Adjuvant chemotherapy in soft tissue sarcomas…Conflicts, consensus, and controversies

Abstract Soft tissue sarcomas (STSs) are an uncommon and diverse group of more than 50 mesenchymal malignancies. Each of these histologic subtypes represents a unique disease with distinct biologic behavior and varying sensitivity to chemotherapy. The judicious use of adjuvant/neoadjuvant chemotherapy along with surgery and radiation in the treatment of localized STS has a role in improving patient outcomes by decreasing local and distant recurrences. There is evidence that the use of adjuvant chemotherapy to a mixed cohort of chemo sensitive and insensitive sarcoma subtypes results in limited benefit. Therefore, it is of paramount importance to identify the subpopulation with high metastatic potential and to identify effective histology-specific treatment options to these patients. Present perspective, will focus on the rationale for adjuvant chemotherapy in sarcoma, with emphasis on the histology driven chemotherapy. It will outline key therapeutic opportunities and hurdles in adjuvant medical treatment of sarcoma, focusing on specific subtypes that are on the verge of new breakthroughs, as well as those in which promise has not lived up to expectations.

• Publication year

  2016

• Venue

  South Asian Journal of Cancer

• Publication date

  2016-01-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.4103/2278-330X.179687PMID 27169114PMCID 4845599
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• Identifying patients with high metastatic potential is presented as central to improving outcomes in adjuvant treatment of soft tissue sarcoma.

  Confidence 0.86

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review
• Histology-driven chemotherapy is emphasized as the key framework for selecting patients and identifying subtype-specific treatment options with the greatest potential benefit.

  Confidence 0.92

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review
• Using adjuvant chemotherapy across a mixed cohort of chemosensitive and chemoinsensitive sarcoma subtypes provides only limited overall benefit.

  Confidence 0.90

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review
• Adjuvant and neoadjuvant chemotherapy can have a role in localized soft tissue sarcoma when used alongside surgery and radiation to reduce local and distant recurrence risk.

  Confidence 0.93

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review

• adjuvant chemotherapy

  treatment approaches

  Systemic chemotherapy given after local treatment and discussed here as part of perioperative management for soft tissue sarcoma.

  Aliases: postoperative chemotherapy

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review
• chemo-insensitive sarcoma subtypes

  subtypes

  Sarcoma histologic subtypes considered less likely to benefit from chemotherapy in the review's discussion of mixed-cohort outcomes.

  Aliases: chemoresistant sarcoma subtypes

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review
• chemo-sensitive sarcoma subtypes

  subtypes

  Sarcoma histologic subtypes considered more likely to respond to chemotherapy in the review's discussion of subtype-specific treatment.

  Aliases: chemosensitive sarcoma subtypes

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review
• histology-driven chemotherapy

  treatment strategies

  A treatment strategy that selects chemotherapy based on sarcoma histologic subtype rather than treating all sarcomas uniformly.

  Aliases: histology specific chemotherapy

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review
• localized soft tissue sarcoma

  disease settings

  Soft tissue sarcoma confined to the initial disease site, the setting in which the review discusses perioperative treatment decisions.

  Aliases: localized STS

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review
• neoadjuvant chemotherapy

  treatment approaches

  Systemic chemotherapy given before definitive local therapy and discussed here as a perioperative option for soft tissue sarcoma.

  Aliases: preoperative chemotherapy

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review
• soft tissue sarcomas

  cancer types

  A diverse group of more than 50 mesenchymal malignancies discussed as the disease family addressed in the review.

  Aliases: STS, STSs

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review
• surgery and radiation

  treatment modalities

  Local treatment modalities used with chemotherapy in the multimodality management of localized soft tissue sarcoma.

  Aliases: surgery, radiation therapy

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewq (76h6bfydm6) review

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