The reports deals with the data on repeat large-scale dissection of soft-tissue sarcoma following non-radical removal in 23 patients (13 males and 10 females , aged 14-75; mean age 42+/-30.2 yrs). Repeat surgery was carried out 3-6 weeks after primary one. Tumor progression was registered in 8 (34.8%): local recurrences which required radical intervention 4 (17.4%), distant metastases - 6 (26.1%) (lung - 3; liver - 1; lung and mediastinal lymph nodes - 1; lung and lumbar vertebra - 1). During the study, 5 patients died of tumor progression; all of them revealed distant metastases while 2 had local recurrences. Overall 5-year survival in 23 patients was 78%; whereas disease-free one - 65%.

Three groups of patients with inoperable soft-tissue sarcoma received preoperative radiotherapy (57), thermoradiotherapy (102) and thermoradiochemotherapy (16) (n=175). Five year recurrence-free survival in group 1 was 37+/-7%, group 2 48+/-6%, and group 3 - 56+/-1,7%. Patients survived 5 years and more in group 3 (60+/-2%), group 2 - 50+/-7%, and group I 44+/-8% (p>0.05). Local hyperthermia used in conjunction with radio- and chemoradiotherapy was followed by a significant rise in the rate of complete and partial tumor regression.

Expression of thymidylate synthase (TS), thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) can predict for clinical outcome of fluoropyrimidine-based therapy and there is every likelihood that relevant tumors will respond. High TP expression was observed in 35 (42%) patients with soft-tissue sarcoma. Seven out of 26 (27%) such patients revealed molecular phenotype prognostically favorable for capecitabine therapy. More clinical research is required to assess the efficacy of capecitabine-based therapy.

The purpose of this study was to improve treatment outcomes in inoperable soft-tissue sarcomas using preoperative thermoradiotherapy and thermoradiochemotherapy. 175 patients with inoperable soft-tissue sarcomas were divided into 3 groups: Group 1 (57 patients) received preoperative radiotherapy, Group 2 (102 patients) received thermoradiotherapy and Group 3 (16 patients) received thermoradiochemotherapy. Radiotherapy was given by split doses. Irradiation was given at 4 or 5 Gy 2 or 3 times a week to a total tumor dose 30-32 Gy. Local electromagnetic hyperthermia was performed using «Yakhta» apparatus at 915; 460 and 40 MHz. Heating was given 2 times weekly for 60 min. Tumor temperature was maintained at 41-45°C. Group 3 patients (thermoradiochemotherapy) received intra-arterial adriamycin and cisplatin chemotherapy at 3-4 days before thermoradiotherapy. Complete tumor response or a more than 50% tumor regression were achieved in 76 (74,5%) patients from Group 2 and in 13 (81,3%) patients from Group 3, cf. with only 14 (24,6%) patients from Group 1 (p0,05). Local hyperthermia in combination with preoperative radioand radiochemotherapy increases significantly complete and partial response in soft-tissue sarcomas.

c-Kit expression in different types of soft tissue sarcomas was studied using standard assessment criteria. The study included 83 patients treated in Cancer Researc h Center, Moscow. Histological verification of tumors was done using standard classification of soft tissue tumors. Immunohistochemical research was performed by the standard avidinbiotin technique. Monoclonal antibody to c-Kit was used as primary antibodies (clone T595, dilution 1:20, Novocastra). We found high c-Kit expression in 75 % gastrointestinal leyomiosarcomas. 25 % malignant peripheral nerve sheath tumor and 13 % synovial sarcomas were also c-Kit positive. Thus, the patients with synovial sarcomas and soft tissue sarcoma of neuroectodermic origin are perspective target for Glivec treatment. Additional studies for c-Kit assessment standardization in tumors are required.