scholarly journals Clinical and Radiologic Features Together Better Predict Lung Nodule Malignancy in Patients with Soft-Tissue Sarcoma

2020 ◽  
Vol 9 (4) ◽  
pp. 1209
Author(s):  
Cecilia Tetta ◽  
Antonio Giugliano ◽  
Laura Tonetti ◽  
Michele Rocca ◽  
Alessandra Longhi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Primary Tumor ◽  
Treatment Options ◽  
Lung Nodule ◽  
Pulmonary Nodules ◽  
Logistic Regression Models ◽  
Preoperative Ct ◽  
Ct Features ◽  
New Onset

We test the hypothesis that a model including clinical and computed tomography (CT) features may allow discrimination between benign and malignant lung nodules in patients with soft-tissue sarcoma (STS). Seventy-one patients with STS undergoing their first lung metastasectomy were examined. The performance of multiple logistic regression models including CT features alone, clinical features alone, and combined features, was tested to evaluate the best model in discriminating malignant from benign nodules. The likelihood of malignancy increased by more than 11, 2, 6 and 7 fold, respectively, when histological synovial sarcoma sub-type was associated with the following CT nodule features: size ≥ 5.6 mm, well defined margins, increased size from baseline CT, and new onset at preoperative CT. Likewise, in the case of grade III primary tumor, the odds ratio (OR) increased by more than 17 times when the diameter of pulmonary nodules (PNs) was >5.6 mm, more than 13 times with well-defined margins, more than 7 times with PNs increased from baseline CT, and more than 20 times when there were new-onset nodules. Finally, when CT nodule was ≥5.6 in size, it had well-defined margins, it increased in size from baseline CT, and when new onset nodules at preoperative CT were concomitant to residual primary tumor R2, the risk of malignancy increased by more than 10, 6, 25 and 28 times, respectively. The combination of clinical and CT features has the highest predictive value for detecting the malignancy of pulmonary nodules in patients with soft tissue sarcoma, allowing early detection of nodule malignancy and treatment options.

Prognostic Factors for Children and Adolescents With Surgically Resected Nonrhabdomyosarcoma Soft Tissue Sarcoma: An Analysis of 121 Patients Treated at St Jude Children's Research Hospital

1999 ◽  
Vol 17 (12) ◽  
pp. 3697-3705 ◽  
Author(s):  
Sheri L. Spunt ◽  
Catherine A. Poquette ◽  
Yasmeen S. Hurt ◽  
Alvida M. Cain ◽  
Bhaskar N. Rao ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Tumor Size ◽  
Primary Tumor ◽  
Distant Recurrence ◽  
High Grade ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Positive Surgical Margins

PURPOSE: The rarity and heterogeneity of pediatric nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) has precluded meaningful analysis of prognostic factors associated with surgically resected disease. To define a population of patients at high risk of treatment failure who might benefit from adjuvant therapies, we evaluated the relationship between various clinicopathologic factors and clinical outcome of children and adolescents with resected NRSTS over a 27-year period at our institution. PATIENTS AND METHODS: We analyzed the records of 121 consecutive patients with NRSTS who underwent surgical resection between August 1969 and December 1996. Demographic data, tumor characteristics, treatment, and outcomes were recorded. Univariate and multivariate analyses of prognostic factors for survival, event-free survival (EFS), and local and distant recurrence were performed. RESULTS: At a median follow-up of 9.2 years, 5-year survival and EFS rates for the entire cohort were 89% ± 3% and 77% ± 4%, respectively. In univariate models, positive surgical margins (P = .004), tumor size ≥ 5 cm (P < .001), invasiveness (P = .002), high grade (P = .028), and intra-abdominal primary tumor site (P = .055) adversely affected EFS. All of these factors except invasiveness remained prognostic of EFS and survival in multivariate models. Positive surgical margins (P = .003), intra-abdominal primary tumor site (P = .028), and the omission of radiation therapy (P = .043) predicted local recurrence, whereas tumor size ≥ 5 cm (P < .001), invasiveness (P < .001), and high grade (P = .004) predicted distant recurrence. CONCLUSION: In this largest single-institution analysis of pediatric patients with surgically resected NRSTS, we identified clinicopathologic features predictive of poor outcome. These variables should be prospectively evaluated as risk-adapted therapies are developed.

scholarly journals Indeterminate Pulmonary Nodules at Diagnosis in Rhabdomyosarcoma: Are They Clinically Significant? A Report From the European Paediatric Soft Tissue Sarcoma Study Group

2019 ◽  
Vol 37 (9) ◽  
pp. 723-730 ◽  
Author(s):  
Bas Vaarwerk ◽  
Gianni Bisogno ◽  
Kieran McHugh ◽  
Hervé J. Brisse ◽  
Carlo Morosi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Overall Survival ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Pulmonary Nodules ◽  
Study Group ◽  
Event Free Survival ◽  
Free Survival ◽  
Chest Computed Tomography ◽  
Computed Tomography Scans

Purpose To evaluate the clinical significance of indeterminate pulmonary nodules at diagnosis (defined as ≤ 4 pulmonary nodules < 5 mm or 1 nodule measuring ≥ 5 and < 10 mm) in patients with pediatric rhabdomyosarcoma (RMS). Patients and Methods We selected patients with supposed nonmetastatic RMS treated in large pediatric oncology centers in the United Kingdom, France, Italy, and the Netherlands, who were enrolled in the European Soft Tissue Sarcoma Study Group (E pSSG) RMS 2005 study. Patients included in the current study received a diagnosis between September 2005 and December 2013, and had chest computed tomography scans available for review that were done at time of diagnosis. Local radiologists were asked to review the chest computed tomography scans for the presence of pulmonary nodules and to record their findings on a standardized case report form. In the E pSSG RMS 2005 Study, patients with indeterminate pulmonary nodules were treated identically to patients without pulmonary nodules, enabling us to compare event-free survival and overall survival between groups by log-rank test. Results In total, 316 patients were included; 67 patients (21.2%) had indeterminate pulmonary nodules on imaging and 249 patients (78.8%) had no pulmonary nodules evident at diagnosis. Median follow-up for survivors (n = 258) was 75.1 months; respective 5-year event-free survival and overall survival rates (95% CI) were 77.0% (64.8% to 85.5%) and 82.0% (69.7% to 89.6%) for patients with indeterminate nodules and 73.2% (67.1% to 78.3%) and 80.8% (75.1% to 85.3%) for patients without nodules at diagnosis ( P = .68 and .76, respectively). Conclusion Our study demonstrated that indeterminate pulmonary nodules at diagnosis do not affect outcome in patients with otherwise localized RMS. There is no need to biopsy or upstage patients with RMS who have indeterminate pulmonary nodules at diagnosis.

scholarly journals Advanced soft-tissue sarcoma and treatment options: critical appraisal of trabectedin

2016 ◽  
Vol Volume 8 ◽  
pp. 95-104 ◽  
Author(s):  
Winette van der Graaf ◽  
Ingrid Desar ◽  
Anastasia Constantinidou ◽  
Suzanne Kaal ◽  
Robin Jones
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Critical Appraisal ◽  
Treatment Options ◽  
Advanced Soft Tissue Sarcoma

scholarly journals Study of soft tissue sarcomas over a period of 3 years

2017 ◽  
Vol 5 (6) ◽  
pp. 2678 ◽  
Author(s):  
Jenna Prabhakar ◽  
J. Sushma ◽  
B. V. S. Kartheek ◽  
A. Bhagya Lakshmi ◽  
Chapara Vaibhav
Keyword(s):  
Soft Tissue ◽  
Health Education ◽  
Soft Tissue Sarcoma ◽  
Treatment Options ◽  
Survival Rates ◽  
Soft Tissue Sarcomas ◽  
Mesenchymal Cell ◽  
Histological Type ◽  
Treatment Modalities ◽  
Site Distribution

Background: Soft tissue malignancies constituted a heterogeneous group of rare solid tumors of mesenchymal cell origin with distinct clinical and pathological features. The aim of the study was to know the prevalence of soft tissue sarcoma, sex, age and site distribution, histopathology and various treatment options adopted with follow up.Methods: A total of 26 cases of soft tissue sarcoma were analyzed for a three-year period. Clinical presentation, age and sex distribution, histological type and treatment modalities adopted were recorded and analyzed.Results: Out of 26 cases 44% of cases were between 30-50 years and 44% of tumors were situated in lower extremity. The commonest histological type was liposarcomas and fibrosarcoma. Lymph node metastasis was seen in 4% of cases. Distant metastasis was present in 3 cases, 2 with lung metastasis and l with lung and liver metastasis. Surgery was the main modality of the treatment. 12% of the cases presented with recurrent tumor, the duration between surgery and recurrence was 6 months. Only 38% turned for follow up, 2 patients succumbed to death because of multiple pulmonary secondaries and chest infections.Conclusion: In the present study, all the cases of soft tissue sarcoma presented in late stage of the disease due to illiteracy and lack of health education. Recurrence was seen in 12% of cases. The overall survival rates and quality of life of the patients can be improved by frequent health camps at primary health centers for early detection of the disease, providing adequate health education, diagnostic and management facilities.

Efficacy of temozolomide in pretreated patients with metastatic sarcoma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23550-e23550
Author(s):  
Nail Paksoy ◽  
Izzet Dogan ◽  
Meltem Ekenel ◽  
Mert Basaran
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Metastatic Disease ◽  
De Novo ◽  
Treatment Options ◽  
Palliative Radiotherapy ◽  
Progression Free Survival ◽  
Primary Treatment Modality ◽  
Heavily Pretreated ◽  
Metastatic Sarcoma

e23550 Background: Sarcoma is a rare heterogeneous group malignancy and most commonly arises from soft tissue. The primary treatment modality is surgery. However, in metastatic disease, treatment options are limited. Cytotoxic chemotherapy is preferred for palliative treatment. This study aimed to assess the efficacy of temozolomide in heavily pretreated soft tissue sarcoma. Methods: We evaluated the patients with a metastatic various types of soft tissue sarcoma retrospectively. The patients with gastrointestinal stromal tumors and bone sarcomas were excluded from the study. We recorded the clinical, pathological, and treatment data of the patients. SPSS 25v was used for statistical analysis. Survival analysis was performed with the Kaplan-Meier method. Results: Sixteen patients were included in this study. The median age was 48 (range, 21-73) years. Six (37.5%) patients were de-novo metastatic. Tumor localizations were intra-abdominal (43.8%), extremity (31.2%), intrathoracic (12.5%), and head-and-neck (12.5%). The most common metastatic sites were lung (75%), bone (31.8%), liver (18.8%), respectively. For metastatic disease, the patients received at least two different chemotherapy regimens (75%), pazopanib (50%) and palliative radiotherapy (31.3%). Metastasectomy was also performed on five (31.3%) patients. Median progression-free survival was 3.5 (95% CI, 2.6-4.3) months. Partial response was observed in one (6.3%) patients, stable disease in four (25 %) patients. Eleven (68.8%) patients had progressive disease. Grade 1-2 adverse events were observed in nine (56.3%) patients, grade 3-4 in one (6.3%) patients. Conclusions: We showed that temozolomide was well-tolerated but had a limited efficacy for the treatment of patients with metastatic sarcoma. Treatment options for metastatic sarcomas are limited. Temozolomide may be considered a treatment option in patients with heavily pretreated soft tissue sarcoma.

Combination of Gemcitabine and Docetaxel in Management of Leiomyosarcoma Metastasis

2017 ◽  
Vol 1 (2) ◽  
pp. AY1-AY2
Author(s):  
Monali Rajawat
Keyword(s):  
Small Intestine ◽  
Radiofrequency Ablation ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Combination Therapy ◽  
Genetic Factors ◽  
Target Therapy ◽  
Treatment Options ◽  
Main Route

Leiomyosarcoma is a type of a soft tissue sarcoma which is one of the rarest tumor found in the human mankind. It is predominantly localized either in stomach, small intestine or retroperitoneum and often metastasizes to the distant parts like the lungs or liver. The main route of the metastasis is via the bloodstream, however, the lymphatics could also be used as a medium. The etiology of leiomyosarcoma (LMS) is yet unknown to men, but few studies has shown that genetic factors have an important role to play. The treatment options available for LMS metastasis (mets) in liver are very limited which ranges from chemotherapy, radiofrequency ablation and target therapy. Here I discuss a case of LMS mets to the liver managed by a combination therapy of Gemcitabine and Docetaxel.

scholarly journals Treatment of advanced, metastatic soft tissue sarcoma: latest evidence and clinical considerations

2017 ◽  
Vol 9 (8) ◽  
pp. 533-550 ◽  
Author(s):  
Gino K. In ◽  
James S. Hu ◽  
William W. Tseng
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Alkylating Agents ◽  
Treatment Options ◽  
Cytotoxic Agents ◽  
High Grade ◽  
Metastatic Setting ◽  
Line Setting ◽  
New Treatments

Soft tissue sarcoma (STS) is a biologically heterogeneous malignancy with over 50 subtypes. Historically, there have been few systemic treatment options for this relatively rare disease. Traditional cytotoxic agents, such as anthracyclines, alkylating agents, and taxanes have limited clinical benefit beyond the first-line setting; across all high-grade STS subtypes, median overall survival remains approximately 12–18 months for advanced metastatic disease. The development of targeted therapies has led to recent US Food and Drug Administration approval of four new treatments for high-grade STS in the advanced metastatic setting. Among these, olaratumab is most notable for its improvement in overall survival for patients with anthracycline-naïve disease. Further progress in STS management will rely on novel trial design, subtype-specific therapies and validation of biomarkers to tailor therapy. Immunotherapy has shown promise as a new, but yet undiscovered frontier in the management of STS.

Pulmonary nodules discovered during the initial evaluation of pediatric patients with bone and soft-tissue sarcoma

2008 ◽  
Vol 50 (6) ◽  
pp. 1147-1153 ◽  
Author(s):  
Michael J. Absalon ◽  
M. Beth McCarville ◽  
Tiebin Liu ◽  
Victor M. Santana ◽  
Najat C. Daw ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Pediatric Patients ◽  
Pulmonary Nodules ◽  
Initial Evaluation
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