Perfusion Chemotherapy

Abstract

The treatment of adult soft tissue sarcomas remains an extremely confusing and difficult problem. These tumors often present as very large lesions with very few local or systemic symptoms and often are misdiagnosed and treated as ’chronic hematomas’ or muscle group ruptures for a long period of time. Furthermore, there is confusion in pathologic nomenclature of these tumors and the biologic importance of the various histogenic varieties. The original work by Lattes and Stout, which separated these tumors into the cell of origin, was a major step toward their systemic categorization [1, 2]; however, because these tumors are often undifferentiated, it has been very difficult for pathologists to reach agreement on the histogenic cell of origin, i.e., a rhabdomyosarcoma versus synovial cell sarcoma. Recently, the American Joint Committee on Staging and End Results proposed a clinical pathological grading system that appeared to accurately predict overal survival in a retrospective review [3]. In this system the grade of tumor was established by determining the number of mitoses per high-power field; a high-grade tumor would display the greatest number of mitoses. Retrospectively, they could show that patients with Grade III tumors treated by surgery alone had less than a 20% 5-year survival rate.

Supported by grants CA29605 and CB04344, awarded by the National Cancer Institute, DHEW.