Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.638
Filtrar
1.
In Vivo ; 36(5): 2260-2264, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36099122

RESUMO

BACKGROUND/AIM: Distant metastasis has a strong influence on prognosis in patients with soft tissue sarcoma (STS). While various risk factors have been reported for distant metastases, risk factors for distant metastases early after treatment of primary tumor have not been investigated. This study aimed to evaluate the factors of early distant metastasis after primary tumor resection in patients with STS. PATIENTS AND METHODS: We retrospectively identified patients with STS involving the extremities or trunk without any metastasis at the first visit. Data on clinical information and detailed assessment were collected. We evaluated clinical information as a risk factor for distant or lung metastases. Additionally, we evaluated risk factors for metastases in patients with distant metastases as early as 6 months after the initial resection of the primary tumor. RESULTS: A total of 337 patients were included in the study. Multivariate analysis revealed that the size of the primary tumor (p=0.0011 and p=0.0167), consultation in a short period after onset (p=0.0325 and p=0.0402), histological high grade (p=0.0006 and p=0.0002), and inadequate surgical margin (p=0.0151 and p=0.0055) were significant predictors for poor prognosis for all distant and lung metastases, respectively. However, the only risk factor for early metastases within 6 months was young age (p=0.0148). CONCLUSION: The only risk factor for early distant metastasis after primary tumor resection in patients with STS was young age, even though large tumor diameter and histological high grade were risk factors for distant metastasis.


Assuntos
Neoplasias Pulmonares , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/cirurgia , Estudos Retrospectivos , Fatores de Risco , Neoplasias de Tecidos Moles/patologia
2.
Hinyokika Kiyo ; 68(8): 277-280, 2022 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-36071020

RESUMO

A 36-year-old man presented with painless swelling in the right side scrotum. Ultrasonography showed a hypoechoic tumor with mosaic pattern. Plain computed tomograghy (CT) revealed a 67 mm scrotal cystic lesion with low density area. We suspected an intrascrotal tumor and performed right side radical orchiectomy. The removed sample was yellow clear and elastic hard. A 7 cm multilocular cystic tumor was present on the head side of the normal testis. The cut-surface and the contents of the mass revealed a jelly-like viscous liquid. On the microscopic examination, the tumor was composed of mucinous stroma and spindle-shaped atypical cells with hyperchromatic oval nuclei and eosinophilic cytoplasm. There was a characteristic network of blood vessesls with hyperhyalinization in the myxoid zones. Immunohistochemically, CDK4, MDM2, AE1/AE3, S-100, Alpha-SMA and desmin were negative, but MUC4 showed focal cytoplasmic positivity in the neoplastic cells. In the reverse transcription polymerase chain reaction assay, no FUS-CREB3L2/FUS-CREB3L1 fusion transcripts were identified although the detectable messages of the housekeeping genes were noted. The tumour was finally diagnosed as a paratesticular low-grade fibromyxoid sarcoma. Postoperative course was uneventful and no recurrence or metastasis was seen four months after the operation.


Assuntos
Fibrossarcoma , Neoplasias de Tecidos Moles , Adulto , Fibrossarcoma/genética , Fibrossarcoma/patologia , Humanos , Masculino , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/genética , Neoplasias de Tecidos Moles/patologia
3.
Medicine (Baltimore) ; 101(36): e30127, 2022 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-36086737

RESUMO

The purpose of the present study was to clarify clinical outcomes of elderly patients with soft tissue sarcoma who underwent surgery neither with neoadjuvant nor adjuvant chemotherapy. The median follow-up period was 46.3 (range 6.7-99.0) months. All patients underwent surgical resections. R0 margins were achieved in 24 cases (92.3%) and R1 margins in 2 cases (7.7%). The 1-, 2-, and 5-year sarcoma-specific survival (SSS) rates were 92.3%, 88.5%, and 83.8%, respectively. Multivariate analysis showed no significant risk factors for SSS. No significant relationship of histological grades and local recurrences (P = .56) or distant metastases (P = .54) was shown. In the current study, we observed a comparable survival ratio, despite no neoadjuvant or adjuvant chemotherapies performed. Tumor resections with adequate margins might, at least in part, have contributed to the decent survival ratio regardless of histological grade. Twenty-six consecutive patients aged ≥ 70 years, who underwent surgical resections of soft tissue sarcoma between January 2013 and December 2019, were included. SSS were analyzed by the Kaplan-Meier method, and the relationships between SSS and clinical parameters were evaluated by Cox proportional hazards analysis.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Idoso , Quimioterapia Adjuvante , Humanos , Margens de Excisão , Fatores de Risco , Sarcoma/patologia , Neoplasias de Tecidos Moles/patologia
4.
Acta Chir Plast ; 64(2): 69-75, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36068081

RESUMO

INTRODUCTION: Artificial skin replacements were developed to cover defects in general surgery or after burns. Their main indication in oncologic surgery is secondary resection of appropriate margins in skin tumors after incomplete primary excision. This is contraindicated in sarcomas where only wide excision is indicated. The aim of the study is to show rare possible indications for temporary skin closure (TSC) in extremity soft tissue sarcomas (STS). MATERIALS AND METHODS: Out of 594 patients with extremity STS treated surgically at the Department of Orthopedics, University Hospital Bulovka, Prague, since 2014, we evaluated those with TSC concerning their indications. RESULTS: TSC (Aquagel twice, Parasorb four times, and COM 30 five times) was used in 11 patients. Six cases were on the foot, three on the femur and two on the lower legs. Seven cases were high-grade sarcomas, two cases were synovial sarcomas, one case was low-grade myxofibrosarcoma and one case was low-grade malignant peripheral nerve sheath tumor. We covered tendons five times, bones four times and vessels once. Ten of the 11 cases were recurrent tumors with extensive reconstructions, an increased risk of infection or unclear final histology. Two-stage surgeries seem good indications to decrease the adverse effects of prolonged surgery on flap perfusion or patients status. DISCUSSION: Not only the anesthesiologic, but also oncologic factors, potentiating the adverse effects of prolonged surgery on the patient and flaps, are discussed. The pros and cons of individual indications and their alternatives are compared. CONCLUSION: The indications for TSC in extremity STS are rare, but exist. TSC can be a good solution, enabling a safe two-stage reconstruction at a specialized plastic surgery unit, after an initial wide excision at a department of oncologic surgery. This can be a safer method concerning the perfusion of flaps and general status of an oncologic patient.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Sarcoma , Neoplasias de Tecidos Moles , Adulto , Humanos , Extremidade Inferior/patologia , Extremidade Inferior/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estudos Retrospectivos , Sarcoma/patologia , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia , Retalhos Cirúrgicos
5.
PLoS One ; 17(9): e0273705, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36099287

RESUMO

Soft tissue sarcomas are pleiotropic tumors of mesenchymal cell origin. These tumors are rare in humans but common in veterinary practice, where they comprise up to 15% of canine skin and subcutaneous cancers. Because they present similar morphologies, primary sites, and growth characteristics, they are treated similarly, generally by surgical resection followed by radiation therapy. Previous studies have examined a variety of genetic changes as potential drivers of tumorigenesis and progression in soft tissue sarcomas as well as their use as markers for soft tissue sarcoma subtypes. However, few studies employing next generation sequencing approaches have been published. Here, we have examined gene expression patterns in canine soft tissue sarcomas using RNA-seq analysis of samples obtained from archived formalin-fixed and paraffin-embedded tumors. We provide a computational framework for using resulting data to categorize tumors, perform cross species comparisons and identify genetic changes associated with tumorigenesis. Functional overrepresentation analysis of differentially expressed genes further implicate both common and tumor-type specific transcription factors as potential mediators of tumorigenesis and aggression. Implications for tumor-type specific therapies are discussed. Our results illustrate the potential utility of this approach for the discovery of new therapeutic approaches to the management of canine soft tissue sarcomas and support the view that both common and tumor-type specific mechanisms drive the development of these tumors.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Animais , Carcinogênese , Transformação Celular Neoplásica , Cães , Perfilação da Expressão Gênica , Humanos , Sarcoma/genética , Sarcoma/patologia , Sarcoma/veterinária , Neoplasias de Tecidos Moles/genética , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/veterinária , Transcriptoma
6.
PLoS One ; 17(9): e0274077, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36054224

RESUMO

INTRODUCTION: Superficial soft tissue sarcomas are often left untreated unless they invade the skin and skin ulcers manifest. Progressive sarcomas frequently result in dismal oncological outcomes despite multidisciplinary treatment. This study aimed to identify prognostic factors for superficial soft tissue sarcomas. MATERIALS AND METHODS: This study retrospectively analyzed the clinicopathological data of 82 patients with superficial soft tissue sarcomas treated between August 2003 and December 2020 at our institution. A superficial soft tissue sarcoma was defined if the percentage of the area occupied by the tumor in the assessed region (skin, subcutaneous) was more than 50%. Age, sex, location, tumor size, tumor-skin invasion, tumor grade, and distant metastasis at initial diagnosis were evaluated as potential prognostic factors. Cox proportional hazards regression models were used to identify the prognostic factors. Five-year survival rates were assessed by the Kaplan-Meier method. RESULTS: The mean follow-up time was 60.1 months. The 5-year overall survival, 5-year local recurrence-free survival, and 5-year metastasis survival rates were 76.4%, 60.6%, and 71.0%, respectively. Univariate analysis showed significant relationships between poor prognosis and tumor size ≥5 cm, distant metastasis at initial diagnosis, and tumor-skin invasion. In the multivariate analysis, only the tumor-skin invasion was associated with worse overall survival. CONCLUSIONS: Superficial soft tissue sarcomas have biologically been considered a separate category due to their better prognosis. In this study, the tumor-skin invasion was the only significant factor associated with a poor prognosis. Therefore, all superficial soft tissue sarcomas without tumor-skin invasion should be treated as early as possible.


Assuntos
Sarcoma , Neoplasias Cutâneas , Neoplasias de Tecidos Moles , Humanos , Recidiva Local de Neoplasia/patologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Sarcoma/patologia , Neoplasias de Tecidos Moles/patologia
9.
Comput Math Methods Med ; 2022: 3287961, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35991143

RESUMO

Methods: The medical data of 47 patients with refractory bone and soft tissue sarcoma, who received anlotinib from January 2019 to December 2020, were retrospectively collected. The overall response rate (ORR) and disease control rate (DCR) were evaluated according to the solid tumor response evaluation version 1.1 standard. The progression-free survival (PFS), overall survival (OS), and adverse reactions were recorded. Results: A total of 44 patients, including 13 with osteosarcoma and 31 with soft tissue sarcoma, were enrolled in this study. Among patients with osteosarcoma, no patients achieved complete response (CR) or partial response (PR), while seven patients (54%) had stable disease (SD). Besides, the median PFS (m-PFS) was 4.4 months, and the median OS (m-OS) was 15.7 months. Among patients with soft tissue sarcoma, the ORR and DCR were 19% and 71%, respectively. The median m-PFS was 5.4 months, and m-OS was 17.9 months. Anlotinib plus chemotherapy had a higher ORR compared with anlotinib monotherapy (6% vs. 38%, P = 0.047). The most common grade 3/4 adverse reactions were pneumothorax (5%) and pleural effusion (5%), and no treatment-related deaths occurred. Conclusions: Anlotinib alone showed encouraging efficacy and favorable tolerability in refractory bone and soft tissue sarcoma. Anlotinib plus chemotherapy did not show a significant clinical benefit compared with anlotinib alone. Anlotinib showed better tumor control when used as first-line drug treatment in refractory bone and soft tissue sarcoma.


Assuntos
Neoplasias Ósseas , Osteossarcoma , Sarcoma , Neoplasias de Tecidos Moles , Neoplasias Ósseas/tratamento farmacológico , Humanos , Indóis , Quinolinas , Estudos Retrospectivos , Sarcoma/tratamento farmacológico , Neoplasias de Tecidos Moles/tratamento farmacológico , Neoplasias de Tecidos Moles/patologia , Resultado do Tratamento
10.
Anticancer Res ; 42(9): 4619-4626, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36039442

RESUMO

BACKGROUND/AIM: This study aimed to retrospectively investigate clinical outcomes after tumor resection surgery and discuss reconstruction methods and postoperative complications. PATIENTS AND METHODS: We analyzed the clinical outcomes, such as graft survival and prognosis, of nine patients with bone and soft-tissue tumors of the extremities with major vascular invasion who underwent limb-sparing surgery with vascular reconstruction between January 2006 and December 2020. RESULTS: The primary tumor was malignant in eight cases and intermediate in one case, with a mean postoperative follow-up duration of 52.1 months. A total of 10 vascular reconstructions (arterial in eight patients and both arterial and venous in one) were performed with autologous vein grafts in four cases and synthetic grafts in five cases. Graft occlusion was observed in two cases reconstructed with the great saphenous vein measuring >200 mm in length, and the 5-year arterial patency rate was 8/9. Only one case showed local recurrence, and at 5 years, local control was achieved in eight out of nine patients. Limb-sparing was achieved in all cases and the 5-year overall and disease-free survival rates were 77.8%. Postoperative complications occurred in six patients and wound-related complications were improved by re-surgery, while the others were controlled by conservative treatment. CONCLUSION: Limb-sparing tumor resection surgery with vascular reconstruction has favorable clinical and oncological outcomes. Most postoperative complications related to this surgery can be controlled by conservative treatment, except for wound-related complications. In reconstructions with autologous vein grafts of a length exceeding 200 mm, the graft occlusion rate may increase, and synthetic grafts may be recommended.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Extremidades/patologia , Humanos , Salvamento de Membro/métodos , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Veia Safena/patologia , Veia Safena/transplante , Sarcoma/patologia , Neoplasias de Tecidos Moles/patologia , Resultado do Tratamento
11.
Anticancer Res ; 42(9): 4485-4492, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36039460

RESUMO

BACKGROUND/AIM: Leiomyosarcomas account for 2-10% of all extremity soft tissue sarcomas. The role of intraoperative brachytherapy as an additive booster therapy is not clearly defined. This study focused on the additive value of brachytherapy in the treatment of leiomyosarcomas on the extremities. PATIENTS AND METHODS: This retrospective multicenter study compared treatment outcomes of 94 patients diagnosed with a primary leiomyosarcoma in their extremities. Patients were divided into three groups according to their radiotherapy protocol: a) adjuvant radiotherapy (aRT), b) neoadjuvant radiotherapy (nRT) and c) intraoperative brachytherapy combined with adjuvant radiotherapy (IOBTaRT). These three treatment groups were compared for local control, time to metastasis, and overall survival. RESULTS: Eleven patients were treated with IOBTaRT, 35 patients with aRT, and seven patients with nRT only. The survival time was 157.6 months for patients in the IORTaRT group, and 111.3 months for patients treated with aRT only. The time to local recurrence was 141.5 months for patients treated with IOBTaRT and 106.1 months for patients treated with aRT. The estimated time to metastasis was 34.6 months for patients in the IOBTaRT group and 69.7 months for patients treated with aRT alone. No significant differences were observed between these treatment groups concerning overall survival, local recurrence, or metastasis. CONCLUSION: Additive brachytherapy did not provide a significant advantage in the treatment of leiomyosarcomas. However, this study was limited by the number of patients per group.


Assuntos
Braquiterapia , Leiomiossarcoma , Neoplasias de Tecidos Moles , Braquiterapia/métodos , Extremidades/patologia , Humanos , Leiomiossarcoma/radioterapia , Leiomiossarcoma/cirurgia , Recidiva Local de Neoplasia/etiologia , Recidiva Local de Neoplasia/radioterapia , Dosagem Radioterapêutica , Radioterapia Adjuvante , Estudos Retrospectivos , Neoplasias de Tecidos Moles/patologia
12.
Am J Dermatopathol ; 44(9): 623-631, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35980090

RESUMO

ABSTRACT: Myopericytoma is a rare soft tissue tumor with a predilection for the distal extremities. It is commonly found in the skin and subcutaneous tissues and usually takes a benign course. Current knowledge is limited to isolated case series and reports; hence, this study aims to report our tertiary institution's experience with this uncommon entity. A review of our institution's pathology records for cases of myopericytoma was performed. From January 2009 to September 2020, 23 cases of myopericytoma were identified and their clinicopathologic features were reported. A unique case of myopericytoma of the ankle from the series was also highlighted as a case report. Among the 22 cutaneous cases, 18 were in the extremities and 4 in the head and neck. One patient had an intracranial lesion. Most patients developed asymptomatic nodules (72.2%), but 1 patient had a locally aggressive tumor on presentation. None recurred despite marginal excision in some patients (80.0%). In conclusion, pathologists and surgeons who encounter this rare neoplasm can reassure patients of its benign tendency.


Assuntos
Miopericitoma , Neoplasias de Tecidos Moles , Humanos , Miopericitoma/patologia , Miopericitoma/cirurgia , Recidiva Local de Neoplasia , Pele/patologia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia
13.
Lancet Oncol ; 23(9): 1156-1166, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35934010

RESUMO

BACKGROUND: Few standard treatment options are available for patients with metastatic sarcomas. We did this trial to evaluate the efficacy, safety, and changes in the tumour microenvironment for durvalumab, an anti-PD-L1 drug, and tremelimumab, an anti-CTLA-4 drug, across multiple sarcoma subtypes. METHODS: In this single-centre phase 2 trial, done at The University of Texas MD Anderson Cancer Center (Houston, TX USA), patients aged 18 years or older with advanced or metastatic sarcoma with an Eastern Cooperative Oncology Group performance status of 0 or 1 who had received at least one previous line of systemic therapy were enrolled in disease subtype-specific groups (liposarcoma, leiomyosarcoma, angiosarcoma, undifferentiated pleomorphic sarcoma, synovial sarcoma, osteosarcoma, alveolar soft-part sarcoma, chordoma, and other sarcomas). Patients received 1500 mg intravenous durvalumab and 75 mg intravenous tremelimumab for four cycles, followed by durvalumab alone every 4 weeks for up to 12 months. The primary endpoint was progression-free survival at 12 weeks in the intention-to-treat population (all patients who received at least one dose of treatment). Safety was also analysed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT02815995, and is completed. FINDINGS: Between Aug 17, 2016, and April 9, 2018, 62 patients were enrolled, of whom 57 (92%) received treatment and were included in the intention-to-treat population. With a median follow-up of 37·2 months (IQR 1·8-10·1), progression-free survival at 12 weeks was 49% (95% CI 36-61). 21 grade 3-4 treatment-related adverse events were reported, the most common of which were increased lipase (four [7%] of 57 patients), colitis (three [5%] patients), and pneumonitis (three [5%] patients). Nine (16%) patients had a treatment related serious adverse event. One patient had grade 5 pneumonitis and colitis. INTERPRETATION: The combination of durvalumab and tremelimumab is an active treatment regimen for advanced or metastatic sarcoma and merits evaluation in specific subsets in future trials. FUNDING: AstraZeneca.


Assuntos
Neoplasias Ósseas , Colite , Osteossarcoma , Pneumonia , Sarcoma Alveolar de Partes Moles , Neoplasias de Tecidos Moles , Anticorpos Monoclonais , Anticorpos Monoclonais Humanizados , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias Ósseas/tratamento farmacológico , Humanos , Osteossarcoma/tratamento farmacológico , Sarcoma Alveolar de Partes Moles/tratamento farmacológico , Neoplasias de Tecidos Moles/patologia , Microambiente Tumoral
14.
Surg Clin North Am ; 102(4): 551-565, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35952687

RESUMO

The potentially curative treatment of sarcoma is negative margin wide resection, the clinical tumor with an en bloc margin of surrounding tissue potentially contains microscopic tumor. Planned margins should be 1 to 2 cm but can be less for oncologically equivalent barrier tissues or to preserve an adjacent critical structure. Tumor spillage should be avoided. The role of radiation and/or chemotherapy should be discussed before surgery, as there are potential benefits to preoperative administration. An isolated local recurrence is potentially curable. Amputation is rarely necessary and should only be pursued after other limb salvage treatment options have been considered.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Amputação , Extremidades/patologia , Extremidades/cirurgia , Humanos , Salvamento de Membro , Margens de Excisão , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Sarcoma/patologia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia
15.
Surg Clin North Am ; 102(4): 567-582, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35952688

RESUMO

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 radiation therapy for retroperitoneal sarcoma is controversial; when used, preoperative delivery of radiation is recommended.


Assuntos
Neoplasias Retroperitoneais , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Dosagem Radioterapêutica , Radioterapia Adjuvante , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/radioterapia , Neoplasias Retroperitoneais/cirurgia , Sarcoma/patologia , Sarcoma/radioterapia , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/radioterapia , Neoplasias de Tecidos Moles/cirurgia
16.
Surg Clin North Am ; 102(4): 601-614, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35952690

RESUMO

Retroperitoneal sarcomas (RPS) are a rare subset of soft tissue sarcoma that are composed of only a few histologic subtypes, each with a distinct tumor biology, clinical presentation, preferred treatment strategy, recurrence risk, and surveillance plan. In the modern era of precision medicine, our understanding of the implications of subtype tumor biology and anatomic location has led to a more nuanced, histology-specific approach to therapy, including surgery, neoadjuvant radiation therapy, and/or chemotherapy. This article provides a summary of recent updates to the management of RPS.


Assuntos
Neoplasias Retroperitoneais , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Terapia Neoadjuvante , Neoplasias Retroperitoneais/patologia , Sarcoma/diagnóstico , Sarcoma/patologia , Sarcoma/terapia , Neoplasias de Tecidos Moles/patologia
17.
Surg Clin North Am ; 102(4): 637-656, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35952693

RESUMO

Lipomatous tumors are among the most common soft tissue lesions encountered by the general surgeon. Shared history and clinical presentation make differentiation between benign lipomas and low-grade liposarcomas a diagnostic dilemma. 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.


Assuntos
Lipoma , Lipossarcoma , Neoplasias de Tecidos Moles , Humanos , Lipoma/diagnóstico , Lipoma/patologia , Lipoma/cirurgia , Lipossarcoma/diagnóstico , Lipossarcoma/patologia , Lipossarcoma/cirurgia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia
18.
Acta Orthop Traumatol Turc ; 56(4): 272-277, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35968619

RESUMO

OBJECTIVE: This study aimed to (1) compare the oncological results of patients who underwent re-excision after unplanned excision with those who underwent planned excision and (2) analyze the impact of local recurrences on oncological outcomes. METHODS: Patients with soft tissue sarcoma who had been treated in our center between 2000 and 2018 were retrospectively reviewed. Patients were divided into two groups: Group PE (Planned excision; n=345) and group UE (Unplanned excision; n=145). Two groups were compared in terms of local recurrence-free survival (LRFS), metastasis-free survival (MFS), and overall survival (OS). Local recurrences effects over MFS and OS were also analyzed. RESULTS: There were 26 (17.9%) local recurrences in the UE group and 30 (8.7%) local recurrences in the PE group (P=0.005). There was no difference in MFS and OS between study groups (P=0.278 and P=0.848, respectively). Five years MFS rates of UE and PE groups were 76.4% and 73.6%, and five-year OS rates of UE and PE groups were 70.3% and 73.9%, respectively (P=0.417, P=0.656). Patients with local recurrence had a 1.96 times higher risk of metastasis than patients without local recurrence (P=0.008). Patients with local recurrence had 1.65 times higher risk of mortality than patients without local recurrence (P=0.047). CONCLUSION: Although local recurrence is much more common in the UE group, this outcome does not seem to affect MFS or OS. These results indicate that similar outcomes can be achieved if UE patients are referred and appropriately treated with wide re-resections. LEVEL OF EVIDENCE: Level III, Therapeutic Study.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Humanos , Reoperação , Estudos Retrospectivos , Sarcoma/patologia , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/patologia , Taxa de Sobrevida
19.
BMC Cancer ; 22(1): 891, 2022 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-35971085

RESUMO

BACKGROUND: Alveolar soft part sarcoma (ASPS) is a rare histological subtype of soft-tissue sarcoma, which remains refractory to conventional cytotoxic chemotherapy. We aimed to characterize ASPS and investigate whether the oncological outcome has improved over the past decade. METHODS: One hundred and twenty patients with newly diagnosed ASPS from 2006 to 2017, identified from the Bone and Soft-Tissue Tumor Registry in Japan, were analyzed retrospectively. RESULTS: The study cohort comprised 34 (28%) patients with localized ASPS and 86 (72%) with metastatic disease at presentation. The 5-year disease-specific survival (DSS) was 68% for all patients and 86% and 62% for localized and metastatic disease, respectively (p = 0.019). Metastasis at presentation was the only adverse prognostic factor for DSS (hazard ratio [HR]: 7.65; p = 0.048). Patients who were > 25 years (80%; p = 0.023), had deep-seated tumors (75%; p = 0.002), and tumors > 5 cm (5-10 cm, 81%; > 10 cm, 81%; p < 0.001) were more likely to have metastases at presentation. In patients with localized ASPS, adjuvant chemotherapy or radiotherapy did not affect survival, and 13 patients (45%) developed distant metastases in the lung (n = 12, 92%) and brain (n = 2, 15%). In patients with metastatic ASPS (lung, n = 85 [99%]; bone, n = 12 [14%]; and brain n = 9 [11%]), surgery for the primary or metastatic site did not affect survival. Prolonged survival was seen in patients who received pazopanib treatment (p = 0.045), but not in those who received doxorubicin-based cytotoxic chemotherapy. Overall, improved DSS for metastatic ASPS has been observed since 2012 (5-year DSS, from 58 to 65%) when pazopanib was approved for advanced diseases, although without a statistically significant difference (p = 0.117). CONCLUSION: The national study confirmed a unique feature of ASPS with frequent metastasis to the lung and brain but an indolent clinical course. An overall trend toward prolonged survival after the introduction of targeted therapy encourages continuous efforts to develop novel therapeutic options for this therapeutically resistant soft-tissue sarcoma.


Assuntos
Sarcoma Alveolar de Partes Moles , Neoplasias de Tecidos Moles , Doxorrubicina/uso terapêutico , Humanos , Estudos Retrospectivos , Sarcoma Alveolar de Partes Moles/diagnóstico , Sarcoma Alveolar de Partes Moles/patologia , Sarcoma Alveolar de Partes Moles/terapia , Neoplasias de Tecidos Moles/patologia , Taxa de Sobrevida
20.
Cardiovasc Pathol ; 60: 107451, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35835430

RESUMO

Primary sarcoma of the aorta is extremely rare. We herein report a case of DICER1-associated sarcoma originating from the aortic arch. A 45-year-old male was admitted to the hospital with a cold left hand and a weakened radial artery pulse on the left side. Computed tomography of the chest showed multiple penetrating ulcers with tumor-like ectasia at the aortic arch, diagnosed as a pseudoaneurysm. Histopathological analysis of the mass revealed a biphasic neoplasm composed of epithelial and mesenchymal components and a transition zone between the epithelial and mesenchymal cells, which supports the diagnosis of a biphasic sarcoma rather than carcinosarcoma. The differentiated cells of soft tissue showed strong and diffuse positivity for TLE-1, Bcl-2, and CD99; the nested epithelial cells were focally positive for CK-pan but negative for EMA, membranous localization of ß-catenin. This case showed a unique pattern of SS18-break-apart probe, with loss of the green signal (approximately 33%) by fluorescence in situ hybridization (FISH). Fusion gene profiling using whole transcriptome RNA sequencing (RNA-seq) indicated that this case was negative for common fusion genes including SS18. Next-generation sequencing (NGS) revealed somatic mutations in DICER1. Taken together, this case was diagnosed as a DICER-associated biphasic sarcoma of the aortic arch. The patient died four months after aorta replacement therapy without radiotherapy and chemotherapy.


Assuntos
Sarcoma Sinovial , Sarcoma , Neoplasias de Tecidos Moles , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/patologia , Biomarcadores Tumorais/genética , RNA Helicases DEAD-box/genética , Humanos , Hibridização in Situ Fluorescente , Masculino , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Repressoras/genética , Ribonuclease III/genética , Sarcoma/genética , Sarcoma Sinovial/genética , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/genética , Neoplasias de Tecidos Moles/patologia , beta Catenina
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...