For advanced limb STSs with large tumor mass, distinct local infiltration or post-surgical relapse, chemotherapy or radiotherapy

combined with surgery is often the first choice [5–7]. Apart from reducing tumor volume, chemotherapy before surgery can also produce a reaction zone between the tumor and peripheral tissues, which serves as an operational tissue space for surgery. However, it remains unclear whether comprehensive treatment schemes using novel chemotherapy regimens could improve the treatment results and prognoses for advanced limb STS [8]. In the present study, we compared pre-operative chemotherapy with oxaliplatin and dacarbazine to the traditional pre-operative VAC treatment, with the hopes of determining it’s safety and to assess whether this regimen imparts a greater advantage, in terms of reducing the tumor margin and MLN2238 manufacturer Cyclopamine increasing progression free survival. Patients and Methods Inclusion Criteria ① Between 14 years and 70 years of age. ② Female patients that were pregnant or lactating were excluded. ③ No history of chronic primary organ disease, heart failure or other major organ malfunction. ④ The sarcoma originated in limb soft tissue. ⑤ Belong to G1-3T3N0M0 or G1-3T1-3N0-1M1, that is, stage IV according to the Russell GTNM staging system. ⑥ No prior chemotherapy or radiation therapy. Patients Between November 2005 and November 2008, the Department of Surgical Oncology of

Zhejiang Provincial Hospital in China received and treated 31 patients with stage IV limb STS. 15 of these were randomly assigned to the experimental group, and the remaining 16 were assigned to the control group. Patients aged between 18 and 66, with a median age of 41 in the experimental group and 50 in the control group (t = -0.858, p > 0.05). The average tumor size for each group was determined to be in the T3 range (for infiltrating the peripheral vessel, nerve or skeleton). The mean tumor size was 8.4 ± 2.8 cm in the experimental group, and 7.2 ± 1.8 cm (t = 1.453, p > 0.05). In the experimental group, two patients

were diagnosed with regional lymph node metastasis, 2 with Pazopanib nmr lung metastasis. In the control group, 3 patients were diagnosed with regional lymph node metastasis, and 1 with lung metastasis in the control group, the difference in the prevalence of metastases was not significant (χ2 = 0.011, p > 0.05). Table 1 shows the clinical characteristics of patients recruited for the study. Table 1 Clinical Characteristics of Patients     Experimental group (cases) Control group (cases) Tumor location upper arm 3 3   Thigh 7 11   lower leg 5 2 Pathological phenotypes malignant fibrous Selleck 3-deazaneplanocin A histiocytoma 8 6   rhabdomyosarcoma 3 3   synovial sarcoma 0 4   malignant nerve sheath tumor 1 1   clear cell sarcoma 2 0   unclassifiable 1 2 Cytological grading G2 0 1   G3 15 15 The study was conducted according to Good Clinical Practices and was approved by the local ethics committee. All patients gave written informed consent.