Can You Be Cured Of Myxofibrosarcoma?

Myxofibrosarcoma (MFS) patients can be cured and some patients live a cancer-free life after proper treatment. The main problem with Myxofibrosarcoma is that it has a high recurrence rate therefore, even after complete resection of the tumor there is a chance of recurrence of cancer in a few years.

Can You Be Cured Of Myxofibrosarcoma?

The definite cure for Myxofibrosarcoma is surgical resection of the tumor with 1-2cm of normal tissue to make sure all cancer cells are removed. If the lesion is massive, radiotherapy/chemotherapy can be given prior to surgery to shrink the tumor size in order to make the resection easy. Then the removed specimen is examined under the microscope to check if the edges of the specimen contain cancer cells. If there are cancer cells in the edges then it is named as “positive margins” then these patients need additional radiotherapy/chemotherapy to destroy the residual cancer cells. Similarly, if the whole tumor or all lesions were unable to resect completely radiotherapy/chemotherapy and sometimes additional surgery is required to remove the cancer cells completely. If lymph nodes are involved possible affected lymph nodes can be removed at the time of surgery then if the lymph nodes become positive for cancer cells radiotherapy is needed. Even after all of this aggressive treatment, there is still a chance of recurrence of Myxofibrosarcoma.(1)

We will present some of the survival statistics and local recurrence statistics of Myxofibrosarcoma from studies found in the literature. This study was done on “Prognostic Factors and Outcomes of Patients with Myxofibrosarcoma” recruited 69 patients who were treated at Massachusetts General Hospital from 1995 to 2010 with pathologically confirmed Myxofibrosarcoma who had lesions in the extremities or in the superficial trunk and who underwent definite surgery and was followed up with a median period of 41 months. 64 patients (93%) had a primary tumor and 5 patients (7%) had locally recurrent tumor. 64% of the patients had a grade 3 tumor.

All patients underwent surgical resection, 20% of patients had positive margins and 80% had negative margins and 53 patients (77%) received radiotherapy and 13 patients (18%) received chemotherapy. After a median follow-up of 41 months, 11 patients (16%) had a local recurrence, 11 patients (16%) had a distant recurrence and 19 patients (28%) died. The 5-year local recurrence-free rate (LRFS) was 72% and 5-year distant recurrence-free survival (DRFS) was 82% and overall survival (OS) for 5-years were 61%. Patients with grade 1 tumor did not have any local or distant recurrence. Patients with 2 and 3 tumor grades had an OS of 53%, LRFS of 66% and DRFS of 80%.(1)

The local recurrence rate of Myxofibrosarcoma ranged from 22-79%. Two other studies reported LRFS rates of 82% and 30% respectively. Myxofibrosarcoma has a multiple recurrence rate of 48-54%. Several factors such as tumor size, depth of the tumor, the grade of the tumor, and extent of the myxoid area in the tumor can predict the local recurrence and metastasis. Surgical resection with a negative margin is the key in reducing local and distant recurrence. It is said that at least removal of 1-2cm of normal tissue reduces the recurrence. Soft tissue edema seen on pre-operative MRI imaging helps to identify the extent of the tumor so, that complete resection of the tumor can be carried out.

Conclusion

Myxofibrosarcoma is curable with surgical resection of the tumor and additional chemotherapy/ radiotherapy. The problem with Myxofibrosarcoma is that it has a very high local and distant recurrence rate. The local recurrence rate of Myxofibrosarcoma ranges from 22-79%. Overall survival for 5-years is about 61%. Most patients with grade 1 tumor do not have a recurrence but patients with grade 2 and 3 have significantly high recurrence rates. Even after adequate radiotherapy following surgery some patients develop local recurrence. Therefore, strategies to reduce recurrence needs to be identified to increase the rates of successful treatment and survival rates.

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