Muscle strength and psychometric properties of the health-related quality of life in patients with soft tissue sarcoma resection in the thigh

Abstract Objectives: The aim of this study was to evaluate the effect of STS resection in the thigh on MS and the HRQoL. Methods: Fourteen adults patients with STS in the thigh who underwent wide resection and limb preservation were evaluated. The patients were submitted to the Mini-Mental State Examination (MMSE). A hand-held dynamometer was used to measure the MS the flexors, adductors, abductors, and extensors muscles of the operated and non-operated thighs and between the dominant and non-dominant operated sides. The Musculoskeletal Tumor Society (MSTS) and Short Form Health Survey-36 (SF-36) questionnaires were applied to quantify the psychometric properties of the HRQoL. The data were submitted to statistical analysis using the Wilcoxon test (MS), and Mann-Whitney and Spearman correlation (MSTS and SF-36) (α = 0.05). Results: There was no significant difference in MS between the operated side and the non-operated side, and between the dominant and non-dominant operated side (ρ > 0.05). The MSTS presented a significant difference in the emotional acceptance for patients submitted to radiotherapy (ρ = 0.029). The SF-36 showed significant differences in the emotional aspect for patients submitted to chemotherapy (ρ = 0.027) and in the social aspect between the dominant and non-dominant operated side (ρ = 0.024). Conclusions: The HRQoL of adult patients is hampered after the treatment of STS even when MS is maintained.

Femoral Fracture Secondary to a Gunshot Wound Leading to Chronic Expanding Hematoma with Osteomyelitis - An Unusual Presentation of a Pseudotumour: A Case Report

@#A chronic expanding hematoma (CEH) is a rare clinicopathologic entity that may simulate the clinical and radiologic presentation of soft tissue sarcomas. Etiology has been attributed to repeated exudation and bleeding from capillaries in granulation tissue, resulting in a gradually enlarging mass. A 51-year-old male presented with a large thigh mass following a gunshot wound one year prior. Diagnostic imaging revealed a large complex mass with cystic areas overlying cortical erosions in the femoral diaphysis suggestive of osteomyelitis versus a primary aggressive new growth. Biopsy confirmed CEH and the absence of malignant cells. Hip disarticulation was performed after noting massive necrosis of the thigh compartments and neurovascular compromise. CEH is an important differential diagnosis to be considered in a patient with a slow-growing soft tissue mass and history of significant trauma. Its similar clinical presentation with a soft tissue sarcoma necessitates a high index of suspicion, diagnostic imaging, and biopsy prior to performing definitive surgery.

Survival and Prognosis of Primary Mediastinal and Pulmonary Sarcoma Based on SEER Database / 肿瘤防治研究

Objective To analyze the factors affecting the prognosis of soft tissue sarcomas originating from the mediastinum and lung using relevant data from the SEER database. Methods The data of 376 patients were collected from the SEER database, and were randomly divided into the train set (n=263) and validation set (n=113). The relationship between each variable and patient survival and prognosis was analyzed using the Kaplan-Meier method and Cox proportional risk regression to establish a nomogram, to predict the overall survival of patients. The calibration curves, consistency index, and ROC curves were used to evaluate the performance of the nomogram. Results Histological type, surgery, chemotherapy, tumor size, and tumor stage were the factors affecting the prognosis of primary mediastinal and pulmonary soft tissue sarcomas. The established nomogram could predict the 6-month, 1-year, and 2-year overall survival of patients, and the calibration curves showed good prediction accuracy with measured values. C index of the train set and validation set were 0.754 and 0.745, respectively. The areas under the curve of ROC were 0.849 and 0.924. Conclusion The nomogram established in this study can predict 6-month, 1-year, and 2-year overall survival in patients with primary mediastinal and pulmonary soft tissue sarcoma.

Clinical efficacy of postoperative radiotherapy using shrinking field for patients with extremity soft tissue sarcoma / 中华放射肿瘤学杂志

Objective:To investigate the effectiveness of postoperative radiotherapy using shrinking field for patients with extremity soft tissue sarcoma (STS), mainly focusing on the local control rate and adverse events.Methods:Clinical data of 49 extremity STS patients who received postoperative intensity-modulated radiotherapy in the First Hospital of Tsinghua University from October 2017 to March 2021 were retrospectively analyzed. Target volumes were contoured on CT and MRI fusion images. The tumor bed was defined as GTV tb, with 3 cm expansion in the longitudinal direction and 1.5 cm expansion in the radial direction to construct CTV (the target volume should be properly repaired according to the anatomical barrier, and the edema area around the tumor should be included). GTV tb and CTV were expanded in all directions by 0.5 cm to construct PTV1 and PTV2 respectively, at a dose of 95%PTV1 63-66 Gy, 95%PTV2 50-56 Gy,1.8-2.0 Gy/f. The dose of surgical volume should be given at 70 Gy for patients who had a microscopic positive margin. Results:The median follow-up time was 32.1 months (7.9-45.6 months). The 3-year local failure-free survival (LFFS), overall survival (OS)and distant metastasis-free survival (DMFS) were 91.7%,77.6% and 71.5%, respectively. Univariate analysis showed that patients with a microscopic positive margin were more likely to develop local recurrence ( P<0.05). The incidence of grade 2 or above wound complications, joint stiffness, fracture, edema and skin fibrosis were 2%, 4.1%, 2%, 8.2% and 26.5%, respectively. Conclusion:Postoperative radiotherapy with shrinking field provides excellent local control rate and low incidence of late adverse events in patients with extremity STS.

First line anlotinib plus liposomal doxorubicin for locally advanced or metastatic soft tissue sarcoma: A prospective, single-arm trial

Objective: To examine the efficacy and safety of anlotinib as firstline therapy to treat locally advanced or metastatic soft-tissue sarcoma. Methods: This is a single-arm trial. Treatment-naive patients (≥14 years) with locally advanced or metastatic soft tissue sarcoma were eligible. Each treatment cycle lasted for 3 weeks, and included liposomal doxorubicin (40-50 mg/m2) on day 1 and anlotinib (12 mg) on days 8-21. Starting from the 9th cycle, treatment consisted of only anlotinib. Treatment continued until disease progression or intolerable toxicities. The primary efficacy end point was progression-free survival (PFS). Results: Eight patients were enrolled between July 25, 2019 and January 8, 2020. The median number of treatment cycles was 5.5. Within 5.9 months median follow-up, PFS events occurred in 4 (4/8, 50%) patients. The median PFS was 11.3 months and the 6-month PFS rate was 56%. No patients attained complete response and 2 patients (fibrosarcoma, 1 patient and undifferentiated pleomorphic sarcoma, 1 patient) achieved partial response. Three patients (fibrosarcoma, 2 patients and synovial sarcoma, 1 patient) had stable disease. The objective response rate was 25% (2/8) for the study population, and the disease control rate was 75% (6/8). No new safety concerns emerged. Conclusions: Anlotinib plus liposomal doxorubicin demonstrated antitumor activities in previously untreated locally advanced or metastatic soft tissue sarcomas. Due to the small sample size, further investigations with a larger population should be undertaken to confirm the study findings.

INTRABEAM Intraoperative Radiation Therapy Combined with Limb Sparing Surgery in Soft Tissue Sarcoma (A Report of Four Cases) / 肿瘤防治研究

Objective To explore the clinical efficacy of surgical operation combined with INTRABEAM intraoperative radiotherapy in the limb-sparing treatment of soft tissue sarcoma. Methods A retrospective study was performed on four patients with limb soft tissue sarcoma admitted from July 2020 to October 2021 who received limb sparing surgery combined with INTRABEAM intraoperative radiotherapy. The operation went smoothly without anesthesia or accident. Results All the four patients received follow-up, ranging from 6 to 22 months. One patient had local recurrence two months after the surgery, and the patient refused amputation and received chemotherapy and targeted therapy. One patient had pulmonary metastasis ten months after the surgery and underwent surgical resection. One recurrent patient had poor limb function, and the other three patients had normal limb function. Conclusion Surgical operation combined with INTRABEAM intraoperative radiotherapy can preserve limb function while improving local control and quality of life.

Extremities Soft Tissue Sarcomas, more Common and as Dangerous as Bone Sarcomas / Sarcomas de partes moles nos membros, mais comuns e tão graves quanto os sarcomas ósseos

Abstract Musculoskeletal sarcomas are rare diseases that require attention. They often present high degree of malignancy at diagnosis and, if underestimated, they can evolve aggressively locally and systemically. They present as soft tissues arcoma and bone sarcomas, with soft tissue being four to five times more common. Most soft tissue sarcomas occur in the extremities. The most common subtypes in children and adolescents are rhabdomyosarcoma and synovial sarcoma; in adults, undifferentiated pleomorphic sarcoma, liposarcoma, leiomyosarcoma, myxofibrosarcoma and synovial sarcoma; all with a high degree of histological malignancy. Many soft tissue sarcomas are confused with benign soft tissue tumors, 100 times more common, so they are resected without the necessary planning, resulting in amputation of a limb that could have been preserved. As in all cancers, the most important prognostic factor is metastatic disease. When it is present, the overall survival rate falls around 20 to 30%. Survival rates are generally similar between bone and soft tissue sarcomas. So soft tissue sarcomas, in addition to being more prevalent, are as aggressive as bones arcomas, deserving a lot of attention from orthopedic surgeons, who are often the first line of care of carriers of these tumors.

Resumo Os sarcomas musculoesqueléticos são doenças raras que exigem atenção. Frequentemente, apresentam alto grau de malignidade ao diagnóstico e se subestimados podem evoluir de forma agressiva local e sistemicamente. Apresentam-se como sarcoma de partes moles e sarcomas ósseos, sendo os de partes moles quatro a cinco vezes mais comuns. A maioria dos sarcomas de partes moles ocorre nos membros. Os subtipos mais comuns nas crianças e adolescentes são o rabdomiossarcoma e o sarcoma sinovial, nos adultos o sarcoma pleomórfico indiferenciado, lipossarcoma, leiomiossarcoma, mixofibrossarcoma e sarcoma sinovial; todos de alto grau de malignidade histológica. Muitos sarcomas de partes moles são confundidos com tumores benignos de partes moles, 100 vezes mais comuns, por isso são ressecados sem o planejamento necessário, acarretando em amputação de um membro que poderia ter sido preservado. Como em todos os cânceres, o fator prognóstico mais importante é a doença metastática. Na sua vigência, a taxa de sobrevida global cai em torno de 20 a 30%. As taxas de sobrevida no geral são parecidas entre os sarcomas ósseos e de partes moles, portanto o sarcoma de partes moles, além de mais prevalente, mostra-se tão agressivo quanto os sarcomas ósseos, por isso merece muita atenção dos ortopedistas que frequentemente são a primeira linha de atendimento dos portadores destes tumores.

Prognostic factors and clinical course of extremity soft-tissue sarcomas

Purpose: Although soft tissue constitutes half of the body weight, soft-tissue sarcomas (STSs) are less common than any other types of tumors. Materials and Methods: In this retrospective study, the prognostic factors and clinical courses of 64 patients with extremity STSs treated at our clinic between 1996 and 2012 were investigated. Results: Of the 64 patients included in this study, 35 (55%) were male and 29 (45%) were female. By the end of follow-up, 29 (45%) of the patients remained alive while 35 (55%) deceased. The overall survival (OS) time of the patients was 89.1 months, and their 1-, 3-, 5-, and 10-year survival rates were 82.8%, 69.3%, 51.6%, and 39.4%, respectively. Univariate analysis revealed the following variables as prognostic factors: tumor stage (P < 0.001), surgical method applied (P = 0.009), radiotherapy (RT) application (P = 0.018), RT dose (P < 0.001), and development of metastasis during follow-up (P < 0.001). Multivariate analysis revealed only type of surgery to be a prognostic factor (P = 0.016). Conclusion: Besides surgery, RT plays a crucial role in the multimodal treatment of STSs and increases local control rates and OS. In our study, stage, surgery, and adjuvant RT were found to be effective factors indicating OS. However, more prospective work in this area is necessary

Manifestaciones paraneoplásicas a propósito de un caso con sarcoma de partes blandas y metástasis ósea / Paraneoplastic manifestations regarding a case with soft tissue sarcoma and bone metastases

Introducción: El sarcoma de tejidos blandos (STB) constituye un grupo variado de más de 60 neoplasias que solo suponen 1 por ciento del total de los tumores. Objetivo: Describir el caso de un paciente con sarcoma de partes blandas con metástasis ósea y manifestaciones paraneoplásicas. Caso clínico: Se presenta el caso de un paciente masculino de 55 años de edad con antecedentes de diabetes mellitus tipo 2 e hipertensión arterial que refiere que hace 50 días inició con decaimiento marcado, luego de permanecer 1 mes con este síntoma inició con dolor en la columna en la parte más baja de la espalda, conjuntamente iniciando con un cuadro febril. Además, tuvo pérdida de la fuerza principalmente en las piernas, y hablaba cosas incoherentes sin sentido, gran inapetencia, con pérdida de peso de 50 lb en 20 días. Ante cuadro de pérdida de la conciencia y de la fuerza principalmente en las piernas se decidió su remisión hacia el Hospital Clínico Quirúrgico Lucía Íñiguez Landín de Holguín donde se concluyó como sarcoma de partes blandas con manifestaciones paraneoplásicas y metástasis ósea. Conclusiones: El caso presentado de sarcoma de partes blandas pretende aportar información sobre esta enfermedad tan infrecuente en nuestro medio(AU)

Introduction: Soft tissue sarcoma (STB) constitutes a varied group of more than 60 malignancies that only accounts for 1% of all tumors. Objective: To report a case of a patient with soft tissue sarcoma with bone metastases and paraneoplastic manifestations. Clinical case report: We report the case of a 55-year-old male patient with a history of type 2 diabetes mellitus and hypertension, who stated that 50 days ago he began to feel markedly listless. And after a month he began to suffer pain in the spine, in the lower back, and have a fever. In addition he had loss of strength mainly in the legs, and spoke inconsistently, nonsense, great loss of appetite, with weight loss of 50 lbs in 20 days. Given the condition of loss of consciousness and strength, mainly in the legs, it was decided to refer him to Lucía Iñiguez Landín Surgical Clinical Hospital in Holguín, where a soft tissue sarcoma with paraneoplastic manifestations and bone metastases was diagnosed. Conclusions: The report of this case of soft tissue sarcoma aims to provide information about this disease, which is so rare in our setting(AU)

Sarcoma de Células Claras en pierna de mujer de 28 años / Clear cell sarcoma on 28 years old woman leg

Los tumores de partes blandas son tumores que se presentan en adultos, aproximadamente a los 60 años. De estos tumores los sarcomas son poco frecuentes y tienen preferencia en las extremidades y muchas veces invaden estructuras músculo aponeuróticas cercanas, y poca invasión vascular o nerviosa lo que las hace de fácil acceso con poca morbilidad para su biopsia. El diagnóstico de los tumores de partes blandas se basa en el estudio histológico de anatomía patológica y, a veces se debe asociar a estudios de citogenética para poder tener un diagnóstico específico. El tratamiento principal es quirúrgico y puede llegar estar asociado a terapia adyuvante.

Soft tissue tumors are tumors that occur in adult's age, at about 60 age. Of these tumors, sarcomas are rare and have preference in the extremities, and often invade nearby muscle-fascia structures, and little vascular or nerve invasion, making them easily accessible with little morbidity for biopsy. The diagnosis of soft tissue tumors is based on the histological study of pathological anatomy and, sometimes, it must be associated with cytogenetic studies in order to have specific diagnosis. The main treatment is surgical and may end up being associated with adjuvant therapy.

Clinical analysis of the use of PEG-rhG-CSF after chemotherapy in patients with soft tissue sarcoma / 肿瘤

Objective: To analyze the clinical effect of prophylactic use of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) after chemotherapy in patients with soft tissue sarcoma. Methods: The clinical data of the patients with soft tissue sarcoma who were diagnosed in the Oncology Department of Zhongshan Hospital Affiliated to Fudan Universtiy from July 2016 to July 2019, and received the preventive treatment of PEG-rhG-CSF after chemotherapy to prevent the increase of leukocyte count in vivo, was collected and analyzed. Results: A total of 107 patients with soft tissue sarcoma were treated with PEG-rhG-CSF after chemotherapy. The incidence of neutropenia was 48.6% (52/107), in which the incidence of grade 3-4 neutropenia was 28.0% (30/107), and the incidence of febrile neutropenia (FN) was 4.7% (5/107). The incidence of neutropenia in male or female patients was 52.8% (28/53) or 44.4% (24/54), respectively; there was no significant difference (P > 0.05). The incidence of neutropenia in elderly patients (≥ 65 years old) or young and mid-aged patients ( 0.05). The use of IA chemotherapy with ifosfamide and doxorubicin was more toxic, the incidence of neutropenia was 50.9% (27/53) with 4 cases of FN. In the patients who received major surgery (grade 3-4) or those who did not receive major surgery (grade 1-2 and no surgery), the incidence of neutropenia was 60.0% (36/60) or 34.0% (16/47), respectively; there was significant difference (P < 0.05). In the patients who received radiotherapy or those without radiotherapy, the incidence of neutropenia was 70.0% (14/20) or 43.7% (38/87), respectively; there was significant difference (P < 0.05). Conclusion: The prophylactic use of PEG-rhG-CSF can avoid severe myelotoxicity in the majority of patients with soft tissue sarcoma. However, the risk of neutropenia is still high in the patients who received chemotherapy based on ifosfamide and anthracyclines, as well as in the patients who have received radiotherapy and major surgery in the past. All these are worthy of concern.

Expression and clinical significance of PRC1 in soft tissue sarcoma based on data mining and effect of PRC1 on the growth of liposarcoma / 西安交通大学学报(医学版)

Objective: To investigate the expression and clinical significance of protein regulator of cytokinesis 1 (PRC1) in soft tissue sarcoma (STS) and the effects of down-regulating the expression of PRC1 on the proliferation and cell cycle of human liposarcoma cell by data mining. Methods: Oncomine database was used to analyze the expression of PRC1 in STS tissue and normal tissue, which was then verified by TCGA database. The prognosis data downloaded from OncoLnc database were used to analyze the correlation between PRC1 expression and prognosis of STS patients. Meanwhile, to collect PRC1 expression in STS cells, we used publicly available data from the Cancer Cell Line Encyclopedia (CCLE) projects. String database was used to determine the co-expression molecules with PRC1 and map the gene co-expression network. The expressions of PRC1 in liposarcoma cell line SW872 and human subcutaneous preadipocytes (HPA-s) were detected by Western blotting and Real-time PCR. PRC1 was silenced in SW872 cell (SW872-siPRC1) by PRC1 target siRNA with SW872-NC cell as its control. MTT assay was used to detect the proliferation of SW872-siPRC1 and SW872-NC cells; flow cytometry was used to detect the cell cycle. Results: In the Oncomine database, 11 studies involved PRC1 expression in STS tissues and normal tissues. Compared with that of the control, the expression of PRC1 in STS tissues was significantly higher (P<0.05). The results were consistent with those in the TCGA database. The analysis using Oncomine database showed that the high expression level of PRC1 was associated with shorter overall survival (P<0.05). The analysis using CCLE database showed high expression of PRC1 in STS cells (P<0.05). The co-expression network of PRC1 was established by String database, including 11 nodes and 55 connections. PRC1 was over-expressed in liposarcoma cell line SW872. Cell proliferation curve showed that compared with that of SW872-NC cells in the control group, the proliferation of SW872-siPRC1 cells decreased significantly after 48 h and 72 h culture (P<0.05). Compared with SW872-NC cell in the control group, the G1 cell proportion of SW872-siPRC1 cells was (40.27±7.42)%, significantly lower than that of SW872-NC cells (62.01±4.89)%. The G2/M cell proportion of SW872-siPRC1 cells was (25.65±1.54)%, which was significantly higher than that of SW872-NC cells (8.17±0.96)% (both P<0.05). Conclusion: Tumor gene database mining shows that PRC1 is highly expressed in STS tissues and STS cells, which is associated with the patient's prognosis. Silencing PRC1 gene can inhibit the proliferation of liposarcoma SW872 cells and keep the cells staying in G2/M phase. PRC1 plays a role in promoting liposarcoma, which may provide a potential target for the clinical treatment and prognosis of soft tissue sarcoma, especially liposarcoma.

Nasal Continuous Positive Airway Pressure for Carcinomatous Lymphangitis in End-stage Malignant Soft Tissue Sarcoma: A Case Report

Background: In the end stage of malignant bone and soft tissue tumors with lung metastasis, it is often necessary to relieve symptoms of dyspnea due to tumor enlargement and carcinomatous lymphangitis. We report a case in which nasal continuous positive airway pressure (nasal CPAP) was effective as a palliative treatment. Case: A 66-year-old male underwent wide resection with a diagnosis soft tissue sarcoma of right femur. Four years after surgery, he was hospitalized for hilar lymph node metastasis, multiple bone metastases, and carcinomatous lymphangitis. He was treated with nasal CPAP for dyspnea, and communication was possible until the day before his death. Discussion: For end-stage respiratory symptoms, medication therapy such as morphine or steroids is often used for palliation, but often symptoms are not sufficiently improved. Nasal CPAP might be a useful treatment for palliation for rapidly progressing respiratory failure.

Pleomorphic hyalinizing angiectatic tumor of the mesorectum: a rare case and review of literature

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare tumor of uncertain tissue origin. Although it has been classified as a benign tumor under the WHO classification, it is locally aggressive, and multiple recurrences have been reported. PHAT commonly involves the lower extremities; however, various unusual sites of origin have been reported. We present the case of a 30-year-old female with dysmenorrhea, who presented a presacral mass on imaging. The core biopsy confirmed the diagnosis of PHAT. She underwent laparotomy and excision. Histopathology confirmed the presence of a tumor comprised of aggregates of ectatic vessels with perivascular hyalinization. An immunohistochemical study showed diffuse CD34 positivity, but S100, MDM2, and smooth muscle actin negativity. After surgical procedures, the patient is disease free as at the 12-month follow-up. Only 120 cases have been published in the English literature to date. Our study is only the third case of PHAT arising from the pelvis to be reported. Though considered to be a rare condition, the diagnosis of PHAT should always be considered in the differential diagnosis of well-defined hypervascular soft tissue mass in the pelvis. The typical histopathological findings along with immunohistochemistry should clinch the diagnosis.

Histopathology and immunohistochemistry of peripheral neural sheath tumor and perivascular wall tumor in dog / Histopatologia e imuno-histoquímica de tumor de bainha de nervo periférico e de tumor de parede perivascular em cães

Soft tissue sarcomas (STS) comprise a heterogeneous group of malignancies derived from extra-skeletal mesenchymal tissues that may show similar histopathological changes. Histopathologic patterns suggestive of perivascular wall tumors (PWT) and peripheral nerve sheath tumors (PNST) have been described. This study investigated the histogenesis in a series of 71 cases of canine STS that showed morphological compatibility with what is described for PWT and PNST. Immunohistochemistry analysis were done to CD56, S100, SMA, Desmin, Von Willebrand Factor, NSE and GFAP. Twenty-one cases (29.6%) showed histopathologic features compatible with PWT, 23 cases (32.4%) with PNST and 27 cases (38.0%) shared both histopathological features. By immunohistochemistry, 59 (83.1%) cases showed positivity only for neural markers and 12 (16.9%) had simultaneous positivity for both neural and muscle markers. PNST was the most prevalent neoplasm and none of the cases were positive for muscle markers only. The histopathologic features were not useful to define the diagnosis of PWT, since most tumors were negative for muscle markers but positive for neural markers. Due to this immunoreactivity and the morphologic features, future studies may propose guidelines for the classification of these neoplasms.(AU)

Sarcoma de tecidos moles (STM) compreende um grupo heterogêneo de neoplasias malignas, derivadas de tecidos extraesqueléticos, que podem apresentar alterações histopatológicas similares. Os padrões histopatológicos sugestivos de tumor de parede perivascular (TPP) e de tumor de bainha de nervo periférico (TBNP) têm sido descritos. Este estudo investigou a histogênese de uma série de 71 STM caninos, que apresentavam compatibilidade morfológica com o que é descrito para TPP e TBNP. A análise imuno-histoquímica foi feita para CD56, S100, SMA, Desmina, Fator Von Willebrand, NSE e GFAP. Vinte e um casos (29,6%) apresentaram características histopatológicas compatíveis com TPP, 23 casos (32,4%) com TBNP e 27 casos (38,0%) apresentaram características histopatológicas de ambos. Na imuno-histoquímica, 59 (83,1%) casos apresentaram positividade somente para marcadores neurais e 12 (16,9%) tiveram positividade simultânea tanto para marcadores neurais como para marcadores musculares. TBNP foi a neoplasia mais prevalente e nenhum dos casos foi positivo para somente para marcadores musculares. As características histopatológicas não foram úteis para definir o diagnóstico de TPP, uma vez que a maioria foi negativa para marcadores musculares, mas positiva para marcadores neurais. Devido a essa imunorreatividade e às características morfológicas, pesquisas futuras poderão propor orientações para a classificação dessas neoplasias.(AU)

Non-rhabdomyosarcoma soft tissue sarcoma in a neonate, a rare and aggressive disease: case report

Neonatal soft tissue sarcomas are a rare group of tumors. The behavior and aggressiveness of neonatal STS is variable. Surgical excision has been noted to be most important factor affecting outcome. However, when non-mutilating surgery is not possible, or resection is incomplete, chemotherapy and radiotherapy have been tried with variable success. We encountered a case of a neonate having large soft tissue mass at anterior abdominal wall. Biopsy and immunohistochemistry confirmed it as undifferentiated soft tissue sarcoma. Surgical excision was incomplete with margin positivity. His disease showed recurrence in short duration of time and despite adjuvant chemotherapy, progression was noted. The child abandoned the treatment and died within 3 months of life.

Radiotherapy of soft tissue sarcoma / 中华放射肿瘤学杂志

Radiation therapy is one of the primary treatment of soft tissue sarcomas.Pre-or postoperative radiotherapy can reduce the risk of tumor local recurrence.Extended local resection combined with pre-or postoperative radiotherapy can achieve long-term survival comparable to those of amputation while preserve the limb function.With the progress of radiation technology in recent years,radiation induced damages of normal tissue is declined.

Oncovascular Surgery: Essential Roles of Vascular Surgeons in Cancer Surgery

For the modern practice of cancer surgery, the concept of oncovascular surgery (OVS), defined as cancer resection with concurrent ligation or reconstruction of a major vascular structure, can be very important. OVS for advanced cancers requires specialized procedures performed by a specialized multidisciplinary team. Roles of oncovascular surgeons are summarized as: a primary surgeon in vessel-origin tumors, a rescue surgeon treating complications during cancer surgery, and a consultant surgeon as a multidisciplinary team for cancer surgery. Vascular surgeons must show leadership in cancer surgery in cases of complex advanced diseases, such as angiosarcoma, leiomyosarcoma, intravenous leiomyomatosis, retroperitoneal soft tissue sarcoma, iatrogenic injury of the major vessels during cancer surgery, pancreatic cancer with vascular invasion, extremity soft tissue sarcoma, melanoma and others.

Clinical application of apatinib in the treatment of advanced bone and soft tissue sar-coma / 中国肿瘤临床

To observe the efficacy and safety of apatinib in the treatment of advanced bone and soft tissue sarcoma, and to analyze the possible related factors affecting the progression-free survival (PFS) of patients. Methods: Twenty-one patients with ad-vanced bone and soft tissue sarcoma admitted to the Department of Orthopaedics, Yunnan Cancer Hospital from June 2017 to Sep-tember 2018, were treated with apatinib tablets. The main efficacy index was progression free survival (PFS), and the secondary effica-cy index was overall survival (OS). Clinical efficacy was evaluated according to response evaluation criteria in solid tumors (RECIST) 1.1, and overall response rate (ORR), disease control rate (DCR), and safety were olserved according to the National Cancer Institute (NCI) 4.0 standard. Results: All of the 21 patients were followed up. At the last follow-up time point, March 31st, 2019, there were no CR, 2 patients (9.5%) with PR, 7 patients with SD (33.3%), and 12 patients with PD (57.1%). The ORR was 9.5%, the DCR was 42.8%, the medi-an PFS was 8 months, and the median OS was 14 months. The patient's gender, age, ECOG score, tissue source, surgery, or chemother-apy had no statistically significant effect on PFS (P>0.05). Only the history of radiotherapy before taking apatinib was a factor for pa-tients with PFS. The effect was statistically significant (P<0.05), and patients with a history of radiotherapy had a lower PFS than pa-tients without a history of radiotherapy. The adverse reactions of gradeⅢand above had hand-foot syndrome (14.3%), pneumotho-rax (14.3%) and anemia (4.8%). Conclusions: Apatinib has a certain effect for advanced bone and soft tissue sarcoma. The adverse re-actions are generally predictable, controllable and reversible. Apatinib can be a choice for patients with advanced bone and soft tissue sarcoma with good treatment adherence and no other treatment options.

Characteristics and Treatment Patterns of Patients with Advanced Soft Tissue Sarcoma in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: A soft tissue sarcoma (STS) is a rare type of cancer, accounting for 1% of adult solid cancers. The aim of the present study is to determine the incidence of localized and advanced STS in Korean patients, their treatment patterns, and the survival of patients by disease status. MATERIALS AND METHODS: The STS patient cohort was defined using National Health Insurance Service medical data from 2002 to 2015. Incidence, distribution, anatomical location of tumors, survival rates (Kaplan-Meyer survival function) and treatment patterns were analyzed by applying different algorithms to the STS cohort containing localized and advanced STS cases. RESULTS: A total of 7,813 patients were diagnosed with STS from 2007 to 2014, 4,307 were localized STS and 3,506 advanced STS cases. The total incidence of STS was 2.49 per 100,000 person- years: 1.37 per 100,000 person-years for localized STS and 1.12 per 100,000 person-years for advanced STS. The 5-year survival rate after diagnosis was 56.4% for all STS, 82.4% for localized, and 27.2% for advanced STS. Half of the advanced STS patients (49.98%) received anthracycline-containing chemotherapy as initial treatment after diagnosis. CONCLUSION: This study provides insights into localized and advanced STS epidemiology, treatment patterns and outcomes in Korea, which could be used as fundamental data in improving clinical outcomes of STS patients in the future.