Adjuvant Therapy for Sarcomas in Adults
The treatment considered optimal for primary soft-tissue sarcomas is operative resection with adequate margins of normal tissue around the neoplasm. This approach has been fully illustrated earlier in this volume for a variety of primary sites and clinical presentations. With this approach, the overall “cure rate” for localized soft-tissue sarcomas in adults has been in the range of 40%. More recent reports do suggest a somewhat higher figure, but this may be due to better initial staging methods and the resulting separation of patients with clinically unsuspected metastatic disease. Unfortunately, local control of the sarcoma is not always achieved by operative resection, despite an attempt to follow the surgical principles that have been outlined. In some instances, local failure may occur due to employment of a less than radical approach in order to maintain a viable extremity or because of other anatomic limitations associated with sarcomas arising from the trunk, retroperitoneum, or the head and neck. Nonoperative adjuvant therapies have been employed to deal with both problems associated with treatment failure—local recurrence and hematogenous metastases. An attempt will be made to assess the value of these additional approaches to clinical management.
KeywordsOncol Sarcoma Doxorubicin Cyclophosphamide Vincristine
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- 1.Antman K, Blum R, Corson J, et al: Effective adjuvant chemotherapy for localized soft tissue sarcoma. Proc AACR 21: 141, 1980.Google Scholar
- 3.Edmonson JH, Fleming TR, Ivins JC, et al: Reduced hematogenous metastasis in patients who receive systemic chemotherapy following excision of soft tissue sarcomas: preliminary report. Proceedings of the American Association for Cancer Research 21: 193, 1980.Google Scholar
- 7.Lindberg RD, Martin RG, Romsdahl MM: Surgery and postoperative radiotherapy in the treatment of soft tissue sarcomas in adults. Am J Roentgenol 123:123– 129, 1975.Google Scholar
- 9.Lindberg RD, Murphy WK, Benjamin RS, et al: Adjuvant chemotherapy in the treatment of primary soft tissue sarcomas: a preliminary report. In Management of Bone and Soft Tissue Tumors (The University of Texas MD Anderson Hospital and Tumor Institute, 21st Annual Clinical Conference on Cancer). Chicago, Year Book Medical Publishers, 1977, pp 343 – 352.Google Scholar
- 12.McBride CM: Regional chemotherapy for soft tissue sarcomas. In Management of Bone and Soft Tissue Tumors (The University of Texas MD Anderson Hospital and Tumor Institute, 21st Annual Clinical Conference on Cancer). Chicago, Year Book Medical Publishers, 1977, pp 353 – 360.Google Scholar
- 15.Rosenberg SA: Treatment of soft tissue sarcomas. In Surgical Oncology Research Workshop (September 9, 1981), pp 77–80, NIH Publ No 82–2444.Google Scholar
- 17.Rosenberg SA, Kent H, Costa J, Webber BI, Young R, Chabner B, Baker AR, Brennan MF, Chretien PB, Cohen MH, DeMoss EV, Sears HF, Seipp C, Simon R: Prospective randomized evaluation of the role of limb-sparing surgery, radiation therapy, and adjuvant chemoimmunotherapy in the treatment of adult soft-tissue sarcomas. Surgery 84: 62 – 69, 1978.PubMedGoogle Scholar
- 18.Rosenberg SA, Tepper J, Glatstein E, Costa J, Baker A, Brennan M, DeMoss EV, Seipp C, Sindelar WF, Sugarbaker P, Wesley R: The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. Ann Surg 196: 305 – 315, 1982.PubMedCrossRefGoogle Scholar