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Metastasectomy for limited metastases from soft tissue sarcoma
Eddie K Abdalla1, Peter W T Pisters
1Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Box 444, 1515 Holcombe Boulevard, Houston, TX 77030-4009, USA.
Current Treatment Options in Oncology
|October 24, 2002
Summary
Surgical resection offers the only cure for metastatic soft tissue sarcoma (stage IV). Patient selection is crucial for maximizing benefits and minimizing risks of metastasectomy, including investigational ablative approaches.
Area of Science:
- Oncology
- Surgical Oncology
Background:
- Metastatic soft tissue sarcoma (American Joint Committee on Cancer stage IV) carries a poor prognosis.
- Surgical resection of metastases is the only potentially curative treatment, while other methods are palliative.
Purpose of the Study:
- To evaluate the role of surgical resection (metastasectomy) in managing metastatic soft tissue sarcoma.
- To discuss patient selection criteria for maximizing clinical benefit and minimizing morbidity.
- To compare surgical metastasectomy with investigational nonresectional ablative approaches.
Main Methods:
- Review of current treatment paradigms for metastatic soft tissue sarcoma.
- Discussion of surgical metastasectomy as a curative option.
- Consideration of ablative techniques like cryosurgery, radiofrequency ablation, and alcohol injection for visceral metastases.
Main Results:
- Surgical metastasectomy is the sole curative treatment for metastatic soft tissue sarcoma.
- Patient selection is critical for successful outcomes and risk mitigation.
- Nonresectional ablative procedures are investigational and require comparison with surgical outcomes.
Conclusions:
- All patients with metastatic soft tissue sarcoma should be assessed for surgical resection eligibility.
- Metastasectomy should be considered for patients with good performance status and resectable disease.
- The optimal treatment sequence and role of perioperative chemotherapy remain undetermined.