Soft tissue sarcoma of neoadjuvant chemotherapy

By | October 15, 2011

Neoadjuvant chemotherapy for soft tissue sarcoma that chemotherapy before surgery, postoperative chemotherapy, late recurrence or metastasis in patients with chemotherapy. Late recurrence or metastasis, chemotherapy may be the only option. Soft tissue sarcoma sub postoperative adjuvant chemotherapy depends on the following factors need.
Neoadjuvant chemotherapy for soft tissue sarcoma (1) malignant soft tissue sarcoma requires a high degree of malignancy of adjuvant chemotherapy, conversely, a low degree of malignancy does not require adjuvant chemotherapy. Low-grade soft tissue sarcoma is fibrosarcoma, well differentiated and moderately differentiated mucus liposarcoma, liposarcoma, lipoma-like liposarcoma. Intermediate grade soft tissue sarcoma, including poorly differentiated mucus liposarcoma, pleomorphic rhabdomyosarcoma, leiomyosarcoma, alveolar soft tissue sarcoma, and superficial malignant fibrous histiocytoma. Highly malignant soft tissue sarcomas, including angiosarcoma, synovial sarcoma, alveolar and embryonal rhabdomyosarcoma, deep malignant fibrous histiocytoma and undifferentiated sarcoma. Also to be noted that about 15% of soft tissue sarcoma histology varied as can not be classified. In general, highly malignant hematogenous spread-prone, less prone to low malignant hematogenous spread. Hematogenous spread is the treatment of soft tissue sarcoma is one important part.
Malignant soft tissue tumors are usually fast growing, large size, infiltration and destruction of surrounding normal tissue. Tumor itself may have necrosis, bleeding and secondary infection, and often have wide hematogenous spread metastasis to the lung, bone, skin, brain, adrenal gland, pancreas and other organs. Various types of malignant soft tissue tumor hematogenous spread is also a significant difference, according to its opportunity to spread the blood channel can be roughly divided into three categories: high probability of a round cell liposarcoma, pleomorphic liposarcoma, alveolar rhabdomyosarcoma sarcoma, synovial sarcoma, angiosarcoma, lymphatic sarcoma; moderate the possibility of a malignant giant cell tumor of the deep, pleomorphic rhabdomyosarcoma, clear cell sarcoma, leiomyosarcoma i, etc.; champion has often occurred in epithelioid sarcoma , superficial malignant giant cell tumor, fiber? sarcoma, well-differentiated liposarcoma and other mucous membranes. In addition, the check is not enough gentle movements, inappropriate physical therapy, tumor biopsy, so squeeze in the time of surgery may lead to hematogenous spread sarcoma cells.
Neoadjuvant chemotherapy for soft tissue sarcoma (2) In addition to the chance of lymphatic spread outside the blood metastasis, soft tissue sarcoma can also be associated with lymph node metastasis, and often have lymph node metastasis in early. Such as synovial sarcoma 17.6%, 15.6% in the case of rhabdomyosarcoma with lymph node metastasis. Liposarcoma, fibrosarcoma and other rare lymph node metastasis.
Neoadjuvant chemotherapy for soft tissue sarcoma (3) the high rate of local recurrence of soft tissue sarcoma of soft tissue benign tumor, in the majority will not relapse after complete resection. For borderline tumors, surgical resection of the tumor four weeks to request a certain distance within the normal tissue, be possible to prevent recurrence. Malignant soft tissue sarcoma after local excision, 75% – 90% of patients of local recurrence, extended resection is still 20% – 60% of local recurrence. Among them, rhabdomyosarcoma, synovial sarcoma, mesenchymal sarcoma is more prominent.

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