Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/ASO.2005.03.041
Annals of Surgical Oncology 12:237-245 (2005)
© 2005 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Thijssens, K. M. J.
Right arrow Articles by Hoekstra, H. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Thijssens, K. M. J.
Right arrow Articles by Hoekstra, H. J.

Original Article

Radiation-Induced Sarcoma: A Challenge for the Surgeon

Katja M. J. Thijssens, MD1, Robert J. van Ginkel, MD, PhD1, Albert J. H. Suurmeijer, MD, PhD2, Elisabeth Pras, MD, PhD3, Winette T. A. van der Graaf, MD4, Miranda Hollander, BA1 and Harald J. Hoekstra, MD, PhD1

1 Department of Surgical Oncology, Groningen University Medical Centre, P.O. Box 30.001, 9700, RB Groningen, The Netherlands
2 Department of Pathology, Groningen University Medical Centre, 9700, RB Groningen, The Netherlands
3 Department of Radiation Oncology, Groningen University Medical Centre, 9700, RB Groningen, The Netherlands
4 Department of Medical Oncology, Groningen University Medical Centre, 9700, RB Groningen, The Netherlands

Correspondence: Address correspondence and reprint requests to: Harald J. Hoekstra, MD, PhD; E-mail: h.j.hoekstra{at}chir.umcg.nl.

Background: Treatment of radiation-induced sarcoma (RIS) remains an unsolved problem. To provide more insight into the disease process, its characteristics, outcome, and potential outcome determinants were defined.

Methods: From 1978 to 2003, 27 patients—20 females (74%) and 7 males (26%) with a median age 44 years (range, 1–73 years) at the time of diagnosis of the primary tumor—developed an RIS after a median interval of 8 years (range, 3–41 years). The histology of the RIS was 10 (37%) undifferentiated high-grade pleomorphic sarcomas, 7 (26%) angiosarcomas, 6 (22%) fibrosarcomas, 2 (7%) osteosarcomas, 1 (4%) pleomorphic rhabdomyosarcoma, and 1 (4%) pleomorphic leiomyosarcoma. Surgical resection was performed in 21 patients: 13 (62%) R0 (microscopically radical), 4 (19%) R1 (microscopically irradical), 2 (9.5%) R2 ( macroscopically irradical), and 2 (9.5%) RX (unknown radicality). Six (22%) patients underwent no resection.

Results: The 5-year disease-free and overall survival rates were 27%and 30%, respectively. The local failure rate after R0 resection was 54%. The distant failure rate for the entire group was 41%. Patients with an R0 resection had a significantly better survival rate (P < .05) than patients with an R1, R2, or no resection.

Conclusions: RISs are aggressive malignancies with a high tendency for local recurrence and distant metastases. Previously applied treatment often hampers adequate resection. Therefore, radical surgical resection is the only chance to improve disease-free and overall survival, but it may also have a palliative role. Still, the overall prognosis remains poor.

Key Words: Sarcoma • Surgery • Radiation • Complications • Combined-modality treatment






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2005 by the Society of Surgical Oncology.