Cranofacial osteosarcoma: Single institutional experience in Korea.

INTRODUCTION: Craniofacial osteosarcoma is a rare disease accounting for only 1% of all head and neck malignancies. Its clinical features and optimal treatments are not yet clearly established. METHODS: We retrospectively analyzed the clinical course of 15 patients with craniofacial osteosarcoma treated in a single institute. RESULTS: Out of 13 patients who initially underwent primary mass resection, disease recurrence was found in five (36%). Patients with positive surgical margins showed higher recurrence and shorter median recurrence-free and overall survival. Of three patients who had secondary operation after local recurrence, two survived for 44.6 and 64.2 months, respectively. One patient who underwent repeated lung metastasectomy had a disease-free survival of 18.4 months from the first recurrence. CONCLUSION: The current study demonstrates that positive surgical margins are important predictive factors for recurrence and overall survival. Salvage surgery for local recurrence and metastasectomy for systemic recurrence might have a positive impact on survival.

Incidence and Survival of Pediatric Soft Tissue Sarcomas: Comparison between Adults and Children.

PURPOSE: Pediatric-type sarcomas such as rhabdomyosarcoma (RMS), Ewing sarcoma (EWS), primitive neuroectodermal tumor (PNET), and desmoplastic small round-cell tumor (DSRCT) are rare in adults, with limited studies on their prognosis and optimal treatment strategies. We aimed to examine the outcome of children and adult patients with RMS, EWS, PNET, and DSRCT and relevant prognostic factors. MATERIALS AND METHODS: We retrospectively reviewed 220 pediatric-type sarcoma patients at a single institution between 1985 and 2011. Comparisons were made in order to examine differences in demographics, disease characteristics, and survival. Survival analyses were performed using the Kaplan-Meier method with log-rank tests and Cox proportional hazards models. RESULTS: A total of 220 consecutive patients were identified at our institute. Median age was 15.6 years (range, 0 to 81 years) and there were 108 children (49%) and 112 adult patients (51%). According to histological classification, 106 patients (48.2%) had RMS, 60 (27.3%) had EWS, 50 (22.7%) had PNET, and 4 (1.8%) had DSRCT. With a median follow-up period of 6.6 years, the estimated median overall survival (OS) of all patients was 75 months (95% confidence interval [CI], 27.2 to 122.8 months) and median event-free survival (EFS) for all patients was 11 months (95% CI, 8.8 to 13.2 months). No significant difference in OS and EFS was observed between adults and children. In multivariate analysis, distant metastasis (hazard ratio [HR], 1.617; 95% CI, 1.022 to 2.557; p=0.040) and no debulking surgery (HR, 1.443; 95% CI, 1.104 to 1.812; p=0.012) showed independent association with worse OS. CONCLUSION: Metastatic disease and no surgical treatment are poor prognostic factors for OS among pediatric-type sarcomas for both adults and children.

Efficacy of oxaliplatin-based chemotherapy in curatively resected colorectal cancer with liver metastasis.

OBJECTIVES: Although surgical resection alone has been validated as a standard treatment for patients with liver metastases from colorectal cancer, a high rate of recurrence is still an issue to be overcome. We aimed to assess the efficacy of adjuvant chemotherapy using an oxaliplatin-based regimen in patients who underwent hepatic and primary colorectal cancer resection. METHODS: Sixty patients who received oxaliplatin-based postoperative chemotherapy combined with curative resection of primary colorectal cancer and synchronous liver metastases between January 2000 and February 2008 were retrospectively reviewed. The Kaplan-Meier method was used to estimate survival, and prognostic factors were evaluated with the log-rank test. RESULTS: Median overall survival (OS) was 62.8 months [95% confidence interval (CI) 44.1-81.3], and median relapse-free survival (RFS) was 32.8 months (95% CI 5.8-59.6). The 1-, 3- and 5-year survival rates were 95.0, 68.8 and 55.5%, respectively. The relapse-free interval and modality of liver resection were independently associated with OS. CONCLUSIONS: Oxaliplatin-based adjuvant chemotherapy after radical resection resulted in increased OS and RFS with acceptable tolerability compared to surgery alone. However, it is not yet clear whether postoperative oxaliplatin-based chemotherapy improves outcome compared to patients treated with 5-fluorouracil plus leucovorin.