SOFT-TISSUE SARCOMAS - A REVIEW

Soft tissues sarcomas are an heterogeneous group of neoplasms. Their e pidemiology is still poorly known. Great strides have been made in the genetic study over the last few years. Histologic grade, tumor size a nd deep location are the main independent prognostic factors in multiv ariate analysis using the Cox model. Overall 5-year survival is approx imately 50% in most of the studies. Surgical conservative treatment as sociated with radiotherapy is actually preferred to radical surgery, b ecause no survival difference is found between the two treatments. Rad iation therapy modalities are discussed: preoperative, postoperative i rradiation, intestitial brachytherapy. Doxorubicin, ifosfamide and DTI C are the most efficient drugs. However, res ponse rates obtained with polychemotherapy are still less than 50%. High-dose chemotherapy is a n encouraging concept. Edatrexate and Taxotere show interesting respon se rates in phase II clinical trials. Adjuvant chemotherapy efficience is probably low: a metaanalysis shows a 5-year survival increase of 9 %. Neoadjuvant chemotherapy allows a high rate of conservative treatme nt.