SOFT-TISSUE SARCOMAS - A REVIEW

Soft tissues sarcomas are an heterogeneous group of neoplasms. Their epidemiology is still poorly known. Great strides have been made in the genetic study over the last few years. Histologic grade, tumor size and deep location are the main independent prognostic factors in multivariate analysis using the Cox model. Overall 5-year survival is approximately 50% in most of the studies. Surgical conservative treatment associated with radiotherapy is actually preferred to radical surgery, because no survival difference is found between the two treatments. Radiation therapy modalities are discussed: preoperative, postoperative irradiation, intestitial brachytherapy. Doxorubicin, ifosfamide and DTIC are the most efficient drugs. However, res ponse rates obtained with polychemotherapy are still less than 50%. High-dose chemotherapy is an encouraging concept. Edatrexate and Taxotere show interesting response 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 treatment.