoma. Ann Surg, 240 (4). 686-95; discussion 695. ISSN 0003-4932 (Print)0003-4932 (Linking)
Abstract
OBJECTIVE: To determine if chemotherapy offers a survival benefit to patients with large, high-grade, primary extremity liposarcoma. SUMMARY BACKGROUND DATA: The impact of chemotherapy on the survival of patients with primary extremity soft tissue sarcoma is controversial and its effect on individual histologic subtypes is not defined. PATIENT AND METHODS: Two prospectively collected sarcoma databases were used to identify all patients with >5 cm, high-grade, primary extremity liposarcoma that underwent surgical treatment of cure from 1975 to 2003 (n = 245). Clinical, pathologic and treatment variables were analyzed for disease-specific survival (DSS), distant recurrence-free survival (DRFS) and local recurrence-free survival (LRFS). RESULTS: Sixty-three (26%) patients were treated with ifosfamide based chemotherapy (IF), 83 (34%) with doxorubicin based chemotherapy (DOX) and 99 (40%) received no chemotherapy (NoC). To assess the impact of DOX, a contemporary cohort analysis of patients treated from 1975 to 1990 was performed. The 5 year DSS of the DOX treated patients was 64% (53%-74%) compared with 56% (51%-79%) for the NoC patients (log-rank P value = 0.28). To assess the impact of IF, a contemporary cohort analysis of patients treated from 1990 to 2003 was performed. The 5 year DSS of the IF treated patients was 92% (84%-100%) compared with 65% (51%-79%) for the NoC patients (log-rank P value = 0.0003). Independent prognostic factors for improved DSS were smaller size (HR = 0.7, P = 0.01), myxoid/round cell histologic subtype (HR = 0.3, P = 0.03) and treatment with IF (HR = 0.3, P = 0.01). The five-year DRFS of the IF treated patients was 81% (70%-92%) compared with 63% (50%-76%) for the NoC patients (log-rank P value = 0.02). The 5 year LRFS of the IF treated patients was 86% (76%-96%) compared with 87% (77%-97%) for the NoC patients (log-rank P value = 0.99). CONCLUSIONS: In patients with large, high-grade, primary extremity liposarcoma; DOX is not associated with improved DSS and IF is associated with an improved DSS. Treatment with IF should be considered in patients with high-risk primary extremity liposarcoma.
| Item Type: | Paper |
|---|---|
| Uncontrolled Keywords: | Adult Aged Aged, 80 and over Antibiotics, Antineoplastic/administration & dosage Antineoplastic Agents, Alkylating/administration & dosage Antineoplastic Combined Chemotherapy Protocols/therapeutic use Chemotherapy, Adjuvant Cohort Studies Disease-Free Survival Doxorubicin/administration & dosage *Extremities Female Humans Ifosfamide/administration & dosage Liposarcoma/*drug therapy/secondary/surgery Male Middle Aged Neoplasm Recurrence, Local/prevention & control Prospective Studies Radiotherapy, Adjuvant Soft Tissue Neoplasms/*drug therapy/surgery Survival Rate |
| Subjects: | diseases & disorders > cancer > drugs and therapies > chemotherapy diseases & disorders > cancer > drugs and therapies diseases & disorders > cancer > cancer types > sarcoma |
| CSHL Authors: | |
| Communities: | CSHL labs > Maki lab |
| Depositing User: | Matt Covey |
| Date: | October 2004 |
| Date Deposited: | 26 Oct 2016 20:50 |
| Last Modified: | 26 Oct 2016 20:50 |
| PMCID: | PMC1356470 |
| Related URLs: | |
| URI: | https://repository.cshl.edu/id/eprint/33652 |
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