Soft tissue sarcoma of the extremities. A multimodality diagnostic and therapeutic approach (original) (raw)
Related papers
Soft Tissue Sarcomas: An Overview on Histomorphology
Annals of SBV
Background: Soft tissue sarcomas (STS) comprise a diverse group of rare malignancies that arise from connective tissues. The natural course of STS is unpredictable and aggressive if not diagnosed at an early stage. Discussion: The subclassification of these tumors is important for prognosis and clinical management of patients. In the present review, we discuss the histomorphologic features of STS and its subtypes based on 2013 World Health Organization classification and throw light on the incidence and presentation of STS. Conclusion: The systematic approach to morphologic assessment of STS outlined in this review will lead to narrowing of differential diagnoses and pave way for effective diagnosis and implementation of treatment strategies.
The archives of bone and joint surgery, 2022
Background Soft-Tissue Sarcoma (STS) is a heterogeneous group of neoplasms of mesenchymal origin, occurring in connective tissues. According to previously conducted studies, STS accounts for approximately 1% and 7-%15% of adult and pediatric malignancies, respectively. Almost 50%-60% of sarcomas arise from extremities and usually present as a large painless or rarely painful soft-tissue mass. The present study aimed to describe the epidemiology of soft-tissue sarcomas, especially in the Iranian population. Methods This epidemiological study of limb soft-tissue sarcoma was conducted based on Iran National Cancer Registry data (INCR) between 2009 and 2014. Patients with soft-tissue sarcoma confirmed by histopathological studies were included, and data were classified based on the International Classification of Diseases for Oncology (first revision-third edition [ICD-O-3]) and analyzed. Descriptive analysis was performed to extract age-standardized and age-specific incidence rates. Re...
Primary multidisciplinary management of extremity soft tissue sarcomas
Current treatment options in oncology, 2004
Soft tissue sarcomas (STS) are a rare and heterogeneous group of malignancies that most commonly present as large painless masses deep in the muscular compartments of the extremities. Investigation and treatment of these patients must be undertaken at a tertiary referral unit. Staging studies must include a high-quality magnetic resonance imaging (MRI) scan of the local site and a computed tomography (CT) scan of the chest to investigate for possible metastatic disease. Review of biopsy material must be undertaken by an experienced musculoskeletal pathologist. Currently, histologic diagnosis and grade are assigned to the tumor, but in tumors such as synovial sarcoma and Ewing's family of tumors, molecular evaluation is becoming crucial for diagnostic, prognostic, and therapeutic reasons. Surgical resection of sarcomas with negative surgical margins remains the mainstay of treatment. Surgical treatment alone is indicated for small superficial masses that are not adjacent to bone ...
Curent concepts in pathology of soft tissue sarcoma
Indian journal of surgical oncology, 2011
Soft tissue sarcomas (STS) constitute a heterogeneous category of soft tissue neoplasia composed mostly of uncommon tumors of diverse histology, different biology and varied outcomes. Substantial developments in immunohistochemistry (IHC), cytogenetics and molecular genetics of STS have caused a significant change in the classification and diagnosis of these tumors with a direct implication for clinical management and prognosis. In this review we discuss newer developments impacting diagnosis and prediction.
Soft Tissue Sarcoma, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology
Journal of the National Comprehensive Cancer Network : JNCCN, 2016
Soft tissue sarcomas (STS) are rare solid tumors of mesenchymal cell origin that display a heterogenous mix of clinical and pathologic characteristics. STS can develop from fat, muscle, nerves, blood vessels, and other connective tissues. The evaluation and treatment of patients with STS requires a multidisciplinary team with demonstrated expertise in the management of these tumors. The complete NCCN Guidelines for Soft Tissue Sarcoma (available at NCCN.org) provide recommendations for the diagnosis, evaluation, and treatment of extremity/superficial trunk/head and neck STS, as well as intra-abdominal/retroperitoneal STS, gastrointestinal stromal tumor, desmoid tumors, and rhabdomyosarcoma. This manuscript discusses guiding principles for the diagnosis and staging of STS and evidence for treatment modalities that include surgery, radiation, chemoradiation, chemotherapy, and targeted therapy.
NCCN Soft Tissue Sarcoma , Version 2 . 2016 Clinical Practice Guidelines in Oncology
2016
Soft tissue sarcomas (STS) are rare solid tumors of mesenchymal cell origin that display a heterogenous mix of clinical and pathologic characteristics. STS can develop from fat, muscle, nerves, blood vessels, and other connective tissues. The evaluation and treatment of patients with STS requires a multidisciplinary team with demonstrated expertise in the management of these tumors. The complete NCCN Guidelines for Soft Tissue Sarcoma (available at NCCN.org) provide recommendations for the diagnosis, evaluation, and treatment of extremity/ superficial trunk/head and neck STS, as well as intra-abdominal/ retroperitoneal STS, gastrointestinal stromal tumor, desmoid tumors, and rhabdomyosarcoma. This manuscript discusses guiding principles for the diagnosis and staging of STS and evidence for treatment modalities that include surgery, radiation, chemoradiation, chemotherapy, and targeted therapy. J Natl Compr Canc Netw 2016;14(6):758–786 NCCN Categories of Evidence and Consensus Catego...
Management of soft-tissue sarcomas; treatment strategies, staging, and outcomes
SICOT-J, 2017
Soft-tissue sarcomas (STS) are a rare group of malignant tumors which can affect any age group. For the majority of patients who present with a localized STS, treatment involves a multidisciplinary team decision-making approach ultimately relying on surgical resection with or without adjuvant radiation for successful limb salvage. The goals of treatment are to provide the patient with a functional extremity without local tumor relapse. The purpose of this article is to review the treatment of extremity STS, with a focus on staging, treatment options, and outcomes.
High-grade soft tissue sarcomas of the extremities
Cancer, 1986
patients were referred to the Surgery Branch of the National Cancer Institute (NCI) with the diagnosis of soft tissue sarcoma of the extremities. Two hundred eleven of these patients presented with resectable, localized high-grade soft-tissue sarcomas and have been included in the present analysis of the management and outcome of patients with high-grade soft tissue sarcomas of the extremity treated at the NCI. One hundred forty-seven of these 211 patients have been included in randomized prospective trials. The remaining 64 patients in this analysis have been followed at the NCI, but were not included in randomized trials because of patient refusal or ineligibility. Tumor size was identified as a highly significant prognostic variable for disease-free and overall survival (P2 = 0.00001 and 0.0081, respectively). Tumor site, histologic type, and microscopic margins of resection were not significant prognostic variables. There was no difference between patients undergoing amputation compared to those undergoing limb-sparing procedures plus postoperative radiotherapy in disease-free or overall survival for all 211 patients in this study (P2 = 0.068 and 0.131, respectively). A significantly greater frequency of local failure among patients treated by local excision was noted compared to patients undergoing amputation (12/128 versus 0/83, P2 = 0.004), but this did not result in decreased overall survival in patients undergoing combined modality limb-sparing procedures. Adjuvant chemotherapy significantly prolonged disease-free survival (P2 = 0.005) for the 124/211 patients treated with adjuvant chemotherapy, although analysis of overall survival did not reveal a significant increase (Pz = 0.10). In a subset of 65 patients included in a prospective randomized trial evaluating the efficacy of adjuvant chemotherapy, a significant improvement in both disease-free (P2 = 0.033) and overall (P2 = 0.055) survival was seen in patients receiving chemotherapy. Sixty-five patients developed recurrent disease (65/211, 31%) and 42 of these patients were rendered disease-free surgically. Survival from the time of first recurrence was significantly prolonged among the 42 patients who were rendered disease-free (median survival, 31 months) compared to those who were not (median survival, 9 months, P2 < 0.001) Cancer 58:190-205. 1986.
Practical Guides in Radiation Oncology
The early detection of disease and accurate staging at presentation are the main prognostic factors for overall survival. Among malignancies, poorly differentiated sarcoma can appear like poorly differentiated carcinoma and melanoma can mimic many sarcoma types. Communication between the pathologist, radiologist, and surgeon can expose nuance between these malignancies and be essential for final diagnosis and staging. Many advances have been made in the histologic diagnosis of STS that have, in turn, guided surgical treatment; however, even with the surgical goal of wide resection obtained in most cases, surgeons are still unable to fully cure some patients.