Neo-adjuvant chemotherapy for primary high-grade extremity soft tissue sarcoma
Background: The purpose of this study was to retrospectively analyze the relationship between neo-adjuvant chemotherapy (NAC) and outcome in patients with high-grade extremity sarcomas. Patients and methods: Inclusion criteria were high-grade, deep, >5 cm extremity soft tissue sarcomas. Patients...
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| Veröffentlicht in: | Annals of oncology 2004-11, Vol.15 (11), p.1667-1672 |
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| container_title | Annals of oncology |
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| creator | Grobmyer, S. R. Maki, R. G. Demetri, G. D. Mazumdar, M. Riedel, E. Brennan, M. F. Singer, S. |
| description | Background: The purpose of this study was to retrospectively analyze the relationship between neo-adjuvant chemotherapy (NAC) and outcome in patients with high-grade extremity sarcomas. Patients and methods: Inclusion criteria were high-grade, deep, >5 cm extremity soft tissue sarcomas. Patients diagnosed between 1990 and 2001 were treated with surgery only (n=282) or NAC containing doxorubicin/ifosfamide/mesna (AIM) (n=74). The stratified Cox proportional hazards model was used to test the effect of NAC on disease-specific survival and recurrence while adjusting for known prognostic factors. Results: NAC was associated with improved disease-specific survival for this cohort of patients (P=0.02). This overall improvement appears to be driven by the benefit of NAC on disease-specific survival for patient with tumors >10 cm. The 3-year disease-specific survival for tumors >10 cm was 0.62 (95% CI: 0.53–0.71) for patients not receiving NAC and 0.83 (95% CI: 0.72–0.95) for patients receiving NAC. Conclusion: NAC with AIM was associated with a significant improvement in disease-specific survival in patients with high-grade extremity soft tissue sarcomas >10 cm. These data emphasize the need for further prospective clinical studies of neo-adjuvant or adjuvant chemotherapy for patients with large high-grade extremity sarcomas. |
| doi_str_mv | 10.1093/annonc/mdh431 |
| format | Article |
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R. ; Maki, R. G. ; Demetri, G. D. ; Mazumdar, M. ; Riedel, E. ; Brennan, M. F. ; Singer, S.</creator><creatorcontrib>Grobmyer, S. R. ; Maki, R. G. ; Demetri, G. D. ; Mazumdar, M. ; Riedel, E. ; Brennan, M. F. ; Singer, S.</creatorcontrib><description>Background: The purpose of this study was to retrospectively analyze the relationship between neo-adjuvant chemotherapy (NAC) and outcome in patients with high-grade extremity sarcomas. Patients and methods: Inclusion criteria were high-grade, deep, >5 cm extremity soft tissue sarcomas. Patients diagnosed between 1990 and 2001 were treated with surgery only (n=282) or NAC containing doxorubicin/ifosfamide/mesna (AIM) (n=74). The stratified Cox proportional hazards model was used to test the effect of NAC on disease-specific survival and recurrence while adjusting for known prognostic factors. Results: NAC was associated with improved disease-specific survival for this cohort of patients (P=0.02). This overall improvement appears to be driven by the benefit of NAC on disease-specific survival for patient with tumors >10 cm. The 3-year disease-specific survival for tumors >10 cm was 0.62 (95% CI: 0.53–0.71) for patients not receiving NAC and 0.83 (95% CI: 0.72–0.95) for patients receiving NAC. Conclusion: NAC with AIM was associated with a significant improvement in disease-specific survival in patients with high-grade extremity soft tissue sarcomas >10 cm. These data emphasize the need for further prospective clinical studies of neo-adjuvant or adjuvant chemotherapy for patients with large high-grade extremity sarcomas.</description><identifier>ISSN: 0923-7534</identifier><identifier>EISSN: 1569-8041</identifier><identifier>DOI: 10.1093/annonc/mdh431</identifier><identifier>PMID: 15520069</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic agents ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; chemotherapy ; Chemotherapy, Adjuvant ; Cohort Studies ; doxorubicin ; Extremities ; Humans ; ifosfamide ; Ifosfamide - administration & dosage ; Medical sciences ; Mesna - administration & dosage ; Middle Aged ; neo-adjuvant ; Pharmacology. Drug treatments ; Proportional Hazards Models ; Prospective Studies ; Retrospective Studies ; sarcoma ; Sarcoma - drug therapy ; Sarcoma - pathology ; Soft Tissue Neoplasms - drug therapy ; Soft Tissue Neoplasms - pathology ; Survival Analysis ; Time Factors ; Treatment Outcome</subject><ispartof>Annals of oncology, 2004-11, Vol.15 (11), p.1667-1672</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-d81154e325d0304018a6fb3ce8baa4f01b78e9bf6a7230a7f711b6d8c70dc00e3</citedby><cites>FETCH-LOGICAL-c462t-d81154e325d0304018a6fb3ce8baa4f01b78e9bf6a7230a7f711b6d8c70dc00e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16276966$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15520069$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grobmyer, S. R.</creatorcontrib><creatorcontrib>Maki, R. G.</creatorcontrib><creatorcontrib>Demetri, G. D.</creatorcontrib><creatorcontrib>Mazumdar, M.</creatorcontrib><creatorcontrib>Riedel, E.</creatorcontrib><creatorcontrib>Brennan, M. F.</creatorcontrib><creatorcontrib>Singer, S.</creatorcontrib><title>Neo-adjuvant chemotherapy for primary high-grade extremity soft tissue sarcoma</title><title>Annals of oncology</title><addtitle>Ann Oncol</addtitle><description>Background: The purpose of this study was to retrospectively analyze the relationship between neo-adjuvant chemotherapy (NAC) and outcome in patients with high-grade extremity sarcomas. Patients and methods: Inclusion criteria were high-grade, deep, >5 cm extremity soft tissue sarcomas. Patients diagnosed between 1990 and 2001 were treated with surgery only (n=282) or NAC containing doxorubicin/ifosfamide/mesna (AIM) (n=74). The stratified Cox proportional hazards model was used to test the effect of NAC on disease-specific survival and recurrence while adjusting for known prognostic factors. Results: NAC was associated with improved disease-specific survival for this cohort of patients (P=0.02). This overall improvement appears to be driven by the benefit of NAC on disease-specific survival for patient with tumors >10 cm. The 3-year disease-specific survival for tumors >10 cm was 0.62 (95% CI: 0.53–0.71) for patients not receiving NAC and 0.83 (95% CI: 0.72–0.95) for patients receiving NAC. Conclusion: NAC with AIM was associated with a significant improvement in disease-specific survival in patients with high-grade extremity soft tissue sarcomas >10 cm. These data emphasize the need for further prospective clinical studies of neo-adjuvant or adjuvant chemotherapy for patients with large high-grade extremity sarcomas.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic agents</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>chemotherapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Cohort Studies</subject><subject>doxorubicin</subject><subject>Extremities</subject><subject>Humans</subject><subject>ifosfamide</subject><subject>Ifosfamide - administration & dosage</subject><subject>Medical sciences</subject><subject>Mesna - administration & dosage</subject><subject>Middle Aged</subject><subject>neo-adjuvant</subject><subject>Pharmacology. Drug treatments</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>sarcoma</subject><subject>Sarcoma - drug therapy</subject><subject>Sarcoma - pathology</subject><subject>Soft Tissue Neoplasms - drug therapy</subject><subject>Soft Tissue Neoplasms - pathology</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0923-7534</issn><issn>1569-8041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkEFv2zAMRoVhxZJ2O-46-LLdvFKWLdnHoe3aAkF7aIsFuwi0TMXOYiuV5KH5900RozkRBB8-ko-xrxx-cqjEOQ6DG8x537S54B_YnBeySkvI-Uc2hyoTqSpEPmOnIawBQFZZ9YnNeFFkb82c3d2RS7FZj_9xiIlpqXexJY_bXWKdT7a-69HvkrZbtenKY0MJvURPfRd3SXA2JrELYaQkoDeux8_sxOIm0JepnrGn31ePFzfp4v769uLXIjW5zGLalJwXOYmsaEBADrxEaWthqKwRcwu8ViVVtZWoMgGorOK8lk1pFDQGgMQZ-3HI3Xr3PFKIuu-Coc0GB3Jj0FKB4CBhD6YH0HgXgierp5c0B_0mUB8E6oPAPf9tCh7rnpojPRnbA98nAIPBjfU4mC4cOZkpWUl5XNyFSC_vc_T_9scJVeib5V9dPiwv_5QV10vxCgXwix8</recordid><startdate>20041101</startdate><enddate>20041101</enddate><creator>Grobmyer, S. R.</creator><creator>Maki, R. G.</creator><creator>Demetri, G. D.</creator><creator>Mazumdar, M.</creator><creator>Riedel, E.</creator><creator>Brennan, M. F.</creator><creator>Singer, S.</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20041101</creationdate><title>Neo-adjuvant chemotherapy for primary high-grade extremity soft tissue sarcoma</title><author>Grobmyer, S. R. ; Maki, R. G. ; Demetri, G. D. ; Mazumdar, M. ; Riedel, E. ; Brennan, M. F. ; Singer, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-d81154e325d0304018a6fb3ce8baa4f01b78e9bf6a7230a7f711b6d8c70dc00e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic agents</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>chemotherapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>Cohort Studies</topic><topic>doxorubicin</topic><topic>Extremities</topic><topic>Humans</topic><topic>ifosfamide</topic><topic>Ifosfamide - administration & dosage</topic><topic>Medical sciences</topic><topic>Mesna - administration & dosage</topic><topic>Middle Aged</topic><topic>neo-adjuvant</topic><topic>Pharmacology. Drug treatments</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>sarcoma</topic><topic>Sarcoma - drug therapy</topic><topic>Sarcoma - pathology</topic><topic>Soft Tissue Neoplasms - drug therapy</topic><topic>Soft Tissue Neoplasms - pathology</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grobmyer, S. R.</creatorcontrib><creatorcontrib>Maki, R. G.</creatorcontrib><creatorcontrib>Demetri, G. D.</creatorcontrib><creatorcontrib>Mazumdar, M.</creatorcontrib><creatorcontrib>Riedel, E.</creatorcontrib><creatorcontrib>Brennan, M. F.</creatorcontrib><creatorcontrib>Singer, S.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grobmyer, S. R.</au><au>Maki, R. G.</au><au>Demetri, G. D.</au><au>Mazumdar, M.</au><au>Riedel, E.</au><au>Brennan, M. F.</au><au>Singer, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neo-adjuvant chemotherapy for primary high-grade extremity soft tissue sarcoma</atitle><jtitle>Annals of oncology</jtitle><addtitle>Ann Oncol</addtitle><date>2004-11-01</date><risdate>2004</risdate><volume>15</volume><issue>11</issue><spage>1667</spage><epage>1672</epage><pages>1667-1672</pages><issn>0923-7534</issn><eissn>1569-8041</eissn><abstract>Background: The purpose of this study was to retrospectively analyze the relationship between neo-adjuvant chemotherapy (NAC) and outcome in patients with high-grade extremity sarcomas. Patients and methods: Inclusion criteria were high-grade, deep, >5 cm extremity soft tissue sarcomas. Patients diagnosed between 1990 and 2001 were treated with surgery only (n=282) or NAC containing doxorubicin/ifosfamide/mesna (AIM) (n=74). The stratified Cox proportional hazards model was used to test the effect of NAC on disease-specific survival and recurrence while adjusting for known prognostic factors. Results: NAC was associated with improved disease-specific survival for this cohort of patients (P=0.02). This overall improvement appears to be driven by the benefit of NAC on disease-specific survival for patient with tumors >10 cm. The 3-year disease-specific survival for tumors >10 cm was 0.62 (95% CI: 0.53–0.71) for patients not receiving NAC and 0.83 (95% CI: 0.72–0.95) for patients receiving NAC. Conclusion: NAC with AIM was associated with a significant improvement in disease-specific survival in patients with high-grade extremity soft tissue sarcomas >10 cm. These data emphasize the need for further prospective clinical studies of neo-adjuvant or adjuvant chemotherapy for patients with large high-grade extremity sarcomas.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>15520069</pmid><doi>10.1093/annonc/mdh431</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Antineoplastic agents Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences chemotherapy Chemotherapy, Adjuvant Cohort Studies doxorubicin Extremities Humans ifosfamide Ifosfamide - administration & dosage Medical sciences Mesna - administration & dosage Middle Aged neo-adjuvant Pharmacology. Drug treatments Proportional Hazards Models Prospective Studies Retrospective Studies sarcoma Sarcoma - drug therapy Sarcoma - pathology Soft Tissue Neoplasms - drug therapy Soft Tissue Neoplasms - pathology Survival Analysis Time Factors Treatment Outcome |
| title | Neo-adjuvant chemotherapy for primary high-grade extremity soft tissue sarcoma |
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