1. The role of adjuvant chemotherapy in children and adolescents with surgically resected, high-risk adult-type soft tissue sarcomas
- Author
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Serena Catania, Christoph Int-Veen, Andrea Ferrari, Ewa Koscielniak, Joern Treuner, Gianni Bisogno, Giovanni Cecchetto, Ines B. Brecht, Michela Casanova, Angela Scagnellato, Cristina Meazza, Rita Alaggio, Tobias M. Dantonello, Sylvia Kirsch, and Modesto Carli
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Adjuvant chemotherapy ,medicine.medical_treatment ,Soft Tissue Neoplasms ,Disease-Free Survival ,Blood cancer ,Germany ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Rhabdomyosarcoma ,Child ,Chemotherapy ,business.industry ,Soft tissue sarcoma ,Soft tissue ,Sarcoma ,Hematology ,medicine.disease ,Surgery ,Survival Rate ,Oncology ,El Niño ,Italy ,Chemotherapy, Adjuvant ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,Adult type ,business - Abstract
Purpose This analysis evaluates whether adjuvant chemotherapy can be recommended for high-risk, surgically-resected, adult-type non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) within the new European Pediatric Soft Tissue Sarcoma Study Group (EpSSG) protocol. The Italian and German Cooperative Groups reviewed their data-bases, analyzing patients classified as group I–II, with high-grade tumor (G3) larger than 5 cm in size. Methods The analysis included 36 patients, and compared the clinical features and outcome of the group of 21 patients who received chemotherapy versus the group of 15 patients treated with local therapies only. Results For the series as a whole, 5-year event-free survival (EFS), metastasis-free survival (MFS), and overall survival (OS) were 26.2%, 34.0%, and 37.5%, respectively. In patients treated with chemotherapy, MFS and OS were 49.5% and 41.5% (median time to relapse: 13 months). In patients who did not receive chemotherapy, MFS and OS were 0% and 23.8% (median time to relapse: 3 months). Conclusion The role of adjuvant chemotherapy in NRSTS is still uncertain, however, the current retrospective analysis showed that: (1) despite the globally good prognosis of grossly-resected cases, patients with G3 and large-size have a high-risk of metastatic spread, and (2) MFS appears to be better in patients who had chemotherapy. Based in part on these results, and in accordance with recent suggestions coming from the literature on adult sarcomas, the EpSSG NRSTS protocol will recommend adjuvant chemotherapy in high-risk surgically-resected patients. Pediatr Blood Cancer © 2005 Wiley-Liss, Inc.
- Published
- 2005