Extremity Soft Tissue Sarcoma: Role of Local Control

Opinion statementFor localized extremity soft tissue sarcoma (eSTS), treatment is individualized and each patient needs to be evaluated by a multidisciplinary team at a referral sarcoma center specialized in the care of sarcoma. For a majority of patients, treatment for eSTS involves limb-salvage surgery, with or without the addition of radiation therapy. Surgery should only be performed by surgeons specifically fellowship trained in the resection of eSTS. Surgery alone may be considered for small, low-grade, and superficial tumors as long a wide ( ≥ 2 cm) margin can be achieved. In cases where a less than wide negative margin can be achieved, radiation therapy should be utilized to facilitate a planned close margin resection to preserve critical structures (such as nerves, blood vessels, and bone) without a significant impact on oncologi c outcomes. Soft tissue sarcomas are rare, and as such patients often present following an inadvertent excision. In these situations, we recommend preoperative radiation and wide tumor bed re-excision, as rates of residual tumor can be high in this scenario. While there is large amount of evidence t o support the use of radiotherapy to enhance local tumor control, the evidence to support the use of chemotherapy to enhance local tumor control is lacking, and as such cannot be recommended for all patients.
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research

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ConclusionsComplete resection is vital for local control in pancreatic metastasis of UPS. Sites of recurrence are rare; hence, patients must be carefully followed up.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Dario Di Stasio Luigi Laino Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in adults. It occurs only occasionally in oral soft tissues, and knowledge about its characteristics is based on a limited number of cases reported in the literature. Malignant fibrous histiocytoma belongs to the group of soft tissue sarcomas and makes up less than 10% of soft tissue sarcomas. For therapeutic purposes, complete exeresis of the lesion (macroscopic and microscopic) is performed because they have frequent recurrences. As for complementary therapy in addition to surgery, neither radiotherapy nor ch...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Review Source Type: research
In this study at UCLA, a national leader in the care of patients with sarcoma, researchers used a condensed five-day radiation regimen that considerably cuts down the length of treatment and the time to surgery.“Shortening the radiation therapy from five weeks to five days has been a very meaningful change for patients,” said lead author Dr. Anusha Kalbasi, assistant professor of radiation oncology in the division of molecular and cellular oncology. “Five weeks of daily treatments is a burdensome com mitment for patients. The daily back-and-forth can be expensive and time consuming, and it can really inte...
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
SummaryThe standard treatment of high-risk localized extremity and trunk soft-tissue sarcoma is wide local excision and radiation therapy, which can be delivered pre- or postoperatively. Improved care for sarcoma patients at expert centres with multidisciplinary tumour boards, specialized pathologists, surgeons, radio-oncologists, and medical oncologists, according to national or international guidelines, has improved outcomes. Yet, a  substantial number of patients will experience disease recurrence with metastatic spread and ultimately die from their disease. In many solid tumours neo/adjuvant chemotherapy has becom...
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 28 November 2019Source: Journal of Pediatric Surgery Case ReportsAuthor(s): Imad Aljabban, Christa GrantAbstractPediatric soft tissue sarcomas comprise a small proportion of pediatric solid malignancies and may arise in numerous anatomic locations such as the head and neck, trunk, extremities, and the genitourinary tract. Here, we present a case of rhabdomyosarcoma (RMS) arising from an unusual location, the urachus. The 3-year-old patient initially presented with signs of small bowel obstruction. On diagnostic laparoscopy, an infraumbilical mass was discovered and removed by laparotomy. ...
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
ConclusionConcurrent radiation therapy and sunitinib leads to diverging results of prognostic gene array testing in a  relevant proportion of sarcoma patients. These changes may reflect tumor heterogeneity, local treatment effects, or prognostic changes of the disease. Caution is advised in the selection of samples and interpretation of test results.
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
Conclusion: This is the first population-level study reporting of 7 different STS treatment regimens in a country with universal and centralized healthcare. Radiation therapy for local disease control and chemotherapy for Stage 4 patients have recently become more utilized. Survival from STS is highly dependent on stage at presentation. Other population-based studies from other countries are needed to establish the current international treatment patterns. PMID: 31636505 [PubMed]
Source: Sarcoma - Category: Cancer & Oncology Tags: Sarcoma Source Type: research
AbstractBackgroundSynovial sarcoma is a high-grade, malignant soft tissue sarcoma (STS) considered as relatively chemosensitive tumor, with particular sensitivity to ifosfamide. The aim of this prospective study was to analyze outcomes of patients (pts) with localized synovial sarcoma treated in a single institution with uniform neo- and adjuvant combined therapy protocol.MethodsOne hundred and seventy one pts (96 women and 75 men) with localized synovial sarcoma were treated at our institution between 1997 and 2014. Chemotherapy consisted of 4 cycles of ifosfamide 12  g/m2 (2 cycles given preoperatively) and two cy...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
Authors: Saiz AM, Gingrich AA, Canter RJ, Kirane AR, Monjazeb AM, Randall RL, Thorpe SW Abstract Radiation therapy (RT) is advocated in the multimodal treatment of high-grade soft tissue sarcoma (STS), but its role may be less clear in chemotherapy-sensitive STS such as extraskeletal Ewing sarcoma (EES). The purpose of this study was to determine the role of RT on overall survival (OS) in localized EES adult patients treated with chemotherapy and surgery. Adult patients diagnosed with EES and reported to the National Cancer Database from 2004 to 2014 were evaluated. All patients were treated with surgical resection...
Source: Sarcoma - Category: Cancer & Oncology Tags: Sarcoma Source Type: research
Conclusions: The proposed nomogram is a reliable and robust tool for accurate prognostic prediction in patients with extremity soft tissue LMS. Introduction Soft tissue leiomyosarcoma (LMS) is an aggressive sarcoma, which originates from smooth muscle cells (1). Soft tissue LMS accounts for about 5–10% of all soft tissue sarcomas (2). It occurs in different sites, including the retroperitoneum, intraabdominal sites, and extremities (3). Extremity LMS comprised about 10–15% of extremity sarcomas, with a preference for the lower limb (4–6). Extremity LMS tends to have a better prognosis than uterine...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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