Patients who received surgery alone or surgery plus adjuvant treatment had disease-free survival rates of about 50 and 40%, respectively. A retrospective analysis of  266 patients with UPS were treated with surgery alone (6% of cases), surgery plus radiotherapy (91% of cases), or surgery plus chemotherapy (3% of cases). Post-treatment local recurrences and metastases were observed in 15% and 38% of cases; 5- and 10-year overall survival rates were 60% and 48%, respectively; Overall median survival time were 10.1 years; and patients with tumors ≥10 cm in longest diameter had an almost 6-fold higher rate of developing metastases than patients with tumors 4 cm or smaller. Poorer prognoses were seen in older patients; in patients with tumors that were large-sized, deep-seated, and/or located in a leg; in patients that presented with metastases; and in patients who had positive surgical margins and/or developed local recurrences after surgery. In another retrospective study, 203 individuals with UPS, 141 of whom had metastatic disease, were treated with regimens selected based on the severity of their disease. In this study, the overall 5 year survival rate was 4%. Patients with the most advanced disease had a median overall survival time 11 months. Immunotherapy
Recent studies have treated UPS by targeting the immune system with pembrolizumab. Pembrolizumab is a manufactured IG4 therapeutic monoclonal antibody that binds to and inhibits stimulation of the PD-1 receptors expressed on the surface of activated T-cells.
Progressive rubella panencephalitis (PRP) is a neurological disorder which may occur in a child with congenital rubella. It is a slow viral infection of the brain characterized by chronic encephalitis, usually manifesting between 8–19 years of age. It is believed to be due to a persistence or reactivation of rubella virus infection. Cause
It develops 6 months to 4 years after the primary rubella infection, which in most cases is a congenital rubella. In children with congenital rubella infection the deficits remain stable; neurological deterioration after the
first few years of life is not believed to occur.Progression of the disease can be divided into two stages:
1st stage: Behavioural Changes
insidious onset
subtle changes in behaviour and declining school work
2nd stage: Neurological Changes
seizures – sometimes myoclonic
cerebellar ataxia
spastic weakness
retinopathy, optic atrophy
frank dementia leading to coma
spasticity and brainstem involvement with death in 2–5 years

Diagnosis
The diagnosis is considered when a child with congenital rubella develops progressive spasticity, ataxia, mental deterioration, and seizures. Testing involves at least CSF examination and serology. Elevated CSF total protein and globulin and elevated rubella antibody titers in CSF and serum occur. CT may show ventricular enlargement due to cerebellar atrophy and white matter disease. Brain biopsy may be necessary to exclude other causes of encephalitis or encephalopathy. Rubella virus cannot usually be recovered by viral culture or immunohistologic testing. Treatment
Although no specific treatment exists, the disease can be managed with anticonvulsants, physiotherapy, etc. Incidence
PRP is very rare and similar to SSPE but without intracellular inclusion bodies. Only 20 patients have been identified since first recognized in 1974.