Soft Tissue Sarcomas

Abstract

Sarcomas are a heterogeneous group of rare tumors that arise predominantly from the embryonic mesoderm. They present most commonly as an asymptomatic mass originating in an extremity but can occur anywhere in the body, particularly the trunk, retroperitoneum, or the head and neck. Pretreatment radiologic imaging is critical for defining the local extent of a tumor, staging the disease, guiding biopsies, and aiding in diagnosis. Core-needle biopsy is the preferred biopsy technique for diagnosing soft tissue sarcomas. The American Joint Committee on Cancer (AJCC) staging system for soft tissue sarcomas is based on histologic grade, the tumor size and depth, and the presence of distant or nodal metastases.Despite improvements in local control rates with wide local resections and radiation therapy, metastasis and death remain a significant problem in 50% of patients who present with high-risk soft tissue sarcomas. The most common site of metastasis is the lungs, and metastasis generally occurs within two to three years after the completion of therapy. Progress in the molecular characteristics of these tumors should in the near future translate into molecularly based therapies that can be incorporated into standard treatment strategies. (CA Cancer J Clin 2004;54:94 -109.) © American Cancer Society, 2004.

Fas Death Pathway in Sarcomas Correlates with Epidermal Growth Factor Transcription

“…Chemotherapy alone or in combination with radiotherapy is frequently employed against a variety of mesenchymal tumors to induce tumor shrinkage, thus facilitating surgical resection [5,7,8,29,36]. Most chemotherapeutic agents accomplish this task by inducing apoptosis [10,32] through the induction of a death receptor [35] or by activation of the endogenous mitochondrial death pathway [12,23].…”

Global Protein-expression Analysis of Bone and Soft Tissue Sarcomas

“…Over the past three decades, advances in diagnostic modalities and treatment methods have substantially improved the survival rate and postoperative limb function of patients with bone and soft tissue sarcomas [5,10,20,27,40]. Wide excision of tumors in conjunction with multiagent chemotherapy now provides 5-year diseasespecific survivals ranging from 60% to 80% in patients with localized high-grade sarcomas [2,5,27].…”

“…Wide excision of tumors in conjunction with multiagent chemotherapy now provides 5-year diseasespecific survivals ranging from 60% to 80% in patients with localized high-grade sarcomas [2,5,27]. Despite this success, the outcomes of patients who have metastatic disease at diagnosis or those with tumors showing a poor response to chemotherapy are still unsatisfactory (5-year disease-specific survival rates, 20%-40%), even with doseintensive or high-dose chemotherapy [9,18,19,33].…”

Multidisciplinary management of soft tissue sarcomas: it’s time to make a team!

“…osteoid or chondroid) produced in bone sarcoma (BS). Musculoskeletal tumours arise anywhere in the body, although lower extremities are the most common site of appearance followed by upper extremities, trunk, retroperitoneum and head and neck area [1][2][3][4][5].…”