Homogenous Good Outcome in a Heterogeneous Group of Tumors: An Institutional Series of Outcomes of Superficial Soft Tissue Sarcomas.

Introduction. Superficial soft tissue sarcomas (S-STS) are generally amenable to wide excision. We hypothesized that local recurrence (LR) should be low, even without radiation therapy (RT), and sought to examine the contribution of depth to LR and OS. Methods. Patients with S-STS were retrospectively reviewed. Demographics, tumor features, treatment received, and outcomes were analyzed. Results. 103 patients were identified. Median age was 55 years; 53% of patients were female. Tumor site was 39% in trunk, 38% in the lower extremity, 14% in the upper extremity, and 9% in other locations. The most common histology was 36% leiomyosarcoma. Median tumor size was 2.8 cm (range 0.2-14 cm). Sixty-six percent of tumors were of intermediate/high grade. RT was administered preoperatively in 6% of patients and postoperatively in 15% of patients. An R0 resection was accomplished in 92%. At a median follow-up of 34.2 months (range 2.3-176), 9 patients had a LR (8.7%). Tumor size and grade were not associated with LR. OS was not associated with any tumor or patient variables on univariate analysis. Conclusions. LR was low for S-STS, even with large or high grade tumors and selective use of RT. Surgical resection alone may be adequate therapy for most patients. Superficial location seems to supersede other factors imparting a good prognosis for this group of tumors.

Targeting the heat shock response in cancer: tipping the balance in transformed cells.

The elucidation of the heat shock response (HSR) as a mediator of cellular stress has created a framework for understanding how these processes may promote tumorigenesis. Furthermore, the identification of specific components of the HSR and how they are co-opted by cancer cells has led to the discovery of new therapeutic targets. A wide range of small molecule inhibitors of the HSR are in various stages of development for clinical application in patients with cancer. The introduction of these novel small molecule inhibitors offers the opportunity for synergy with existing therapies and the potential for highly targeted treatments.

Quality of life after an esophagectomy.

Specialized centers have reduced the adverse outcomes associated with esophagectomy in the last 2 decades and now report operative mortalities of less than 5%. With the expanding use of screening endoscopy, early invasive esophageal adenocarcinoma is diagnosed more commonly. As a result, more patients enjoy long-term survival after curative resection. Simultaneously, emerging evidence supports the equivalence of competing endoscopic therapies for treatment of very early cancers and benign diseases. Accordingly, surgical resection requires re-evaluation using enhanced parameters to enable more meaningful comparative outcome analyses. This article summarizes the current evidence and examines future directions regarding esophagectomy quality of life.