Imaging strategy for detecting lung metastases at presentation in patients with soft tissue sarcomas

Christie-Large, M.; James, Stanley L.; Tiessen, L.; Davies, A. M.; Grimer, R. J.

doi:10.1016/j.ejca.2008.06.004

Cited by 71 publications

(57 citation statements)

References 11 publications

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“…Whilst the preferred method of imaging is MRI, other options including computerised tomography (CT) or ultrasound may be appropriate depending on local expertise. Patients with a confirmed STS should be staged with a high resolution CT chest to exclude pulmonary metastases prior to definitive treatment, although plain chest X-ray may be acceptable in a minority of cases (e.g., the very elderly and those with small low grade lesions) [17]. CT abdomen and isotope bone scan are not recommended as routine staging investigations, however depending on the histological type and other clinical features, further staging assessments may be recommended (e.g., regional lymph node assessment for synovial sarcoma, clear cell sarcoma or epithelioid sarcoma; abdominal and pelvic CT scan for myxoid liposarcoma).…”

Section: Investigationmentioning

confidence: 99%

Guidelines for the Management of Soft Tissue Sarcomas

Grimer

Judson

Peake

et al. 2010

Sarcoma

276

322

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These guidelines were drawn up following a consensus meeting of UK sarcoma specialists convened under the auspices of the British Sarcoma Group and are intended to provide a framework for the multidisciplinary care of patients with soft tissue sarcomas. The guidelines published by the European Society of Medical Oncology (ESMO) and the National Comprehensive Cancer Network (NCCN) were used as the basis for discussion and adapted according to UK clinical practice and local requirements. Note was also taken of the National Institute for Health and Clinical Excellence (NICE) improving outcomes guidance (IOG) for people with sarcoma and existing technology appraisals. The guidelines are not intended to challenge NICE guidance but discrepancies may exist where current guidance does not reflect an international standard of care owing to the ever-evolving nature of cancer treatment. It is acknowledged that these guidelines will require updating on a regular basis. An appendix lists the key recommendations which are summarised below. Any patient with a suspected soft tissue sarcoma should be referred to a diagnostic centre and managed by a specialist sarcoma multidisciplinary team. Surgical excision followed by post operative radiotherapy is the standard management of high grade limb sarcomas although occasionally amputation remains the only option. Pre-operative treatment with chemotherapy or radiotherapy should be considered for patients with borderline resectable tumours. Isolated limb perfusion may permit limb salvage in some cases where amputation is the only other option. Adjuvant chemotherapy is not routinely recommended but may be considered in certain specific situations. Regular follow up is recommended to assess local control and the development of metastatic disease. Single agent doxorubicin is the standard first line therapy for metastatic disease. Ifosfamide is an alternative if anthracyclines are contraindicated. Combination therapy may be considered in individual patients. Second line agents include ifosfamide, dacarbazine, trabectedin and the combination of gemcitabine + docetaxel. Surgical resection of local recurrence and pulmonary metastases should be considered in individual patients. There is specific guidance on the management of retroperitoneal and uterine sarcomas.

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Section: Investigationmentioning

confidence: 99%

Guidelines for the Management of Soft Tissue Sarcomas

Grimer

Judson

Peake

et al. 2010

Sarcoma

276

322

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“…At the time of diagnosis, a large percentage of patients have distant metastases, most commonly to the lungs via hematogenous spread. 77 Despite optimal treatment, approximately one quarter of patients go on to develop progressive metastatic disease. 78,79 The failure of these systemic treatments has been attributed to the resistance of presumably quiescent mesenchymal cancer stem cells to standard chemotherapeutic agents.…”

Section: Sarcomamentioning

confidence: 99%

LB100, a small molecule inhibitor of PP2A with potent chemo- and radio-sensitizing potential

Zhang

et al. 2015

Cancer Biology & Therapy

103

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“…Additional imaging to complete staging can include an X-ray or a computed tomographic (CT) scan of the chest and an ultrasound or CT scan of the pelvis to identify involved lymph nodes if present. CT scan of the chest is recommended for sarcomas larger than 5 cm or for those with moderate to poor differentiation 11. Nodal involvement is rare, occurring in less than 3% of patients with sarcoma 12.…”

Section: Diagnosis and Stagingmentioning

confidence: 99%

Management of extremity soft tissue sarcomas

Puri

Gulia

2011

IJOO

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Soft-tissue sarcomas are a rare and heterogeneous group of tumors. The last few decades have seen rapid strides in surgery with function preserving alternatives for local control in these lesions becoming the norm without compromising on overall disease survival. Good functional and oncological results can be achieved with a combination of excision of the tumor, and where required, suitable adjuvant therapies. These lesions are best managed at specialty centres where the requisite multidisciplinary care can be offered to the patient to optimise results. This overview is intended as a review of current understanding and the multimodality management of these challenging tumors.

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Imaging strategy for detecting lung metastases at presentation in patients with soft tissue sarcomas

Cited by 71 publications

References 11 publications

Guidelines for the Management of Soft Tissue Sarcomas

Guidelines for the Management of Soft Tissue Sarcomas

LB100, a small molecule inhibitor of PP2A with potent chemo- and radio-sensitizing potential

Management of extremity soft tissue sarcomas

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