Abstract
The occurrence of local failures in soft tissue sarcomas, though frequently seen only after inadequate surgery and radiation, remains a major problem, since it compromises local control and overall survival (Suit 1992). The impact of local recurrences on the development of metastases and overall survival is stressed below. Locally recurrent tumors showed histologic changes, compared with the primary tumor, which were expressed as increased cellularity and mitotic counts in 30% and 43% of the cases investigated, respectively, and these histologic conversions carry an adverse prognosis (Tsujimoto et al. 1988). The natural genetic shift of human soft tissue sarcomas was also observed in an experimental model system (Donhuijsen et al. 1988): xenotransplanted tumors showed differentiation as well as dedifferentiation and the occurrence of new cell lines in more than 30% of 22 investigated xenografts. Wilson et al. (1984) found recurrent tumors to be of low-grade malignancy after previous adjuvant therapies, e.g., radiation or chemotherapy. After surgery alone, local failures were generally highly malignant. The authors conclude that chemoradiotherapy kills high-grade subclones of the tumors, leaving low-grade remnants from which relapses originate.
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Budach, V., Stuschke, M., Budach, W. (1995). Local Recurrences of Soft Tissue Sarcomas — A Therapeutic Challenge. In: Bamberg, M., Hoffmann, W., Hossfeld, D.K. (eds) Soft Tissue Sarcomas in Adults. Recent Results in Cancer Research, vol 138. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78768-3_12
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DOI: https://doi.org/10.1007/978-3-642-78768-3_12
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