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• W3210218539 abstract "Purpose/Objective(s)To compare long-term outcomes of high grade primary soft tissue sarcoma (STS), using ifosfamide-doxorubicin vs local therapy alone, in histology-specific sarcomas.Materials/MethodsRetrospective analysis was performed on 127 patients from 2005 to 2018, who had high grade STS of extremity or trunk, > 5cm, that were either Synovial Cell, Dedifferentiated Liposarcoma (DDL), Myxofibrosarcoma, Round Cell Liposarcoma (RCLS), Undifferentiated Pleomorphic Sarcoma (UPS), or Undifferentiated Sarcoma not otherwise specified (NOS), with central pathology review. Ifosfamide-doxorubicin was given over 4-5 cycles, with chemotherapy given in 38 patients, while 89 received local therapy alone. Pre-operative radiation was given in 93 (73.2%), postoperative in 31 (24.4%), and amputation in 3 (2.4%). Multi-variable analysis of prognostic factors was performed, and local-recurrence-free-survival (LRFS), distant-metastases-free-survival (DMFS), disease-specific-survival (DSS), and overall-survival (OS) were estimated using Kaplan-Meier.ResultsMedian follow-up was 4.5 years. Younger age (P < 0.0001) and Synovial histology (P = 0.0002) were more likely to undergo chemotherapy. Size > 10cm and trunk location were poor prognostic features on multivariable analysis (MVA) affecting DMFS, DSS, and OS, while DDL had more favorable survival; although size, trunk location, and DDL histology were not significantly different between treatment groups. Sequence of radiation did not significantly affect any of the survival outcomes. Ifosfamide-doxorubicin vs local therapy alone improved 5-year DMFS at 70.2% vs 49.5%, P = 0.02, DSS 83.5% vs 57.9%, P = 0.009, and OS 80.6% vs 53.8%, P = 0.002. Sub-analysis of non-synovial histology still showed a significant improvement in favor of chemotherapy in DMFS, (P = 0.04), DSS (P = 0.02), and OS (P = 0.003).ConclusionIfosfamide-doxorubicin benefits younger patients with > 5cm, high grade, STS of the trunk or extremity in Synovial Cell, DDL, Myxofibrosarcoma, RCLS, UPS, and Undifferentiated Sarcoma NOS. To compare long-term outcomes of high grade primary soft tissue sarcoma (STS), using ifosfamide-doxorubicin vs local therapy alone, in histology-specific sarcomas. Retrospective analysis was performed on 127 patients from 2005 to 2018, who had high grade STS of extremity or trunk, > 5cm, that were either Synovial Cell, Dedifferentiated Liposarcoma (DDL), Myxofibrosarcoma, Round Cell Liposarcoma (RCLS), Undifferentiated Pleomorphic Sarcoma (UPS), or Undifferentiated Sarcoma not otherwise specified (NOS), with central pathology review. Ifosfamide-doxorubicin was given over 4-5 cycles, with chemotherapy given in 38 patients, while 89 received local therapy alone. Pre-operative radiation was given in 93 (73.2%), postoperative in 31 (24.4%), and amputation in 3 (2.4%). Multi-variable analysis of prognostic factors was performed, and local-recurrence-free-survival (LRFS), distant-metastases-free-survival (DMFS), disease-specific-survival (DSS), and overall-survival (OS) were estimated using Kaplan-Meier. Median follow-up was 4.5 years. Younger age (P < 0.0001) and Synovial histology (P = 0.0002) were more likely to undergo chemotherapy. Size > 10cm and trunk location were poor prognostic features on multivariable analysis (MVA) affecting DMFS, DSS, and OS, while DDL had more favorable survival; although size, trunk location, and DDL histology were not significantly different between treatment groups. Sequence of radiation did not significantly affect any of the survival outcomes. Ifosfamide-doxorubicin vs local therapy alone improved 5-year DMFS at 70.2% vs 49.5%, P = 0.02, DSS 83.5% vs 57.9%, P = 0.009, and OS 80.6% vs 53.8%, P = 0.002. Sub-analysis of non-synovial histology still showed a significant improvement in favor of chemotherapy in DMFS, (P = 0.04), DSS (P = 0.02), and OS (P = 0.003). Ifosfamide-doxorubicin benefits younger patients with > 5cm, high grade, STS of the trunk or extremity in Synovial Cell, DDL, Myxofibrosarcoma, RCLS, UPS, and Undifferentiated Sarcoma NOS." @default.
• W3210218539 created "2021-11-08" @default.
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• W3210218539 date "2021-11-01" @default.
• W3210218539 modified "2023-09-27" @default.
• W3210218539 title "The Role of Ifosfamide-Doxorubicin Chemotherapy in Histology-Specific, High Grade, Locally Advanced Soft Tissue Sarcoma, Treated With Wide Excision Plus Radiation" @default.
• W3210218539 doi "https://doi.org/10.1016/j.ijrobp.2021.07.977" @default.
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