The impact of chemotherapy on the survival of patients with high-grade primary extremity liposarcoma

Fritz C. Eilber, Frederick R. Eilber, Jeffery Eckardt, Gerald Rosen, Elyn Riedel, Robert G. Maki, Murray F. Brennan, Samuel Singer, Raphael E. Pollock, Frederick C. Eilber, Harold J. Wanebo, James E Goodnight Jr, Jonathan L. Meakins

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Abstract

Objective: To determine if chemotherapy offers a survival benefit to patients with large, high-grade, primary extremity liposarcoma. Summary Background Data: The impact of chemotherapy on the survival of patients with primary extremity soft tissue sarcoma is controversial and its effect on individual histologic subtypes is not defined. Patient and Methods: Two prospectively collected sarcoma databases were used to identify all patients with >5 cm, high-grade, primary extremity liposarcoma that underwent surgical treatment of cure from 1975 to 2003 (n = 245). Clinical, pathologic and treatment variables were analyzed for disease-specific survival (DSS), distant recurrence-free survival (DRFS) and local recurrence-free survival (LRFS). Results: Sixty-three (26%) patients were treated with ifosfamide based chemotherapy (IF), 83 (34%) with doxorubicin based chemotherapy (DOX) and 99 (40%) received no chemotherapy (NoC). To assess the impact of DOX, a contemporary cohort analysis of patients treated from 1975 to 1990 was performed. The 5 year DSS of the DOX treated patients was 64% (53%-74%) compared with 56% (51%-79%) for the NoC patients (log-rank P value = 0.28). To assess the impact of IF, a contemporary cohort analysis of patients treated from 1990 to 2003 was performed. The 5 year DSS of the IF treated patients was 92% (84%-100%) compared with 65% (51%-79%) for the NoC patients (log-rank P value = 0.0003). Independent prognostic factors for improved DSS were smaller size (HR = 0.7, P = 0.01), myxoid/round cell histologic subtype (HR = 0.3, P = 0.03) and treatment with IF (HR = 0.3, P = 0.01). The five-year DRFS of the IF treated patients was 81% (70%-92%) compared with 63% (50%-76%) for the NoC patients (log-rank P value = 0.02). The 5 year LRFS of the IF treated patients was 86% (76%-96%) compared with 87% (77%-97%) for the NoC patients (log-rank P value = 0.99). Conclusions: In patients with large, high-grade, primary extremity liposarcoma; DOX is not associated with improved DSS and IF is associated with an improved DSS. Treatment with IF should be considered in patients with high-risk primary extremity liposarcoma.

Original languageEnglish (US)
Pages (from-to)686-697
Number of pages12
JournalAnnals of Surgery
Volume240
Issue number4
DOIs
StatePublished - Oct 2004

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Liposarcoma
Extremities
Drug Therapy
Survival
Recurrence
Sarcoma
Cohort Studies
Ifosfamide

ASJC Scopus subject areas

  • Surgery

Cite this

Eilber, F. C., Eilber, F. R., Eckardt, J., Rosen, G., Riedel, E., Maki, R. G., ... Meakins, J. L. (2004). The impact of chemotherapy on the survival of patients with high-grade primary extremity liposarcoma. Annals of Surgery, 240(4), 686-697. https://doi.org/10.1097/01.sla.0000141710.74073.0d

The impact of chemotherapy on the survival of patients with high-grade primary extremity liposarcoma. / Eilber, Fritz C.; Eilber, Frederick R.; Eckardt, Jeffery; Rosen, Gerald; Riedel, Elyn; Maki, Robert G.; Brennan, Murray F.; Singer, Samuel; Pollock, Raphael E.; Eilber, Frederick C.; Wanebo, Harold J.; Goodnight Jr, James E; Meakins, Jonathan L.

In: Annals of Surgery, Vol. 240, No. 4, 10.2004, p. 686-697.

Research output: Contribution to journalArticle

Eilber, FC, Eilber, FR, Eckardt, J, Rosen, G, Riedel, E, Maki, RG, Brennan, MF, Singer, S, Pollock, RE, Eilber, FC, Wanebo, HJ, Goodnight Jr, JE & Meakins, JL 2004, 'The impact of chemotherapy on the survival of patients with high-grade primary extremity liposarcoma', Annals of Surgery, vol. 240, no. 4, pp. 686-697. https://doi.org/10.1097/01.sla.0000141710.74073.0d
Eilber, Fritz C. ; Eilber, Frederick R. ; Eckardt, Jeffery ; Rosen, Gerald ; Riedel, Elyn ; Maki, Robert G. ; Brennan, Murray F. ; Singer, Samuel ; Pollock, Raphael E. ; Eilber, Frederick C. ; Wanebo, Harold J. ; Goodnight Jr, James E ; Meakins, Jonathan L. / The impact of chemotherapy on the survival of patients with high-grade primary extremity liposarcoma. In: Annals of Surgery. 2004 ; Vol. 240, No. 4. pp. 686-697.
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abstract = "Objective: To determine if chemotherapy offers a survival benefit to patients with large, high-grade, primary extremity liposarcoma. Summary Background Data: The impact of chemotherapy on the survival of patients with primary extremity soft tissue sarcoma is controversial and its effect on individual histologic subtypes is not defined. Patient and Methods: Two prospectively collected sarcoma databases were used to identify all patients with >5 cm, high-grade, primary extremity liposarcoma that underwent surgical treatment of cure from 1975 to 2003 (n = 245). Clinical, pathologic and treatment variables were analyzed for disease-specific survival (DSS), distant recurrence-free survival (DRFS) and local recurrence-free survival (LRFS). Results: Sixty-three (26{\%}) patients were treated with ifosfamide based chemotherapy (IF), 83 (34{\%}) with doxorubicin based chemotherapy (DOX) and 99 (40{\%}) received no chemotherapy (NoC). To assess the impact of DOX, a contemporary cohort analysis of patients treated from 1975 to 1990 was performed. The 5 year DSS of the DOX treated patients was 64{\%} (53{\%}-74{\%}) compared with 56{\%} (51{\%}-79{\%}) for the NoC patients (log-rank P value = 0.28). To assess the impact of IF, a contemporary cohort analysis of patients treated from 1990 to 2003 was performed. The 5 year DSS of the IF treated patients was 92{\%} (84{\%}-100{\%}) compared with 65{\%} (51{\%}-79{\%}) for the NoC patients (log-rank P value = 0.0003). Independent prognostic factors for improved DSS were smaller size (HR = 0.7, P = 0.01), myxoid/round cell histologic subtype (HR = 0.3, P = 0.03) and treatment with IF (HR = 0.3, P = 0.01). The five-year DRFS of the IF treated patients was 81{\%} (70{\%}-92{\%}) compared with 63{\%} (50{\%}-76{\%}) for the NoC patients (log-rank P value = 0.02). The 5 year LRFS of the IF treated patients was 86{\%} (76{\%}-96{\%}) compared with 87{\%} (77{\%}-97{\%}) for the NoC patients (log-rank P value = 0.99). Conclusions: In patients with large, high-grade, primary extremity liposarcoma; DOX is not associated with improved DSS and IF is associated with an improved DSS. Treatment with IF should be considered in patients with high-risk primary extremity liposarcoma.",
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T1 - The impact of chemotherapy on the survival of patients with high-grade primary extremity liposarcoma

AU - Eilber, Fritz C.

AU - Eilber, Frederick R.

AU - Eckardt, Jeffery

AU - Rosen, Gerald

AU - Riedel, Elyn

AU - Maki, Robert G.

AU - Brennan, Murray F.

AU - Singer, Samuel

AU - Pollock, Raphael E.

AU - Eilber, Frederick C.

AU - Wanebo, Harold J.

AU - Goodnight Jr, James E

AU - Meakins, Jonathan L.

PY - 2004/10

Y1 - 2004/10

N2 - Objective: To determine if chemotherapy offers a survival benefit to patients with large, high-grade, primary extremity liposarcoma. Summary Background Data: The impact of chemotherapy on the survival of patients with primary extremity soft tissue sarcoma is controversial and its effect on individual histologic subtypes is not defined. Patient and Methods: Two prospectively collected sarcoma databases were used to identify all patients with >5 cm, high-grade, primary extremity liposarcoma that underwent surgical treatment of cure from 1975 to 2003 (n = 245). Clinical, pathologic and treatment variables were analyzed for disease-specific survival (DSS), distant recurrence-free survival (DRFS) and local recurrence-free survival (LRFS). Results: Sixty-three (26%) patients were treated with ifosfamide based chemotherapy (IF), 83 (34%) with doxorubicin based chemotherapy (DOX) and 99 (40%) received no chemotherapy (NoC). To assess the impact of DOX, a contemporary cohort analysis of patients treated from 1975 to 1990 was performed. The 5 year DSS of the DOX treated patients was 64% (53%-74%) compared with 56% (51%-79%) for the NoC patients (log-rank P value = 0.28). To assess the impact of IF, a contemporary cohort analysis of patients treated from 1990 to 2003 was performed. The 5 year DSS of the IF treated patients was 92% (84%-100%) compared with 65% (51%-79%) for the NoC patients (log-rank P value = 0.0003). Independent prognostic factors for improved DSS were smaller size (HR = 0.7, P = 0.01), myxoid/round cell histologic subtype (HR = 0.3, P = 0.03) and treatment with IF (HR = 0.3, P = 0.01). The five-year DRFS of the IF treated patients was 81% (70%-92%) compared with 63% (50%-76%) for the NoC patients (log-rank P value = 0.02). The 5 year LRFS of the IF treated patients was 86% (76%-96%) compared with 87% (77%-97%) for the NoC patients (log-rank P value = 0.99). Conclusions: In patients with large, high-grade, primary extremity liposarcoma; DOX is not associated with improved DSS and IF is associated with an improved DSS. Treatment with IF should be considered in patients with high-risk primary extremity liposarcoma.

AB - Objective: To determine if chemotherapy offers a survival benefit to patients with large, high-grade, primary extremity liposarcoma. Summary Background Data: The impact of chemotherapy on the survival of patients with primary extremity soft tissue sarcoma is controversial and its effect on individual histologic subtypes is not defined. Patient and Methods: Two prospectively collected sarcoma databases were used to identify all patients with >5 cm, high-grade, primary extremity liposarcoma that underwent surgical treatment of cure from 1975 to 2003 (n = 245). Clinical, pathologic and treatment variables were analyzed for disease-specific survival (DSS), distant recurrence-free survival (DRFS) and local recurrence-free survival (LRFS). Results: Sixty-three (26%) patients were treated with ifosfamide based chemotherapy (IF), 83 (34%) with doxorubicin based chemotherapy (DOX) and 99 (40%) received no chemotherapy (NoC). To assess the impact of DOX, a contemporary cohort analysis of patients treated from 1975 to 1990 was performed. The 5 year DSS of the DOX treated patients was 64% (53%-74%) compared with 56% (51%-79%) for the NoC patients (log-rank P value = 0.28). To assess the impact of IF, a contemporary cohort analysis of patients treated from 1990 to 2003 was performed. The 5 year DSS of the IF treated patients was 92% (84%-100%) compared with 65% (51%-79%) for the NoC patients (log-rank P value = 0.0003). Independent prognostic factors for improved DSS were smaller size (HR = 0.7, P = 0.01), myxoid/round cell histologic subtype (HR = 0.3, P = 0.03) and treatment with IF (HR = 0.3, P = 0.01). The five-year DRFS of the IF treated patients was 81% (70%-92%) compared with 63% (50%-76%) for the NoC patients (log-rank P value = 0.02). The 5 year LRFS of the IF treated patients was 86% (76%-96%) compared with 87% (77%-97%) for the NoC patients (log-rank P value = 0.99). Conclusions: In patients with large, high-grade, primary extremity liposarcoma; DOX is not associated with improved DSS and IF is associated with an improved DSS. Treatment with IF should be considered in patients with high-risk primary extremity liposarcoma.

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