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Clinical management of infantile fibrosarcoma: a retrospective single-institution review

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Abstract

Background

Infantile fibrosarcoma (IFS) is an uncommon soft-tissue sarcoma. Here we review our experience treating this tumor.

Patients and methods

We retrospectively reviewed records of patients with IFS treated at St. Jude Children’s Research Hospital between 1980 and 2009.

Results

We identified 15 patients, 8 girls and 7 boys; 13 white and 2 black. Median age at diagnosis was 3 months. Primary sites included the leg (n = 3), chest wall (n = 2), foot (n = 2), and one each in the tongue, occipital region, axilla, parascapular region, arm, forearm, retroperitoneum, and thigh. All patients underwent resection; 11 upfront surgery, and 4 delayed. Complications included loss of the posterior tibial nerve and artery, axillary vein, biceps, pectoralis major, gallbladder, and transverse/sigmoid sinus. Eight received chemotherapy and three radiotherapy. Seven experienced local recurrence and three lung metastasis. Median follow-up was 65 months. At the time of the review, 12 patients were alive and 3 had died. All deaths were in patients older than 1 year at diagnosis with an axial primary site.

Conclusions

Non-mutilating surgery should be the primary treatment for IFS. Neoadjuvant chemotherapy is indicated when upfront resection is unfeasible. Patients with positive surgical margins should receive adjuvant chemotherapy. Radiotherapy is indicated for axial primary sites where complete resection is impossible.

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Acknowledgments

Our sincere thanks to Angela J. McArthur and David Galloway of Scientific Editing for assistance in the preparation of this manuscript. This work is supported in part by a grant from the Cancer Center Support (CORE) Grant 21765 and Grant 23099 from the National Cancer Institute and by the American Lebanese Syrian Associated Charities (ALSAC).

Conflict of interest

Nothing to declare.

Author information

Author notes

  1. Lalit Parida

    Present address: Kalyani Poly Clinic, Bhubaneswar, Orissa, India

  2. Israel Fernandez-Pineda

    Present address: Department of Pediatric Surgery, Virgen del Rocio Children’s Hospital, Seville, Spain

  3. John K. Uffman

    Present address: Department of Pediatric Surgery, Cook Children’s Medical Center, Fort Worth, TX, USA

Authors and Affiliations

  1. Department of Surgery, MS 133, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA

    Lalit Parida, Israel Fernandez-Pineda, John K. Uffman, Andrew M. Davidoff & Bhaskar N. Rao

  2. Division of Pediatric General Surgery, Le Bonheur Children’s Hospital, Memphis, TN, USA

    John K. Uffman & Andrew M. Davidoff

  3. Department of Surgery and Pediatrics, University of Tennessee College of Medicine, Memphis, TN, USA

    Andrew M. Davidoff & Bhaskar N. Rao

  4. Division of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Matthew J. Krasin

  5. Solid Tumor Division, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Alberto Pappo

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  1. Lalit Parida
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Correspondence to Bhaskar N. Rao.

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Parida, L., Fernandez-Pineda, I., Uffman, J.K. et al. Clinical management of infantile fibrosarcoma: a retrospective single-institution review. Pediatr Surg Int 29, 703–708 (2013). https://doi.org/10.1007/s00383-013-3326-4

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  • DOI: https://doi.org/10.1007/s00383-013-3326-4

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