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  • 1
    ISSN: 1534-4681
    Keywords: Soft tissue sarcoma ; Prognosis ; Superficial sarcoma ; Extremity sarcoma ; Staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Experience with soft tissue sarcoma has suggested that superficial tumors have a favorable prognosis. We evaluated the prognostic features of this subset of sarcoma. Methods: Prospective data on 215 patients presenting to Memorial Sloan-Kettering Cancer Center with primary extremity superficial soft tissue sarcomas between July 1, 1982 and July 1, 1996 were analyzed. Superficial sarcomas were defined as subcutaneous tumors not invading the investing fascia of the muscle. Analysis was by univariate and multivariate tests for local recurrence, metastasis, and tumor mortality. Results: Ninety (42%) patients were over 50 years of age, 115 (53%) had high-grade tumors, 53 (25%) had tumors ⩾5 cm, and 18 (8%) had positive margins following definitive resection. Median follow-up was 45 months (range 2 days to 151 months), 31 (14%) patients had local recurrences, 20 (9%) had distant metastases, and 15 (7%) died of disease. Five- and 10-year actuarial disease-specific survivals were 91% and 85%, respectively. On multivariate analysis, age 〉50 years predicted local recurrence (RR 5.7; 95% CI, 2.4–13.3;p〈0.0001). High grade (RR 4.2; 95% CI, 1.4–12.7;p〈0.006), and size ⩾5 cm (RR 4.4; 95% CI, 1.8–11;p〈0.002) predicted distant metastases. High grade (RR 7; 95% CI, 1.5–31.4;p〈0.003), size ⩾5 cm (RR 6.9; 95% CI, 2.3–20.8;p〈0.0006), and positive margins (RR 3.8; 95% CI, 1.2–12.4;p〈0.006) predicted tumor mortality. Conclusion: Primary superficial extremity soft tissue sarcomas have a favorable prognosis. Size and grade of superficial tumors are the strongest factors in predicting survival.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0843
    Keywords: Key words All-trans-retinoic acid ; Chemoprevention ; Inhalers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Retinoids have shown promising activity for both cancer chemoprevention and as a treatment for emphysema. However, chronic oral administration of these drugs is limited by systemic side effects, including hepatic dysfunction, skeletal malformations, hyperlipidemia, hypercalcemia, and other reactions. In order to improve the pulmonary targeting of this potentially useful therapy, we developed a system for aerosolization of retinoids that substantially increased their local bioavailability. We compared the biodistribution and pharmacokinetics of an inhaled formulation of all-trans-retinoic acid (all-trans-RA), which was packaged in a metered dose inhaler, following both intratracheal (IT) and intravenous (IV) administration in male Sprague-Dawley rats. After drug administration, anesthetized animals were killed at 5 min, and at 1, 2, 4, 6 and 24 h. Plasma and emulsified samples of liver and lung tissues were dissected, extracted, and frozen prior to measurement of all-trans-RA concentration by high-performance liquid chromatography (HPLC). Aerosolization and IT injection of all-trans-RA resulted in a significantly longer pulmonary half-life of the drug (both 5–17 h), lower peak serum concentrations (aerosol 71 ± 31 ng/ml, IT 68 ± 50 ng/ml), and lower liver levels (aerosol 111 ± 28 ng/g, IT 753 ± 350 ng/g) than the same dose administered IV (2 h, 838 ± 56 ng/ml, 4258 ± 1006 ng/g, respectively; P 〈 0.05 for each comparison). Histologic examination of lungs and trachea showed no focal irritation attributable to the drug after single-dose administration. These results suggest that aerosolization of retinoids may offer a practical alternative to systemic oral administration for chemoprevention trials or treatment of lung diseases. This method may substantially increase the therapeutic index of these compounds by reducing systemic complications associated with long-term dosing.
    Type of Medium: Electronic Resource
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