Soft-Tissue Sarcomas in Adults

Clark, Matthew A.; Fisher, Cyril; Judson, Ian; Thomas, Joseph

doi:10.1056/nejmra041866

Cited by 795 publications

(666 citation statements)

References 89 publications

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“…There was an overall gradual increase in ASR over the entire period with peak incidence in 2003, this is comparable to some extent with the overall increase in incidence rates of STS worldwide most probably due to better recognition and diagnosis as well as the influence of risk factors 19. This increase in incidence was highly significant statistically.…”

Section: Discussionsupporting

confidence: 54%

“…Majority of all STS where stage of tumor was recorded were already at an advanced (Stage IV) at the time of diagnosis but STS in limbs was discovered in earlier. Advanced stage of tumors at presentation could be one of the reasons for the lower relative survival of STS in Ireland 19, 20. The staging data were only complete in a low number, hence a robust association with survival is not possible to make.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiological study of soft‐tissue sarcomas in Ireland

et al. 2015

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Soft‐tissue sarcomas (STS) account for 1% of adult and 7% of pediatric malignancies. Histopathology and classification of these rare tumors requires further refinements. The aim of this paper is to describe the current incidence and survival of STS from 1994 to 2012 in Ireland and compare these with comparably coded international published reports. This is a retrospective, population study based on the data from the National Cancer Registry of Ireland (NCRI). Incidence and relative survival rates for STS in Ireland were generated. Incidence of STS based on gender, age and anatomical location was examined. Annual mean incidence rate (European Age Standardized) in Ireland between 1994 and 2012 was 4.48 ± 0.15 per 100,000 person‐years. The overall relative 5‐year survival rate of STS for the period 1994–2011 in Ireland was 56%, which was similar to that reported in the U.K. but lower than in most of Europe and U.S.A. Survival rate fluctuated over the period examined, declining slightly in females but showing an increase in males. STS incidence trends in Ireland were comparable to international reports. Survival trends of STS were significantly different between Ireland and other European countries, requiring further study to understand causation.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Epidemiological study of soft‐tissue sarcomas in Ireland

et al. 2015

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“…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].…”

Section: Introductionmentioning

confidence: 99%

Fas Death Pathway in Sarcomas Correlates with Epidermal Growth Factor Transcription

Joyner

Aboulafia

Damron

et al. 2008

Clin Orthop Relat Res

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Modulation of apoptosis may influence sarcoma pathogenesis and/or aggressiveness. The Fas death pathway, mediated by FasL or TGFb, is one of two apoptotic pathways. Recent studies report that EGF can modulate TGFb and/or FasL expression/activity; thus, EGF has the potential to influence activation of the Fas pathway. EGF is not always detectable in mesenchymal tumors; therefore, we hypothesized EGF would define which Fas ligand predominates. We assayed 57 surgically removed human sarcomas for 10 genes involved in the Fas pathway. Skeletal muscle biopsies from eight patients served as controls. Sample transcripts were detected by real-time RT-PCR. We attempted to identify relevant predictor variables. The 57 sarcomas were segregated into two categories defined by EGF mRNA content: (1) 23 tumors with EGF concentrations that approximated muscle EGF transcript levels (high-EGF tumors); and (2) 34 tumors that either lacked EGF mRNA, or whose mRNA levels were very low and frequently undetected by PCR (low-EGF tumors). TGFb1 expression best predicted Fas transcript concentrations in the 34 low-EGF sarcomas, while FasL predicted Fas mRNA levels in the remaining 23 high-EGF sarcomas. The results suggest ligand activity in the Fas death pathway correlates with EGF transcription in sarcomas.

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“…It should be considered, in fact, that STT (especially malignant) are almost never uniform formations, but inhomogeneous masses with large necrotic and/or fibrous components, which, if taken as a single sample, preventing the pathologist's diagnosis. This problem leads to a delay in diagnosis, which will result in a worse outcome of the patient, or even worse, to incorrect diagnosis, on the basis of which may be formulated inappropriate therapeutic indications, with the consequences [17]. The purpose of this pilot prospective longitudinal study is to provide preliminary data regarding the useful of CEUS, compared with unenhanced US, as imaging modality to guide the CNB in patients with suspected STT.…”

Section: Discussionmentioning

confidence: 99%

Core needle biopsy of soft tissue tumors, CEUS vs US guided: a pilot study

et al. 2015

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Purpose The purpose of this study was to evaluate the usefulness of contrast-enhanced ultrasonography (CEUS) in the bioptic sampling of soft tissue tumors (STT) compared with unenhanced ultrasonography alone. Methods This is a prospective longitudinal study of 40 patients subjected to ultrasonography (US)-guided core needle biopsy (CNB) to characterize a suspected STT. Three series of bioptic samplings were carried out on each patient, respectively using unenhanced US alone and CEUS in both the areas of the tumor enhanced or not by the contrast medium. All bioptic samples underwent a histological evaluation and the results were analyzed by comparing the histology of the biopsy with the definitive diagnosis in 15 surgically excised samples. Results 27 (67.5 %) of the 40 patients completed the entire study procedure; in 19 cases (70.3 %) the three bioptic samplings gave unanimous results, also when compared to the surgical specimen; in seven cases (25.9 %) use of CEUS allowed to obtain additional or more accurate information about the mass in question, compared to simple US guidance without contrast; in one patient (3.7 %) sampling obtained using unenhanced ultrasonography guidance and in the areas enhanced by the contrast agent had precisely the same results of the surgical specimen. Conclusions CEUS, due to its ability to evaluate microvascular areas, has proven to be a promising method in guiding bioptic sampling of soft tissue tumor, directing the needle to the most significant areas of the tumor. Given the small number of patients evaluated in our study, to achieve statistically significant results, it would be appropriate to obtain a larger sample size, since the very first results seem to be encouraging and to justify the increase of the population.Keywords Contrast-enhanced ultrasonography Á Soft tissue tumors Á Core needle biopsy Riassunto Scopo Lo scopo di questo studio è stato quello di valutare l'utilità dell'ecografia conmdc (CEUS) rispetto alla ecografia tradizionale, nel prelievo bioptico dei tumori dei tessuti molli (STT). Metodi si tratta di uno studio longitudinale prospettico di 40 pazienti sottoposti ad ago-biopsia ecoguidata (US-CNB) per la caratterizzazione di un STT sospetto. Sono stati prelevati 3 campioni bioptici su ogni paziente, utilizzando ecografia b-mode e CEUS sia nelle aree del tumore non evidenziate dal mezzo di contrasto che in quelle dotate di contrast-enhancement. Tutti i campioni bioptici sono stati sottoposti a valutazione istologica e sono stati analizzati i risultati confrontando l'istologico della biopsia con i 15 campioni asportati chirurgicamente, con diagnosi definitiva. (2015( ) 18:335-342 DOI 10.1007 Risultati 27 (67,5%) dei 40 pazienti hanno completato l'intera procedura di studio; in 19 casi (70,3%) i tre campioni bioptici hanno dato risultati unanimi, anche rispetto al modello chirurgico; in 7 casi (25,9%) l'uso della CEUS ha permesso di ottenere informazioni supplementari, o più precise, circa la massa in questione, rispetto al semplice esame ecografico ...

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Soft-Tissue Sarcomas in Adults

Cited by 795 publications

References 89 publications

Epidemiological study of soft‐tissue sarcomas in Ireland

Epidemiological study of soft‐tissue sarcomas in Ireland

Fas Death Pathway in Sarcomas Correlates with Epidermal Growth Factor Transcription

Core needle biopsy of soft tissue tumors, CEUS vs US guided: a pilot study

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