Management of soft-tissue sarcomas; treatment strategies, staging, and outcomes

Ramu, Eyal M.; Houdek, Matthew T.; Isaac, Christian E.; Dickie, Colleen; Ferguson, Peter C.; Wunder, Jay S.

doi:10.1051/sicotj/2017010

Cited by 34 publications

(36 citation statements)

References 69 publications

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“…The acute awareness of one's own mortality further contributed to their subjective levels of distress. Some participants found little comfort in learning more about their illness, perhaps because STS is a rare disease with unknown causes and high morbidity 1,2,12 . These factors might make worries in patients with STS unique in their nature.…”

Section: Discussionmentioning

confidence: 99%

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Psychological functioning, coping styles and their relationship to appraisal of physical limitations following invasive surgical procedures for soft‐tissue sarcoma: A qualitative study

Košir

Denis‐Larocque

Tsimicalis

et al. 2020

Journal of Surgical Oncology

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Background and Objectives: This study explored psychological functioning and coping styles in adult patients with soft-tissue sarcoma who underwent surgical procedures in a single expert sarcoma medical center in Canada.Methods: This is a qualitative study with three formats of data collection. The interview guide was based on theoretical health-related quality of life model. We began the investigation with 2 online and 2 in-person focus groups. Four individual semistructured interviews were added to further explore emerging themes. Data were analyzed using inductive thematic networks approach.Results: Twenty-eight adults (13 female, 24-75 years of age) participated. In the domain of psychological functioning we identified three main themes; changes in mood, worry, and body image concerns. In the domain of coping styles, we identified four adaptive coping styles; positive reframing and optimism, finding a purpose, being proactive, and using humor. Among the maladaptive coping styles, we found passive acceptance, and avoidance and denial.

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Section: Discussionmentioning

confidence: 99%

“…Patients with STS typically undergo a combination of invasive surgery and radiation therapy, which can result in disfigurement, wound complications, or amputation 1,2,12 . While these procedures have a curative intention and are largely limb‐sparing, these medical interventions come with a high burden to patients 9 .…”

Section: Introductionmentioning

confidence: 99%

Psychological functioning, coping styles and their relationship to appraisal of physical limitations following invasive surgical procedures for soft‐tissue sarcoma: A qualitative study

Košir

Denis‐Larocque

Tsimicalis

et al. 2020

Journal of Surgical Oncology

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“…However, chemotherapy for SS remains controversial because it is di cult to conduct a prospective study on the e cacy of neoadjuvant therapy, speci cally for this tumor type. Moreover, several pretreatment characteristics, including the tumor size, age, histologic grade, and tumor depth [6,9,11,[14][15][16], in uence the prognosis of a patient with SS and may have affected the results of previous studies.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Neoadjuvant Chemotherapy for Synovial Sarcoma: Retrospective Analysis of a Nationwide Database in Japan

Xu¹,

Aiba²,

Yamamoto³

et al. 2020

Preprint

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BackgroundSynovial sarcoma is an aggressive but chemosensitive soft-tissue tumor. We retrospectively analyzed the efficacy of neoadjuvant chemotherapy for synovial sarcoma with data from the nationwide database, Bone and Soft Tissue Tumor Registry in Japan.MethodsThis study included 316 patients diagnosed with synovial sarcoma between 2006 and 2012. Oncologic outcomes were analyzed using a Cox-hazard regression model. The effects of neoadjuvant chemotherapy on outcomes were evaluated using a matched-pair analysis. The oncologic outcomes of patients who did or did not receive neoadjuvant chemotherapy were compared (cx+ and cx-).ResultsMultivariate analysis revealed significant correlations of distant postoperative metastasis (hazard ratio [HR] = 0.01, p<0.001) with overall survival; surgical margin type (marginal resection, HR=0.12, p=0.011 and intralesional resection, HR=0.08, p=0.022 versus wide resection) with local recurrence; and postoperative local recurrence (HR=0.30, p=0.027) and surgical margin (marginal resection, HR=0.31, p=0.023 versus wide resection) with distant relapse-free survival. Before propensity score matching, neoadjuvant chemotherapy was mainly administered for the patients with younger age, deeper tumor locations, larger tumors, more advanced-stage disease, and monophasic-type disease. The 3-year overall survival rates, local control rates and distant relapse-free survival rates were 82.9% / 80.7% (HR = 0.79, p = 0.102), 91.2% / 89.8% (HR = 1.04, p = 0.837) and 76.6% / 75.0% (HR = 0.76, p = 0.307) in the cx+/cx- groups, respectively. After propensity score matching, 172 patients were selected such that the patient demographics were nearly identical for both the groups. The 3-year overall survival rates, local control rates and distant relapse-free survival rates were 80.8% / 81.4% (HR = 0.83, p = 0.563), 93.2% / 89.4% (HR = 0.83, p = 0.491) and 76.9% / 78.7% (HR = 1.01, p = 0.982) in the cx+ and cx- group, respectively.ConclusionThis large-sample study indicated that the margin status and postoperative disease control were associated directly or indirectly with improved oncologic outcomes. However, the efficacy of neoadjuvant chemotherapy for survival outcomes in synovial sarcoma patients was not proven.

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“…Sarcomas comprise a rare, heterogeneous group of malignant neoplasms that frequently arise from the soft tissue structures of the lower extremity . Current sarcoma management practices utilize a multidisciplinary approach combining limb‐sparing surgery and oncologic therapy to achieve local disease control while preserving the function of the limb . Wide surgical resection of soft tissue sarcomas can lead to large, complex defects with exposure of underlying neurovascular structures, tendons, and/or bone.…”

Section: Introductionmentioning

confidence: 99%

“…Wide surgical resection of soft tissue sarcomas can lead to large, complex defects with exposure of underlying neurovascular structures, tendons, and/or bone. Subsequent reconstructive surgery is often required to provide adequate soft tissue coverage and restore limb function . The utilization of a multidisciplinary approach involving orthopedic and plastic surgeons, medical oncologists, and radiation oncologists has led to limb salvage rates of greater than 90% with favorable oncologic and functional outcomes …”

Section: Introductionmentioning

confidence: 99%

Reconstructive limb‐salvage surgery after lower extremity soft tissue sarcoma resection: A 20‐year experience

Bridgham

Abiad

et al. 2019

Journal of Surgical Oncology

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Background Reconstructive surgery is often required following lower extremity soft tissue sarcoma resection. The relationship between the method of plastic surgery reconstruction and postoperative wound healing or functional oncologic outcomes in this patient population is poorly understood. Methods We performed a retrospective review on all adult patients that underwent soft tissue reconstruction following resection of lower extremity soft tissue sarcomas between 1996 and 2016 at our institution. Results One hundred and thirty‐six patients were identified. Wound complications occurred within 6‐months postoperatively in 72 patients (52.9%). Average time to heal was 13.0 weeks. Limb survival was 94.9%. 16.9% and 36.8% of patients had evidence of local recurrence or metastatic disease, respectively. There was no significant difference in the incidence of overall wound complications, time to heal, limb survival, local recurrence, or metastatic disease between the different reconstructive methods. Conclusions In our cohort, the utilization of different reconstructive techniques did not correlate with a difference in postoperative wound complications or oncologic outcomes. Local flaps can effectively reconstruct the majority of lower extremity sarcoma defects that cannot be closed primarily. However, alternative reconstructive techniques may be utilized when indicated without a significant increase in postoperative morbidity in this patient population.

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Management of soft-tissue sarcomas; treatment strategies, staging, and outcomes

Cited by 34 publications

References 69 publications

Psychological functioning, coping styles and their relationship to appraisal of physical limitations following invasive surgical procedures for soft‐tissue sarcoma: A qualitative study

Psychological functioning, coping styles and their relationship to appraisal of physical limitations following invasive surgical procedures for soft‐tissue sarcoma: A qualitative study

Efficacy of Neoadjuvant Chemotherapy for Synovial Sarcoma: Retrospective Analysis of a Nationwide Database in Japan

Reconstructive limb‐salvage surgery after lower extremity soft tissue sarcoma resection: A 20‐year experience

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