Preoperative chemotherapy for stage IIIB extremity soft tissue sarcoma: Long-term results from a single institution

Peter W T Pisters, Shreyaskumar R. Patel, Datla G K Varma, Su Chun Cheng, Nancy P. Chen, H. T B Nguyen, Barry W. Feig, Alan Pollack, Raphael E. Pollock, Robert S. Benjamin

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Abstract

Purpose: To review a single institution's long-term results with doxorubicin-based preoperative chemotherapy for American Joint Committee on Cancer (AJCC) stage IIIB extremity soft tissue sarcoma (STS). Patients and Methods: The records of all patients with AJCC stage IIIB extremity STS treated with preoperative chemotherapy between 1986 and 1990 at The University of Texas M.D. Anderson Cancer Center were reviewed to assess rates of response, local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS). Results: Seventy-six patients with stage IIIB disease received preoperative chemotherapy. The median sarcoma size was 10 cm. Seventy-two patients (95%) had tumors located deep to the muscular fascia. Most patients received a median of three preoperative cycles of doxorubicin and dacarbazine (ADIC), cyclophosphamide and ADIC (CyADIC), or other doxorubicin-based regimens. Radiographic response rates were as follows: complete response (CR), 9%; partial response (PR), 19%; minor response, 13%; stable disease, 30%; and progression, 30%. The overall objective major response rate (CRs plus PRs) was 27%. At a media, follow-up time of 85 months, 5-year actuarial rates of LRFS, DMFS, DFS, and OS with 95% confidence intervals (CIs) were 83% (CI, 73% to 94%), 52% (CI, 41% to 66%), 46% (CI, 35% to 60%), and 59% (CI, 48% to 72%), respectively. Comparison of responding patients (CRs plus PRs) and nonresponding patients did not shaw any significant differences in LRFS, DMFS, DFS, or OS. Conclusion: Preoperative doxorubicin-based chemotherapy was associated with response, DFS, and OS rates similar to those observed in randomized postoperative chemotherapy trials. Responding patients had rates of LRFS, DMFS, DFS, and OS comparable to those of nonresponders.

Original languageEnglish
Pages (from-to)3481-3487
Number of pages7
JournalJournal of Clinical Oncology
Volume15
Issue number12
StatePublished - Dec 1 1997
Externally publishedYes

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Sarcoma
Extremities
Drug Therapy
Survival
Disease-Free Survival
Doxorubicin
Confidence Intervals
Neoplasm Metastasis
Recurrence
Neoplasms
Dacarbazine
Fascia
Cyclophosphamide
Survival Rate

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Pisters, P. W. T., Patel, S. R., Varma, D. G. K., Cheng, S. C., Chen, N. P., Nguyen, H. T. B., ... Benjamin, R. S. (1997). Preoperative chemotherapy for stage IIIB extremity soft tissue sarcoma: Long-term results from a single institution. Journal of Clinical Oncology, 15(12), 3481-3487.

Preoperative chemotherapy for stage IIIB extremity soft tissue sarcoma : Long-term results from a single institution. / Pisters, Peter W T; Patel, Shreyaskumar R.; Varma, Datla G K; Cheng, Su Chun; Chen, Nancy P.; Nguyen, H. T B; Feig, Barry W.; Pollack, Alan; Pollock, Raphael E.; Benjamin, Robert S.

In: Journal of Clinical Oncology, Vol. 15, No. 12, 01.12.1997, p. 3481-3487.

Research output: Contribution to journalArticle

Pisters, PWT, Patel, SR, Varma, DGK, Cheng, SC, Chen, NP, Nguyen, HTB, Feig, BW, Pollack, A, Pollock, RE & Benjamin, RS 1997, 'Preoperative chemotherapy for stage IIIB extremity soft tissue sarcoma: Long-term results from a single institution', Journal of Clinical Oncology, vol. 15, no. 12, pp. 3481-3487.
Pisters PWT, Patel SR, Varma DGK, Cheng SC, Chen NP, Nguyen HTB et al. Preoperative chemotherapy for stage IIIB extremity soft tissue sarcoma: Long-term results from a single institution. Journal of Clinical Oncology. 1997 Dec 1;15(12):3481-3487.
Pisters, Peter W T ; Patel, Shreyaskumar R. ; Varma, Datla G K ; Cheng, Su Chun ; Chen, Nancy P. ; Nguyen, H. T B ; Feig, Barry W. ; Pollack, Alan ; Pollock, Raphael E. ; Benjamin, Robert S. / Preoperative chemotherapy for stage IIIB extremity soft tissue sarcoma : Long-term results from a single institution. In: Journal of Clinical Oncology. 1997 ; Vol. 15, No. 12. pp. 3481-3487.
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abstract = "Purpose: To review a single institution's long-term results with doxorubicin-based preoperative chemotherapy for American Joint Committee on Cancer (AJCC) stage IIIB extremity soft tissue sarcoma (STS). Patients and Methods: The records of all patients with AJCC stage IIIB extremity STS treated with preoperative chemotherapy between 1986 and 1990 at The University of Texas M.D. Anderson Cancer Center were reviewed to assess rates of response, local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS). Results: Seventy-six patients with stage IIIB disease received preoperative chemotherapy. The median sarcoma size was 10 cm. Seventy-two patients (95{\%}) had tumors located deep to the muscular fascia. Most patients received a median of three preoperative cycles of doxorubicin and dacarbazine (ADIC), cyclophosphamide and ADIC (CyADIC), or other doxorubicin-based regimens. Radiographic response rates were as follows: complete response (CR), 9{\%}; partial response (PR), 19{\%}; minor response, 13{\%}; stable disease, 30{\%}; and progression, 30{\%}. The overall objective major response rate (CRs plus PRs) was 27{\%}. At a media, follow-up time of 85 months, 5-year actuarial rates of LRFS, DMFS, DFS, and OS with 95{\%} confidence intervals (CIs) were 83{\%} (CI, 73{\%} to 94{\%}), 52{\%} (CI, 41{\%} to 66{\%}), 46{\%} (CI, 35{\%} to 60{\%}), and 59{\%} (CI, 48{\%} to 72{\%}), respectively. Comparison of responding patients (CRs plus PRs) and nonresponding patients did not shaw any significant differences in LRFS, DMFS, DFS, or OS. Conclusion: Preoperative doxorubicin-based chemotherapy was associated with response, DFS, and OS rates similar to those observed in randomized postoperative chemotherapy trials. Responding patients had rates of LRFS, DMFS, DFS, and OS comparable to those of nonresponders.",
author = "Pisters, {Peter W T} and Patel, {Shreyaskumar R.} and Varma, {Datla G K} and Cheng, {Su Chun} and Chen, {Nancy P.} and Nguyen, {H. T B} and Feig, {Barry W.} and Alan Pollack and Pollock, {Raphael E.} and Benjamin, {Robert S.}",
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T1 - Preoperative chemotherapy for stage IIIB extremity soft tissue sarcoma

T2 - Long-term results from a single institution

AU - Pisters, Peter W T

AU - Patel, Shreyaskumar R.

AU - Varma, Datla G K

AU - Cheng, Su Chun

AU - Chen, Nancy P.

AU - Nguyen, H. T B

AU - Feig, Barry W.

AU - Pollack, Alan

AU - Pollock, Raphael E.

AU - Benjamin, Robert S.

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N2 - Purpose: To review a single institution's long-term results with doxorubicin-based preoperative chemotherapy for American Joint Committee on Cancer (AJCC) stage IIIB extremity soft tissue sarcoma (STS). Patients and Methods: The records of all patients with AJCC stage IIIB extremity STS treated with preoperative chemotherapy between 1986 and 1990 at The University of Texas M.D. Anderson Cancer Center were reviewed to assess rates of response, local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS). Results: Seventy-six patients with stage IIIB disease received preoperative chemotherapy. The median sarcoma size was 10 cm. Seventy-two patients (95%) had tumors located deep to the muscular fascia. Most patients received a median of three preoperative cycles of doxorubicin and dacarbazine (ADIC), cyclophosphamide and ADIC (CyADIC), or other doxorubicin-based regimens. Radiographic response rates were as follows: complete response (CR), 9%; partial response (PR), 19%; minor response, 13%; stable disease, 30%; and progression, 30%. The overall objective major response rate (CRs plus PRs) was 27%. At a media, follow-up time of 85 months, 5-year actuarial rates of LRFS, DMFS, DFS, and OS with 95% confidence intervals (CIs) were 83% (CI, 73% to 94%), 52% (CI, 41% to 66%), 46% (CI, 35% to 60%), and 59% (CI, 48% to 72%), respectively. Comparison of responding patients (CRs plus PRs) and nonresponding patients did not shaw any significant differences in LRFS, DMFS, DFS, or OS. Conclusion: Preoperative doxorubicin-based chemotherapy was associated with response, DFS, and OS rates similar to those observed in randomized postoperative chemotherapy trials. Responding patients had rates of LRFS, DMFS, DFS, and OS comparable to those of nonresponders.

AB - Purpose: To review a single institution's long-term results with doxorubicin-based preoperative chemotherapy for American Joint Committee on Cancer (AJCC) stage IIIB extremity soft tissue sarcoma (STS). Patients and Methods: The records of all patients with AJCC stage IIIB extremity STS treated with preoperative chemotherapy between 1986 and 1990 at The University of Texas M.D. Anderson Cancer Center were reviewed to assess rates of response, local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS). Results: Seventy-six patients with stage IIIB disease received preoperative chemotherapy. The median sarcoma size was 10 cm. Seventy-two patients (95%) had tumors located deep to the muscular fascia. Most patients received a median of three preoperative cycles of doxorubicin and dacarbazine (ADIC), cyclophosphamide and ADIC (CyADIC), or other doxorubicin-based regimens. Radiographic response rates were as follows: complete response (CR), 9%; partial response (PR), 19%; minor response, 13%; stable disease, 30%; and progression, 30%. The overall objective major response rate (CRs plus PRs) was 27%. At a media, follow-up time of 85 months, 5-year actuarial rates of LRFS, DMFS, DFS, and OS with 95% confidence intervals (CIs) were 83% (CI, 73% to 94%), 52% (CI, 41% to 66%), 46% (CI, 35% to 60%), and 59% (CI, 48% to 72%), respectively. Comparison of responding patients (CRs plus PRs) and nonresponding patients did not shaw any significant differences in LRFS, DMFS, DFS, or OS. Conclusion: Preoperative doxorubicin-based chemotherapy was associated with response, DFS, and OS rates similar to those observed in randomized postoperative chemotherapy trials. Responding patients had rates of LRFS, DMFS, DFS, and OS comparable to those of nonresponders.

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