The pedicled myocutaneous flap as a choice reconstructive technique for immediate adjuvant brachytherapy in sarcoma treatment

Soft tissue sarcomas are a group of rare mesenchymal tumors with more than 70 subtypes described. Treatment of these subtypes in an advanced setting is mainly according to a one-size-fits-all strategy indicating a high unmet need of new and more targeted therapeutic options in order to optimize survival. The introduction of advanced molecular techniques in cancer has led to better diagnostics and identification of new therapeutic targets, leading to more personalized treatment and improved prognosis for several cancer types. In sarcoma, a likewise evolution is seen, albeit at a slower pace. This manuscript describes how in the past years advanced molecular profiling in soft tissue sarcomas was able to identify specific and often pathognomonic aberrations, deferring standard sarcoma treatment in favor of more targeted treatment from an oncologist’s point of view.

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Reconstruction with a pectoralis major myocutaneous flap after left first rib and clavicular chest wall resection for a metastasis from laryngeal cancer

General Thoracic and Cardiovascular Surgery ◽

10.1007/s11748-014-0485-8 ◽

2014 ◽

Vol 64 (5) ◽

pp. 294-297 ◽

Cited By ~ 1

Author(s):

Francesco Paolo Caronia ◽

Alfonso Fiorelli ◽

Fabio Zanchini ◽

Mario Santini ◽

Attilio Ignazio Lo Monte ◽

...

Keyword(s):

Chest Wall ◽

Laryngeal Cancer ◽

Myocutaneous Flap ◽

Pectoralis Major ◽

Pectoralis Major Myocutaneous Flap ◽

Chest Wall Resection ◽

First Rib

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Perineal reconstruction with pedicled rectus abdominis myocutaneous flap after posterior pelvic exenteration –A 3D model study

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2021.02.015 ◽

2021 ◽

Vol 80 ◽

pp. 105629

Author(s):

Daiki Kitano ◽

Takeo Osaki ◽

Shunsuke Sakakibara ◽

Tadashi Nomura ◽

Kazunobu Hashikawa ◽

...

Keyword(s):

3D Model ◽

Pelvic Exenteration ◽

Myocutaneous Flap ◽

Rectus Abdominis ◽

Perineal Reconstruction ◽

Rectus Abdominis Myocutaneous Flap ◽

Model Study

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Algorithm of rational approach to reconstruction in Fournier’s disease

Open Medicine ◽

10.1515/med-2021-0294 ◽

2021 ◽

Vol 16 (1) ◽

pp. 1028-1037

Author(s):

Domenico Tripodi ◽

Maria Ida Amabile ◽

Federica Gagliardi ◽

Federico Frusone ◽

Marzia Varanese ◽

...

Keyword(s):

Necrotizing Fasciitis ◽

Fournier’S Gangrene ◽

Rational Approach ◽

Skin Grafts ◽

Local Infection ◽

Fournier's Gangrene ◽

Rare Form ◽

Perineal Region ◽

Reconstructive Technique ◽

Diabetes And Obesity

Abstract Background Fournier’s gangrene is a rare form of necrotizing fasciitis that affects the genital area up to the perineal region and sometimes the abdominal wall. Objectives Our article aims to show that in the treatment of extensive forms of Fournier’s gangrene, correct use of flap and skin grafts and a quick reconstruction of the exposed tissues avoid scarring retraction of the testicles and deformation of the penis. Materials and methods We retrospectively reviewed the clinical and photographic data of Fournier’s gangrene cases treated at our Institute. The data were evaluated to obtain an estimate of the results of the reconstructive technique used, in terms of percentage of occurred healings and eventual complications. Results A total of 34 patients underwent surgery for Fournier’s gangrene. In nine cases (26.5%), we had minor complications: in four patients, suffering from diabetes and obesity, a retard in attachment of graft occurred, while in five patients with perianal problems there was a delay in healing due to the onset of local infection. Conclusion The reconstruction approach described here may reduce surgical times. In Fournier’s gangrene, the exposed tissues must be reconstructed as quickly as possible.

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A new antisarcoma strategy: multisubtype heat shock protein/peptide immunotherapy combined with PD-L1 immunological checkpoint inhibitors

Clinical & Translational Oncology ◽

10.1007/s12094-021-02570-4 ◽

2021 ◽

Author(s):

H. Li ◽

X. Sui ◽

Z. Wang ◽

H. Fu ◽

Z. Wang ◽

...

Keyword(s):

Heat Shock ◽

Heat Shock Protein ◽

Lung Metastasis ◽

Checkpoint Inhibitors ◽

Combined Therapy ◽

Peptide Vaccine ◽

Tumor Environment ◽

Immune Check Point Inhibitor ◽

Shock Proteins ◽

Sarcoma Treatment

AbstractOsteosarcoma, a common malignant tumor in orthopedics, often has a very poor prognosis after lung metastasis. Immunotherapy has not achieved much progress in the treatment because of the characteristics of solid tumors and immune environment of osteosarcoma. The tumor environment is rather essential for sarcoma treatment. Our previous study demonstrated that heat shock proteins could be used as antitumor vaccines by carrying tumor antigen peptides, and we hypothesize that an anti-osteosarcoma effect may be increased with an immune check point inhibitor (PD-L1 inhibitor) as a combination treatment strategy. The present study prepared a multisubtype mixed heat shock protein osteosarcoma vaccine (mHSP/peptide vaccine) and concluded that the mHSP/peptide vaccine was more effective than a single subtype heat shock protein, like Grp94. Therefore, we used the mHSP/peptide vaccine in combination with a PD-L1 inhibitor to treat osteosarcoma, and the deterioration of osteosarcoma was effectively hampered. The mechanism of combined therapy was investigated, and AKT expression participates with sarcoma lung metastasis. This study proposed an antisarcoma strategy via stimulation of the immune system as a further alternative approach for sarcoma treatment and elucidated the mechanism of combined therapy.

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“We’re on a Merry-Go-Round”: Reflections of Patients and Carers after Completing Treatment for Sarcoma

Current Oncology ◽

10.3390/curroncol28040263 ◽

2021 ◽

Vol 28 (4) ◽

pp. 3003-3014

Author(s):

Rhys Weaver ◽

Moira O’Connor ◽

Richard Carey Smith ◽

Dianne Sheppard ◽

Georgia K. B. Halkett

Keyword(s):

Social Constructionist ◽

Rare Cancer ◽

Family Carers ◽

Structured Interviews ◽

Qualitative Research Design ◽

Previously Treated ◽

Sarcoma Treatment ◽

Silver Lining

Sarcoma is a rare cancer that has a significant impact on patients’ and carers’ quality of life. Despite this, there has been a paucity of research exploring the diverse experiences of patients and carers following sarcoma treatment. The aim of this study was to explore patients’ and carers’ reflections on life after treatment for sarcoma. A qualitative research design with a social constructionist epistemology was used. Participants included patients previously treated for sarcoma (n = 21) and family carers of patients treated for sarcoma (n = 16). Participants completed semi-structured interviews which were analysed using thematic analysis. Three primary themes were identified: “This journey is never going to be over”, “But what happens when I am better?”, and finding a silver lining. Participants represented sarcoma as having a long-term, and sometimes indefinite, threat on their life that they had limited control over. Conclusions: This study highlight the heterogeneous and ongoing needs of sarcoma survivors and their families. Patients and carers strove to translate their experiences in a meaningful way, such as by improving outcomes for other people affected by sarcoma. Parental carers in particular attempted to protect the patient from the ongoing stress of managing the disease.

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Pilomatrix Carcinoma in a Patient With Type 1 Myotonic Dystrophy: A Case Report

Plastic Surgery Case Studies ◽

10.1177/2513826x19898833 ◽

2020 ◽

Vol 6 ◽

pp. 2513826X1989883

Author(s):

Sarah L. Zhu ◽

David Choi ◽

Jenny Santos ◽

Bernard S. Jackson ◽

Matthew McRae

Keyword(s):

Case Report ◽

Myotonic Dystrophy ◽

Latissimus Dorsi ◽

Myocutaneous Flap ◽

Myotonic Dystrophy Type 1 ◽

Myotonic Dystrophy Type ◽

Genetic Condition ◽

Latissimus Dorsi Myocutaneous Flap ◽

Pilomatrix Carcinoma

This is the first report of pilomatrix carcinoma in a man with C282Y myotonic dystrophy type 1. This pilomatrix carcinoma had originally presented as a rapidly growing recurrence of a histopathologically confirmed pilomatrixoma, removed a year prior. On examination, the fungating mass had measured 10 × 23 cm. A wide local resection with removal of suspicious lymph nodes was preformed, and the resulting defect was reconstructed with a latissimus dorsi myocutaneous flap and skin graft. Histologic investigation of the excised mass confirmed the diagnosis of pilomatrix carcinoma. This is the first reported case of pilomatrix carcinoma in a patient with a genetic condition that often presents with scalp pilomatrixomas. Potential implications of myotonic dystrophy on developing pilomatrix carcinoma are discussed.

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Outcome and Toxicity of an Ifosfamide-Based Soft Tissue Sarcoma Treatment Protocol in Children. The Importance of Local Therapy

Sarcoma ◽

10.1080/13577149877939 ◽

1998 ◽

Vol 2 (3-4) ◽

pp. 171-177

Author(s):

S. Murray Yule ◽

Roderick Skinner ◽

Martin W. English ◽

Mike Cole ◽

Andrew D. J. Pearson ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Primary Tumour ◽

Treatment Protocol ◽

Disease Free Survival ◽

Local Therapy ◽

Complete Response ◽

One Year ◽

Sarcoma Treatment

Background.Although the survival of children with soft tissue sarcoma (STS) has improved considerably, the outcome of patients with metastatic disease, and those with primary tumours of the extremities or parameningeal sites remains disappointing. We describe the clinical outcome of an ifosfamide-based regimen with local therapy directed only to children who failed to achieve a complete response to initial chemotherapy.Patients and Methods.Twenty-one children with STS (16 rhabdomyosarcoma) who presented with unresectable tumours were treated with five courses of ifosfamide (9 g/m2) and etoposide (600 mg/m2). Patients who did not achieve a complete response then received local therapy. Chemotherapy with ifosfamide combined with etoposide, vincristine (1.5 mg/m2and doxorubicin (60 mg/m2) or vincristine and actinomycin D (1.5 mg/m2) was continued for one year.Results and Discussion.Objective responses to five courses of ifosfamide and etoposide were seen in all patients. Disease free survival (DFS) at a median follow up of 59 months was 57% (95% CI 29–75%). The DFS of children who received local therapy was 89% compared with 33% in those who received chemotherapy alone (p=0.027). Locoregional recurrences did not occur in children who received radiotherapy to the site of the primary tumour. Ifosfamide-based chemotherapy does not reduce the incidence of loco-regional recurrence in children who do not receive local therapy.

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