Author of

• 11851

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  P2.16 - Poster Session 2 - Other Thoracic Malignancies (ID 187)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Thymoma & Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11853

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    P2.16-002 - Long-term Treatment Results in Soft Tissue Sarcomas of The Thoracic Wall Treated by Pre-or-Postoperative Radiotherapy in a Multidisciplinary Approach-<br /> Results of the CTF Sarcoma Group (ID 1842)

    09:30 - 09:30  |  Author(s): N. Kaydıhan
    • Abstract

    Background
    To evaluate the long term treatment results and the prognostic factors among patients with soft tissue sarcoma of the thoracic wall who were treated with pre-or postoperative radiotherapy

    Methods
    Forty two cases were referred to our clinic between December 1980- December 2007 with the diagnosis of soft tissue sarcoma of the thoracic wall, and 13 of them were excluded from further evaluation due to the absence of radiotherapy indication or the predilection of the patients to receive radiotherapy at another center. The mean age was 44 (14-85) and 15 of them were male and 11 female. Malignant fibrous histiocytoma was the most common histopathology (27.6%). 7 patients had well differentiated, 6 had moderately differentiated and 13 had poorly differentiated tumor. Tumor size varied between 1- 25 cm (mean 7.8 cm). Twenty one of the patients admitted to our clinic after primary surgery, 5 after local recurrence. Seventeen of the cases had marginal and 9 had wide local resection. The surgical margin was positive in 11 of the patients. Four cases received postoperative radiotherapy with a mean dose of 60 Gy (50-66 Gy) and 22 received preoperative radiotherapy with a mean dose of 46 Gy. adjuvant chemotherapy with Doxorubicin, Ifosfamide and Holoxan was given to 6 patients.

    Results
    Mean follow-up time was 97 (9-309 months) months. Nine patients (34.6%) developed local recurrence with a median time to recurrence of 20 months (2-53 months). the surgical margin was positive in 6 of them. All patients with recurrent disease had undergone surgery. And 4 of them were treated with chemotherapy, 1 of them received external radiotherapy, and 1 patient received brachytherapy afterwards. 11 (42.3%) patients developed distant metastasis after a median of 40 months (4-92 months). The most common metastases sites were the lungs (38.5%) and the bones (3.8%). Three cases developed both local and distant metastasis. Five-year local control (LC), disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS) rates were 62%, 38%, 69%, and 76% respectively. Chemotherapy was given to all cases developing distant metastasis. Seventeen cases died due to disease progression, 2 patients died due to cardiac disorders. On univariate analysis, although LC was approximately twice worse for the patients with positive surgical margin, the difference was not significant. 5-year DFS and DSS rates were significantly worse for the patients with poorly differentiated tumors than well and moderately differentiated tumors (0%, 66% and 60%, 92% respectively. DFS was significantly better for the patients who received chemotherapy (p=0.01) and there was a trend for DSS (p=0.09). On multivariate analysis, no factor affected the results significantly.

    Conclusion
    In our series, high grade found to be the most important factor affecting prognosis. Although we couldn’t show statistically, it seems that radiotherapy helped to achieve better LC, even in margin positive patients. In addition to this, while a definitive conclusion is not possible due to the small number of cases, chemotherapy improved the treatment results.. Thoracic wall sarcomas should be approached in a multidisciplinary manner as with sarcomas in other regions.