Tail of Superficial Myxofibrosarcoma and Undifferentiated Pleomorphic Sarcoma After Preoperative Radiotherapy

Anticancer Res. 2016 May;36(5):2339-44.

Abstract

Background/aim: Superficial myxofibrosarcoma (MFS) and undifferentiated pleomorphic sarcoma (UPS) are highly associated with infiltrative growth (tail sign) and local recurrence, but the impact of preoperative radiotherapy is uncertain.

Patients and methods: Eight consecutive superficial MFS and 10 superficial UPS cases treated with preoperative radiotherapy and surgery were reviewed. Pathological response, surgical margin and magnetic resonance imaging (MRI) were retrospectively evaluated. Oncological events were reported in a descriptive form.

Results: Pathologically, nearly-complete response was observed in six UPS cases. Tail sign was pathologically detected in 13 cases, eight of which remained viable. Among the eight cases with viable tail, three cases, including two with positive margin, locally recurred. No major discrepancy was observed between tail length on pre-treatment T1-weighted post-contrast, fat-saturated MRI and pathological tail length.

Conclusion: Tail of superficial MFS and UPS can retain viability even after radiotherapy and cause local recurrence unless they respond to radiotherapy well. Wider resection including the tail on MRI is recommended.

Keywords: Soft-tissue sarcoma; infiltration; radiotherapy; recurrence; surgical margin.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Female
  • Fibrosarcoma / diagnostic imaging
  • Fibrosarcoma / pathology*
  • Fibrosarcoma / radiotherapy
  • Fibrosarcoma / surgery
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neoadjuvant Therapy*
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / prevention & control
  • Preoperative Care
  • Retrospective Studies
  • Sarcoma / diagnostic imaging
  • Sarcoma / pathology*
  • Sarcoma / radiotherapy
  • Sarcoma / surgery
  • Soft Tissue Neoplasms / diagnostic imaging
  • Soft Tissue Neoplasms / pathology*
  • Soft Tissue Neoplasms / radiotherapy
  • Soft Tissue Neoplasms / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome