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Related Experiment Videos

Failure patterns and survival in pediatric soft tissue sarcoma.

D M Brizel1, H Weinstein, M Hunt

  • 1Joint Center for Radiation Therapy, Dana-Farber Cancer Institute, Children's Hospital, Boston, MA.

International Journal of Radiation Oncology, Biology, Physics
|July 1, 1988
PubMed
Summary

Localized soft tissue sarcomas in children show excellent 10-year overall survival (75%). Tumor size and residual disease after surgery are key predictors of local failure, suggesting a need for more aggressive local treatment strategies.

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Area of Science:

  • Pediatric Oncology
  • Surgical Oncology
  • Radiation Oncology

Background:

  • Soft tissue sarcomas (STS) are a group of malignant tumors that arise from connective tissues.
  • Localized STS in children require effective treatment strategies to improve survival and reduce recurrence.
  • Previous studies have evaluated various treatment modalities, but optimal management, particularly regarding local control, remains an area of investigation.

Purpose of the Study:

  • To retrospectively analyze treatment outcomes for localized soft tissue sarcomas in children.
  • To identify prognostic factors influencing disease-free survival (DFS) and overall survival (OS).
  • To evaluate the impact of tumor size and residual disease on local failure rates.

Main Methods:

  • Retrospective analysis of 44 pediatric patients with localized STS (excluding rhabdomyosarcoma) treated between 1970-1984.

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  • All patients underwent surgery followed by post-operative irradiation; 26 received adjuvant chemotherapy.
  • Survival rates (DFS and OS) and failure patterns were assessed using univariate analysis, with staging by Intergroup Rhabdomyosarcoma Staging System (IRS) and American Joint Committee on Cancer (AJCC) criteria.

    • Main Results:

    • Actuarial 5- and 10-year DFS were 70% and 59%, respectively; 5- and 10-year OS were both 75%.
    • Presenting stage significantly impacted OS (IRS: p=0.04; AJCC: p=0.05).
    • Tumor size >5 cm (p=0.04) and gross residual disease after surgery (p=0.02) were associated with higher local failure rates.

    Conclusions:

    • Childhood localized STS demonstrates a favorable 10-year overall survival rate of 75%.
    • Tumor size and the presence of residual disease post-surgery are critical predictors of local recurrence.
    • The predominantly local pattern of failure suggests that more intensive local therapies, potentially including higher radiation doses, may be beneficial for specific patient groups.