Management Strategies for Localized Epithelioid Sarcoma: The Role of Neoadjuvant and Adjuvant Therapies

EP: 1.Epithelioid Sarcoma: Overview and Presentation

EP: 2.Epithelioid Sarcoma: Histological Features and Differential Diagnoses

EP: 3.Confirming Epithelioid Sarcoma: Diagnostic Approach, Imaging, and Molecular Markers

EP: 4.Navigating Diagnostic Challenges in Epithelioid Sarcoma: Multidisciplinary Strategies to Optimize Diagnosis

EP: 5.A 62-Year-Old Woman With Epithelioid Sarcoma Treated With Tazemetostat

Now Viewing

EP: 6.Management Strategies for Localized Epithelioid Sarcoma: The Role of Neoadjuvant and Adjuvant Therapies

Summary for Physicians: Management Strategies for Localized ES

Neoadjuvant Therapy: For localized ES, neoadjuvant therapies may be considered in patients with large, resectable tumors or those at high risk for local recurrence. The goal of neoadjuvant therapy, which may include chemotherapy or radiation, is to shrink the tumor prior to surgical resection, making the tumor more amenable to complete surgical excision with clear margins. Neoadjuvant radiation is commonly used for tumors in areas difficult to resect completely or when a high risk of recurrence is anticipated. Chemotherapy in the neoadjuvant setting, though less frequently used, may be considered in high-risk cases with aggressive features.

Adjuvant Therapy: Adjuvant therapies are employed following surgical resection to reduce the risk of local recurrence and metastasis. Adjuvant radiation therapy is commonly used after surgery, particularly when margins are positive or close, or if the tumor is located in a high-risk area. Chemotherapy is sometimes considered in high-risk patients who have aggressive tumor features or if there is concern for micrometastatic disease. The choice between chemotherapy and radiation in the adjuvant setting is influenced by tumor characteristics, such as size, grade, and location, as well as the patient’s overall health and response to prior therapies.

In summary, the use of neoadjuvant and adjuvant therapies for localized ES aims to improve surgical outcomes and reduce the likelihood of recurrence, with the selection of therapy guided by tumor characteristics and patient factors.