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Radiation-associated sarcoma of bone and soft tissue
M S Brady1, J J Gaynor, M F Brennan
1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Archives of Surgery (Chicago, Ill. : 1960)
|December 1, 1992
Summary
Radiation-associated sarcomas are rare secondary cancers, often developing after breast cancer or lymphoma treatment. Prognosis depends on metastasis, surgical completeness, and tumor size, not histology or location.
Area of Science:
- Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- Radiation-associated sarcomas (RAS) are uncommon secondary malignancies, representing less than 5% of all sarcomas.
- These tumors typically carry a poor prognosis, necessitating a deeper understanding of their characteristics and prognostic factors.
Purpose of the Study:
- To investigate the incidence, histologic subtypes, and prognostic variables of radiation-associated sarcomas.
- To identify patient and tumor characteristics associated with outcomes in RAS.
Main Methods:
- Retrospective review of medical records for 565 patients with sarcoma and a second malignancy.
- Analysis of 160 identified cases of radiation-associated sarcoma, focusing on prior diagnoses, histology, grade, and treatment.
- Multivariate analysis to determine prognostic significance of various factors.
Main Results:
- Radiation-associated sarcomas constituted 28% of secondary sarcomas in the study cohort.
- Common prior diagnoses included breast cancer (26%), lymphoma (25%), and cervical cancer (14%).
- Predominant histologic types were osteogenic sarcoma (21%), malignant fibrous histiocytoma (16%), and angiosarcoma/lymphangiosarcoma (15%). Most tumors were high grade (87%).
- Prognostic significance was found for metastatic disease, completeness of surgical resection, and primary tumor size in resectable cases.
- Survival was independent of histologic subtype or tumor site.
Conclusions:
- Radiation-associated sarcomas are a significant subset of secondary sarcomas, often linked to treatments for breast cancer, lymphoma, and cervical cancer.
- Prognosis in RAS is primarily influenced by disease stage at diagnosis and treatment completeness, rather than specific histologic features or tumor location.