Division of Surgical Oncology, University of California Davis Medical Center, Sacramento, CA, USA.
Anticancer Res. 2012 Sep;32(9):3911-5.
We sought to determine if complete pathological necrosis (pathCR) predicts favorable oncological outcome in soft tissue sarcoma (STS) patients receiving pre-operative radiation monotherapy (RT).
We evaluated 30 patients with primary STS treated with neoadjuvant RT followed by definitive resection, from 2000 to 2010 at our institution. We defined ≥ 95% tumor necrosis as pathCR.
There were 22 STS of the extremities (73%), 7 of the retroperitoneum (23%), and 1 (4%) of the trunk. The median pathological percentage of tumor necrosis was 35% (range 5-100%) with three tumors (10%) demonstrating pathCR. With a median follow-up of 40 months, the 5-year local recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), and overall survival (OS) for the entire cohort were 100%, 61% ± 11%, and 69% ± 11%, respectively. Among patients with pathCR, 3-year DRFS was 100% compared to 63±11% in patients without pathCR (p=0.28).
Following neoadjuvant RT for STS, pathCR is associated with a clinically but not statistically significant 37% improvement in 3-year DRFS.
我们试图确定软组织肉瘤（STS）患者接受术前放射单药治疗（RT）时，完全病理性坏死（pathCR）是否预测良好的肿瘤学结果。
我们评估了 2000 年至 2010 年在我院接受新辅助 RT 后行确定性切除的 30 例原发性 STS 患者。我们将≥95%的肿瘤坏死定义为 pathCR。
有 22 例 STS 位于四肢（73%），7 例位于腹膜后（23%），1 例位于躯干（4%）。肿瘤坏死的中位数病理百分比为 35%（范围 5-100%），其中 3 例（10%）表现为 pathCR。中位随访 40 个月时，全队列的 5 年局部无复发生存率（LRFS）、远处无复发生存率（DRFS）和总生存率（OS）分别为 100%、61%±11%和 69%±11%。在 pathCR 患者中，3 年 DRFS 为 100%，而无 pathCR 患者为 63%±11%（p=0.28）。
在 STS 接受新辅助 RT 后，pathCR 与 3 年 DRFS 临床显著但无统计学意义的 37%改善相关。
