Margin status and multimodal therapy in infantile fibrosarcoma
Jason P Sulkowski1, Mehul V Raval, Marybeth Browne
1Division of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH 43205, USA.
Pediatric Surgery International
|June 15, 2013
Summary
Infantile fibrosarcoma (IF) treatment evaluation shows multimodal therapy use increased over time. While negative margins and multimodal therapy showed a slight survival increase, results were not statistically significant for this rare pediatric cancer.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Cancer Research
Background:
- Infantile fibrosarcoma (IF) is a rare pediatric malignancy.
- Limited data exists on optimal treatment strategies due to its rarity.
- Previous studies have not comprehensively evaluated surgical resection extent and chemotherapy's role.
Purpose of the Study:
- To define the extent of surgical resection needed for infantile fibrosarcoma.
- To evaluate the role of chemotherapy in infantile fibrosarcoma management.
- To analyze treatment outcomes based on margin status and multimodal therapy.
Main Methods:
- Retrospective analysis of 224 patients (0-2 years) with IF from the National Cancer Data Base (1985-2007).
- Survival analysis using Kaplan-Meier method, stratified by margin status (positive/negative) and chemotherapy use.
- Evaluation of demographic, tumor, and treatment variables impacting survival.
Main Results:
- Most patients (76.4%) underwent surgical resection; 28.6% had positive margins, with no metastases found.
- The use of surgery and chemotherapy combined increased significantly over time (18% to 40%).
- No significant differences in disease-free survival were observed based on margin status, nodal involvement, tumor size, or treatment modality.
Conclusions:
- Multimodal therapy for infantile fibrosarcoma has become more common.
- While negative margins and multimodal therapy suggested a trend towards improved survival, statistical significance was not reached.
- Further research into tumor biology and chemosensitivity is crucial for optimizing IF treatment.
