Retroperitoneal Sarcomas
This article provides a summary of recent updates to the management of RPS. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Authors: Michael K. Turgeon, Kenneth Cardona Source Type: research
Gastrointestinal Stromal Tumors and the General Surgeon
Gastrointestinal stromal tumors (GISTs) are rare malignancies of the gastrointestinal tract but are the most common sarcoma. This review covers aspects of the care of patients with GIST relevant to surgeons. In particular, management of sub-2 cm GISTs, the utility of neoadjuvant and adjuvant therapy for primary GISTs, and indications for surgery in the setting of metastatic disease are discussed. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Authors: Ilaria Caturegli, Chandrajit P. Raut Source Type: research
Lipoma and Its Doppelganger
This article reviews the epidemiology, clinical history, diagnostic workup, management, natural history, and surveillance of benign lipomas and atypical lipomatous tumors/well-differentiated liposarcomas. Although it is important that aggressive, potentially malignant atypical lipomatous tumors and liposarcomas be managed in a multidisciplinary, preferably high-volume setting, it is equally as important for the nonspecialist general surgeon to be familiar with lipoma and its doppelganger —the well-differentiated liposarcoma. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Authors: Elliott J. Yee, Camille L. Stewart, Michael R. Clay, Martin M. McCarter Source Type: research
Benign Neurogenic Tumors
Neurogenic tumors arise from cells of the nervous system. These tumors can be found anywhere along the distribution of the sympathetic and parasympathetic nervous system and are categorized based on cell of origin: ganglion cell, paraganglion cell, and nerve sheath cells. Ganglion cell-derived tumors include neuroblastomas, ganglioneuroblastomas, and ganglioneuromas. Paraganglion cell-derived tumors include paragangliomas and pheochromocytomas. Nerve sheath cell-derived tumors include schwannomas (neurilemmomas), neurofibromas, and neurofibromatosis. Most of these are benign; however, they can cause local compressive sympt...
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Authors: Jeffrey M. Farma, Andrea S. Porpiglia, Elaine T. Vo Source Type: research
Sarcoma Pulmonary Metastatic Disease
Tumors of soft tissue origin are not common but are increasing in incidence. Given the rare and heterogeneous nature of the disease, deciding on an effective treatment approach to the patient can be challenging. Approximately 20-50% of patients with sarcoma will develop metastases to the lung via hematogenous spread. Despite improvements in systemic therapy options for patients with metastatic disease to the lung, surgical resection of metastases is often the preferred option in patients who are safe surgical candidates. Clearance of metastatic disease with surgical resection has been proven to be cost-effective and can im...
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Authors: Mark Hennon Source Type: research
Dermatofibrosarcoma Protuberans: What Is This?
Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive dermal-based sarcoma. Metastatic potential is extremely low, primarily in the setting of fibrosarcomatous transformation. DFSP is characterized by a t(17;22) (q22;q13) translocation that results in active PDGFB signaling. Surgical resection with negative margins (typically including the underlying fascia) is the potentially curative treatment. Delayed wound closure should be considered for cases requiring extensive resection or tissue rearrangement. Tyrosine kinase inhibitors, such as imatinib, have shown response rates of 50% to 60% in patients with loca...
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Authors: Gerardo A. Vitiello, Ann Y. Lee, Russell S. Berman Source Type: research
The Evolving Management of Desmoid Fibromatosis
Desmoid fibromatosis is a rare disease caused by genetic alterations that activate β-catenin. The tumors were previously treated with aggressive surgeries but do not metastasize and may regress spontaneously. For these reasons, in the absence of symptoms and when growth would not induce significant complications, active observation is considered first-line therapy. When intervent ion is required, surgery can be considered based on anatomy and risk of postoperative recurrence, but increasingly nonoperative therapies such as liposomal doxorubicin or sorafenib are prescribed. Cryoablation, chemoembolization, and high-intensi...
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Authors: Katherine Prendergast, Sara Kryeziu, Aimee M. Crago Source Type: research
Sarcoma
It has been said that medicine is an unusual industry in that its goal is to make itself obsolete. That may be the case in some circumstances, but I would say that it not likely to happen any time soon. In some areas of medicine, we may be closer to reducing the need for our services, while in other areas we are certainly generating increased demand for services. Also, given that health care as economic entity writ large represents approximately one-fifth of the US gross domestic product, there are substantial forces at play that must assure that any downward pressure on the need for medical care will be incremental at bes...
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Authors: Ronald F. Martin Tags: Foreword Source Type: research
A Surgeon's Guide to Sarcomas and Other Soft Tissue Tumors
SURGICAL CLINICS OF NORTH AMERICA (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Authors: John M. Kane Source Type: research
Copyright
ELSEVIER (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Source Type: research
Contributors
RONALD F. MARTIN, MD, FACS (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Source Type: research
Contents
Ronald F. Martin (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Source Type: research
Forthcoming Issues
Pediatric Surgery (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - August 1, 2022 Category: Surgery Source Type: research
Radiation Therapy for Soft Tissue Sarcoma
Radiation therapy is an integral component of local management with oncologic resection for soft tissue sarcoma. Radiotherapy is indicated in patients at an increased risk of local recurrence so that improved local control may be achieved. Sequencing of radiotherapy and resection should be determined by multidisciplinary input before treatment initiation. For most patients, preoperative delivery of radiation therapy is preferred. In patients initially thought to be at low risk for local recurrence and found to have unexpected adverse pathologic features at resection, postoperative radiation therapy is indicated. The use of...
Source: Surgical Clinics of North America - June 23, 2022 Category: Surgery Authors: Kilian E. Salerno Source Type: research
The Implications of an Unplanned Sarcoma Excision (the “Whoops” Operation)
In this review, the risk factors of an unplanned excision of soft-tissue sarcoma and the implications of non-oncologic resection are discussed. Although soft-tissue sarcoma remains a rare disease, many studies have shown the deleterious effects of unplanned excision, including decreased recurrence-free survival and increased morbidity. Once discovered, sarcomas should be referred to expert centers for further management, which often entails re-excision, radiation, and/or chemotherapy treatment. Although much still needs to be learned about this complex disease, a multidisciplinary approach including surgeons, medical oncol...
Source: Surgical Clinics of North America - June 23, 2022 Category: Surgery Authors: Valerie P. Grignol, Alexandra G. Lopez-Aguiar Source Type: research
