Brazilian consensus on the diagnosis and treatment of extremities soft tissue sarcomas

Spencer, Ranyell M.S.S.B.; Camargo, Veridiana Pires de; Silva, Maria L.G.; Pinto, Fábio; Costa, Felipe D’Almeida; Cequeira, Wagner S.; Munhoz, Rodrigo Ramella; Mello, Celso Abdon Lopes de; Schmerling, Rafael; Filho, Waldec Jorge David; Coelho, Tharcisio Machado; Ambrósio, Alexandre; Leite, Elton Trigo Teixeira; Hanna, Samir Abdallah; Nakagawa, Suely Akiko; Baptista, André Mathias; Pinheiro, Rodrigo Nascimento; Oliveira, Jadivan Leite de; Araújo, Marcelo S.á. de; Araújo, Raphael Leonardo Cunha de; Laporte, Gustavo Andreazza; Quadros, Claudio de Almeida; Oliveira, Alexandre Ferreira; Lopes, Ademar

doi:10.1002/jso.25847

Cited by 8 publications

(11 citation statements)

References 102 publications

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“…The majority of respondents were still administering neoadjuvant (82.6%) and adjuvant chemotherapy (82.4%), as well as neoadjuvant (72.4%) and adjuvant radiotherapy (77.2%). Although palliative chemotherapy and radiation therapy can relieve symptoms and improve quality of life in seriously ill patients [13], these therapies were reported by 16.7% and 20.3% of our respondents to have been stopped or delayed, respectively.…”

Section: Discussionmentioning

confidence: 75%

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Impact of the COVID-19 pandemic on patients suffering from musculoskeletal tumours

Thaler

Khosravi

Leithner

et al. 2020

International Orthopaedics (SICOT)

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Background The aim of the current study was to evaluate the impact of the coronavirus disease (COVID-19) pandemic on musculoskeletal tumor service by conducting an online survey of physicians. Methods The survey was conducted among the members of the ISOLS (International Society of Limb Salvage) and the EMSOS (European Musculo-Skeletal Oncology Society). The survey consisted of 20 questions (single, multiple-response, ranked): origin and surgical experience of the participant (four questions), potential disruption of healthcare (12 questions), and influence of the COVID-19 pandemic on the particular physician (four questions). A matrix with four different response options was created for the particular surgical procedures). Results One hundred forty-nine physicians from five continents completed the survey. Of the respondents, 20.1% and 20.7% stated that surgery for life-threatening sarcomas were stopped or delayed, respectively. Even when the malignancy was expected to involve infiltration of a neurovascular bundle or fracture of a bone, still 13.8% and 14.7% of the respondents, respectively, stated that surgery was not performed. In cases of pending fractures of bone tumors, 37.5 to 46.2% of operations were canceled. Conclusion The SARS-CoV-2 pandemic caused a significant reduction in healthcare (surgery, radiotherapy, chemotherapy) for malignancies of the musculoskeletal system. Delaying or stopping these treatments is life-threatening or can cause severe morbidity, pain, and loss of function. Although the coronavirus disease causes severe medical complications, serious collateral damage including death due to delayed or untreated sarcomas should be avoided.

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Section: Discussionmentioning

confidence: 75%

“…Geographically, physicians from Asia, Europe, Australia, North, and South America responded. Most respondents were from the USA (20), followed by Japan (14), India (13), and Italy (12).…”

Section: Resultsmentioning

confidence: 99%

Impact of the COVID-19 pandemic on patients suffering from musculoskeletal tumours

Thaler

Khosravi

Leithner

et al. 2020

International Orthopaedics (SICOT)

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“…However, the median overall survival (OS) of patients with metastatic disease does not surpass 20 months in the most recent trials [6]. Doxorubicin continues to be the standard treatment for most histologies in the first line [3,7]. The combination of doxorubicin with other agents did not proved to increase OS, despite the increment in the response rate (RR) [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…Doxorubicin continues to be the standard treatment for most histologies in the first line [ 3 , 7 ]. The combination of doxorubicin with other agents did not proved to increase OS, despite the increment in the response rate (RR) [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Combination of ifosfamide and etoposide as a salvage regimen for previously treated soft tissue sarcomas: a retrospective single centre study

Ribeiro¹,

Campos²,

Mello³

2022

ecancer

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Introduction: Systemic treatment for metastatic soft tissue sarcoma (STS) results in modest activity in second and further lines. The aim of this study was to evaluate the efficacy of ifosfamide and etoposide (IE) as a salvage regimen for patients with metastatic STS. Methods:A retrospective, single centre study included patients with STS treated with IE from 2010 to 2018. The primary endpoint was progression-free survival (PFS). Secondary endpoints were toxicity, response rate (RR) and overall survival (OS). Survival was estimated by the Kaplan-Meier method and log-rank test used to compare the groups.Results: A total of 33 patients were identified, median age was 43 years, 60% were female, 12 had leiomyosarcoma. IE was used in second line in 51.5% and in >third line in 30.3% of patients. Median number of cycles was four and treatment discontinuation due to grade 3/4 toxicity occurred in 30.3%. The objective RR was 9% and the disease control rate was 60.6%. Median PFS was 4 months (95% CI, 2.1-5.9) and the median OS was 15 months (95% CI, 7.1-22.9). In the univariate analysis, smoking history, line of therapy and prior response to previous chemotherapy were prognostic factors for PFS. Conclusion:IE showed activity in previously treated STS, but with a non-negligible toxicity profile, worse than that with other available therapies. The use of the IE combination is not supported by our findings outside a clinical trial for soft part sarcomas.

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“…The pathogenesis of desmoid fibroma has not yet been elucidated, and it is considered to be closely related to many factors, such as heredity, hormones, previous surgery, and trauma. Because of its complex imaging features, differential diagnosis is difficult, resulting in a low incidence of preoperative diagnosis[ 4 - 6 ]. Therefore, it is of great significance to clarify the clinical and imaging features of desmoid tumors of the extremities.…”

Section: Introductionmentioning

confidence: 99%

Clinical and imaging features of desmoid tumors of the extremities

Shi¹,

Zhao²,

Jiang³

et al. 2021

WJCC

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BACKGROUND Desmoid fibroma is a rare soft tissue tumor originating from the aponeurosis, fascia, and muscle, and it is also known as aponeurotic fibroma, invasive fibroma, or ligamentous fibroma. AIM To investigate the clinical and imaging features of desmoid tumors of the extremities. METHODS Thirteen patients with desmoid fibroma of the extremities admitted to our hospital from October 2016 to March 2021 were included. All patients underwent computed tomography (CT), magnetic resonance imaging (MRI), and pathological examination of the lesion. Data on the diameter and distribution of the lesion, the relationship between the lesion morphology and surrounding structures, MRI and CT findings, and pathological features were statistically analyzed. RESULTS The lesion diameter ranged from 1.7 to 8.9 cm, with an average of 5.35 ± 2.39 cm. All lesions were located in the deep muscular space, with the left and right forearm each accounting for 23.08% of cases. Among the 13 patients with desmoid fibroma of the extremities, the lesions were "patchy" in 1 case, irregular in 10, and quasi-round in 2. The boundary between the lesion and surrounding soft tissue was blurred in 10 cases, and the focus infiltrated along the tissue space and invaded the adjacent structures. Furthermore, the edge of the lesion showed "beard-like" infiltration in 2 cases; bone resorption and damage were found in 8, and bending of the bone was present in 2; the boundary of the focus was clear in 1. According to the MRI examination, the lesions were larger than 5 cm (61.54%), round or fusiform in shape (84.62%), had an unclear boundary (76.92%), showed uniform signal (69.23%), inhomogeneous enhancement (84.62%), and "root" or "claw" infiltration (69.23%). Neurovascular tract invasion was present in 30.77% of cases. CT examination showed that the desmoid tumors had slightly a lower density (69.23%), higher enhancement (61.54%), and unclear boundary (84.62%); a CT value < 50 Hu was present in 53.85% of lesions, and the enhancement was uneven in 53.85% of cases. Microscopically, fibroblasts and myofibroblasts were arranged in strands and bundles, without obvious atypia but with occasional karyotyping; cells were surrounded by collagen tissue. There were disparities in the proportion of collagen tissue in different regions, with abundant collagen tissue and few tumor cells in some areas, similar to the structure of aponeuroses or ligaments, and tumor cells invading the surrounding tissues. CONCLUSION Desmoid tumors of the extremities have certain imaging features on CT and MRI. The two imaging techniques can be combined to improve the diagnostic accuracy, achieve a comprehensive diagnosis of the disease in the clinical practice, and reduce the risk of missed diagnosis or misdiagnosis. In addition, their use can ensure timely diagnosis and treatment.

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Brazilian consensus on the diagnosis and treatment of extremities soft tissue sarcomas

Cited by 8 publications

References 102 publications

Impact of the COVID-19 pandemic on patients suffering from musculoskeletal tumours

Impact of the COVID-19 pandemic on patients suffering from musculoskeletal tumours

Combination of ifosfamide and etoposide as a salvage regimen for previously treated soft tissue sarcomas: a retrospective single centre study

Clinical and imaging features of desmoid tumors of the extremities

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