Soft-tissue sarcomas in adults.

Soft-tissue sarcomas have traditionally been managed by wide excisional surgery and radiotherapy, with chemotherapy reserved for advanced disease. However, advances in multidisciplinary care have improved the evaluation and treatment of patients with this uncommon tumor. Limb-conserving surgery, superior radiotherapy delivery, and novel adjuvant agents for specific tumors are now available. This article reviews the current understanding and treatment of soft-tissue sarcoma, with an emphasis on recent advances.

[1]  E. Venkatraman,et al.  Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[2]  S. Singer,et al.  Evaluation of a Clinically Applicable Post-Surgical Classification System for Primary Retroperitoneal Soft-Tissue Sarcoma , 2004, Annals of Surgical Oncology.

[3]  A. Davis,et al.  Classification of positive margins after resection of soft-tissue sarcoma of the limb predicts the risk of local recurrence. , 2001, The Journal of bone and joint surgery. British volume.

[4]  W Vaalburg,et al.  The value of FDG-PET in the detection, grading and response to therapy of soft tissue and bone sarcomas; a systematic review and meta-analysis. , 2004, Cancer treatment reviews.

[5]  K. Tilling,et al.  Variable management of soft tissue sarcoma: Regional audit with implications for specialist care , 1997, The British journal of surgery.

[6]  F. Collin,et al.  Comparative study of the National Cancer Institute and French Federation of Cancer Centers Sarcoma Group grading systems in a population of 410 adult patients with soft tissue sarcoma. , 1997, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[7]  A. Kuten,et al.  Clinical performance of PET/CT in evaluation of cancer: additional value for diagnostic imaging and patient management. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[8]  M. Hansen,et al.  Molecular genetics and cytogenetics of sarcomas. , 1995, Hematology/oncology clinics of North America.

[9]  A. McTiernan,et al.  Single center experience of a new intensive induction therapy for ewing's family of tumors: feasibility, toxicity, and stem cell mobilization properties. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[10]  A. Rydholm.  Centralization of soft tissue sarcoma. The southern Sweden experience. , 1997, Acta orthopaedica Scandinavica. Supplementum.

[11]  Samuel Singer,et al.  Histologic Subtype and Margin of Resection Predict Pattern of Recurrence and Survival for Retroperitoneal Liposarcoma , 2003, Annals of surgery.

[12]  William Stafford Noble,et al.  Classification and subtype prediction of adult soft tissue sarcoma by functional genomics. , 2003, The American journal of pathology.

[13]  L. Kindblom,et al.  Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. , 1998, The American journal of pathology.

[14]  A. Hauschild,et al.  Complete remission of a radio‐resistant cutaneous angiosarcoma of the scalp by systemic treatment with liposomal doxorubicin , 2002, The British journal of dermatology.

[15]  J. Thomas,et al.  Portsite Recurrence After Laparoscopy for Staging of Retroperitoneal Sarcoma , 2003, Surgical laparoscopy, endoscopy & percutaneous techniques.

[16]  J. Blay,et al.  Randomised phase II trial of pegylated liposomal doxorubicin (DOXIL/CAELYX) versus doxorubicin in the treatment of advanced or metastatic soft tissue sarcoma: a study by the EORTC Soft Tissue and Bone Sarcoma Group. , 2001, European journal of cancer.

[17]  D. Crowther.  Adjuvant chemotherapy for localised resectable soft-tissue sarcoma of adults: meta-analysis of individual data , 1997, The Lancet.

[18]  D. Botstein,et al.  Copyright © American Society for Investigative Pathology Tissue Microarray Validation of Epidermal Growth Factor Receptor and SALL2 in Synovial Sarcoma with Comparison to Tumors of Similar Histology , 2022 .

[19]  Sigrid Stroobants,et al.  Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: a phase I study , 2001, The Lancet.

[20]  R. Ramanathan,et al.  Modified Staging System for Extremity Soft Tissue Sarcomas , 1999, Annals of surgical oncology.

[21]  M. Mooney,et al.  Primary Extremity Sarcoma: What Is the Appropriate Follow-Up? , 2000, Annals of Surgical Oncology.

[22]  T. Sjöblom,et al.  The dermatofibrosarcoma protuberans-associated collagen type Ialpha1/platelet-derived growth factor (PDGF) B-chain fusion gene generates a transforming protein that is processed to functional PDGF-BB. , 1999, Cancer research.

[23]  G E Laramore,et al.  Fast neutron radiotherapy for soft tissue and cartilaginous sarcomas at high risk for local recurrence. , 2001, International journal of radiation oncology, biology, physics.

[24]  L. Temple,et al.  The role of pulmonary metastasectomy in soft tissue sarcoma. , 2002, Seminars in thoracic and cardiovascular surgery.

[25]  L. Skoog,et al.  Fine needle aspiration (FNA) cytology in the diagnosis of recurrent soft tissue sarcoma , 1998, Cytopathology : official journal of the British Society for Clinical Cytology.

[26]  D. Botstein,et al.  For Personal Use. Only Reproduce with Permission from the Lancet Publishing Group , 2022 .

[27]  E. Mindell,et al.  The principles and technique of resection of soft parts for sarcoma. , 1958, Surgery.

[28]  M. Malawer,et al.  Sciatic Nerve Resection: Is That Truly an Indication for Amputation? , 2002, Clinical orthopaedics and related research.

[29]  O. S. Nielsen,et al.  Results of randomised studies of the EORTC Soft Tissue and Bone Sarcoma Group (STBSG) with two different ifosfamide regimens in first- and second-line chemotherapy in advanced soft tissue sarcoma patients. , 2002, European journal of cancer.

[30]  J. Thomas,et al.  Serum vascular endothelial growth factor as a tumour marker in soft tissue sarcoma , 2004, The British journal of surgery.

[31]  S. Hirota,et al.  Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. , 1998, Science.

[32]  T. Alvegård,et al.  Histopathology peer review of high-grade soft tissue sarcoma: the Scandinavian Sarcoma Group experience. , 1989, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[33]  C. Fisher,et al.  Accuracy of Biopsy Techniques for Limb and Limb Girdle Soft Tissue Tumors , 2001, Annals of Surgical Oncology.

[34]  A. Davis,et al.  Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial , 2002, The Lancet.

[35]  F. Mertens,et al.  World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone , 2002 .

[36]  Ma Dong,et al.  Bevacizumab plus Irinotecan,Fluorouracil,and Leucovorin for Metastatic Colorectal Cancer , 2006 .

[37]  L. Strong,et al.  The Li-Fraumeni syndrome: from clinical epidemiology to molecular genetics. , 1992, American journal of epidemiology.

[38]  C. Arndt,et al.  Common musculoskeletal tumors of childhood and adolescence. , 1999, New England Journal of Medicine.

[39]  K. Hunt,et al.  Interval between surgery and radiotherapy: effect on local control of soft tissue sarcoma. , 2004, International journal of radiation oncology, biology, physics.

[40]  R. Parmley,et al.  Association of Epstein-Barr virus with leiomyosarcomas in young people with AIDS. , 1995, The New England journal of medicine.

[41]  I. Ray-Coquard,et al.  Conformity to clinical practice guidelines, multidisciplinary management and outcome of treatment for soft tissue sarcomas. , 2004, Annals of oncology : official journal of the European Society for Medical Oncology.

[42]  M. Burt,et al.  Pulmonary metastases from soft tissue sarcoma: analysis of patterns of diseases and postmetastasis survival. , 1999, Annals of surgery.

[43]  B. Bui,et al.  Prognostic factors in localized Ewing's tumours and peripheral neuroectodermal tumours: the third study of the French Society of Paediatric Oncology (EW88 study) , 2001, British Journal of Cancer.

[44]  S. Mocellin,et al.  Hyperthermic intraperitoneal intraoperative chemotherapy after cytoreductive surgery for the treatment of abdominal sarcomatosis , 2004, Cancer.

[45]  C. Antonescu,et al.  Differential sensitivity to imatinib of 2 patients with metastatic sarcoma arising from dermatofibrosarcoma protuberans , 2002, International journal of cancer.

[46]  H. Mankin,et al.  The Hazards of the Biopsy, Revisited. For the Members of the Musculoskeletal Tumor Society* , 1996, The Journal of bone and joint surgery. American volume.

[47]  R. Benjamin,et al.  Results of two consecutive trials of dose-intensive chemotherapy with doxorubicin and ifosfamide in patients with sarcomas. , 1998, American journal of clinical oncology.

[48]  M. McCarter,et al.  Randomized clinical trials in soft tissue sarcoma. , 2002, Surgical oncology clinics of North America.

[49]  T. Sanders,et al.  Radiographic imaging of musculoskeletal neoplasia. , 2001, Cancer control : journal of the Moffitt Cancer Center.

[50]  J. Fraumeni,et al.  The epidemiology of soft tissue sarcoma. , 1997, Seminars in oncology.

[51]  M. D’Incalci,et al.  Preclinical and clinical results with the natural marine product ET-743 , 2003, Expert opinion on investigational drugs.

[52]  J. Tepper,et al.  The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. , 1982, Annals of surgery.

[53]  B. Gusterson,et al.  Evidence for increased epidermal growth factor receptors in human sarcomas , 1985, International journal of cancer.

[54]  R. Wooster,et al.  Molecular classification of synovial sarcomas, leiomyosarcomas and malignant fibrous histiocytomas by gene expression profiling , 2003, British Journal of Cancer.

[55]  C. Antonescu,et al.  Localized extremity soft tissue sarcoma: improved knowledge with unchanged survival over time. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[56]  R. Marcove,et al.  Soft-tissue sarcomas of the extremities: comparison of MR and CT in determining the extent of disease. , 1988, AJR. American journal of roentgenology.

[57]  C. Cordon-Cardo,et al.  Altered patterns of retinoblastoma gene product expression in adult soft-tissue sarcomas. , 1995, British Journal of Cancer.

[58]  Samuel Singer,et al.  PDGFRA Activating Mutations in Gastrointestinal Stromal Tumors , 2003, Science.

[59]  Jonathan J. Lewis,et al.  Core needle biopsy for diagnosis of extremity soft tissue sarcoma , 1997, Annals of Surgical Oncology.

[60]  C. Fisher,et al.  Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread. , 2003, Radiology.

[61]  M. Stratton,et al.  Mutation of the p53 gene in human soft tissue sarcomas: association with abnormalities of the RB1 gene. , 1990, Oncogene.

[62]  D. Coit,et al.  Lymph Node Metastasis From Soft Tissue Sarcoma in Adults Analysis of Data From a Prospective Database of 1772 Sarcoma Patients , 1993, Annals of surgery.

[63]  A. Eggermont,et al.  Current uses of isolated limb perfusion in the clinic and a model system for new strategies. , 2003, The Lancet. Oncology.

[64]  R. A. MSc,et al.  Prognosis of Lymph Node Metastasis in Soft Tissue Sarcoma , 2004, Annals of Surgical Oncology.

[65]  M Bonetti,et al.  Adjuvant chemotherapy for adult soft tissue sarcomas of the extremities and girdles: results of the Italian randomized cooperative trial. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[66]  M. Kattan,et al.  Postoperative nomogram for 12-year sarcoma-specific death. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[67]  J. Fraumeni,et al.  Cancer incidence after retinoblastoma. Radiation dose and sarcoma risk. , 1997, JAMA.

[68]  J. Tepper,et al.  Intraoperative radiotherapy in retroperitoneal sarcomas. Final results of a prospective, randomized, clinical trial. , 1993, Archives of surgery.

[69]  A. Huvos,et al.  Long-term event-free survival after intensive chemotherapy for Ewing's family of tumors in children and young adults. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[70]  O. Merimsky,et al.  Palliative major amputation and quality of life in cancer patients. , 1997, Acta oncologica.

[71]  M. Ladanyi,et al.  Impact of SYT-SSX fusion type on the clinical behavior of synovial sarcoma: a multi-institutional retrospective study of 243 patients. , 2002, Cancer research.

[72]  Jonathan J. Lewis,et al.  Primary adult soft tissue sarcoma: time-dependent influence of prognostic variables. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[73]  J. Blay,et al.  Phase II study of ecteinascidin-743 in advanced pretreated soft tissue sarcoma patients. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[74]  G. Schwartz,et al.  Paclitaxel in the treatment of patients with angiosarcoma of the scalp or face , 1999, Cancer.

[75]  A. Jemal,et al.  Cancer Statistics, 2004 , 2004, CA: a cancer journal for clinicians.

[76]  T S Lawrence,et al.  Recent advances in radiation oncology. , 1995, The New England journal of medicine.

[77]  G. Sæter,et al.  The role of pulmonary metastasectomy for soft tissue sarcoma. , 1997, Acta orthopaedica Scandinavica. Supplementum.

[78]  A. Rydholm.  Improving the management of soft tissue sarcoma , 1998, BMJ.

[79]  C. Catton,et al.  Recent advances in radiotherapy for soft-tissue sarcoma , 2003, Current oncology reports.

[80]  H. Langstein,et al.  Reconstructive approaches in soft tissue sarcoma. , 1999, Seminars in surgical oncology.

[81]  W. Winkelmann,et al.  Local therapy in localized Ewing tumors: results of 1058 patients treated in the CESS 81, CESS 86, and EICESS 92 trials. , 2003, International journal of radiation oncology, biology, physics.

[82]  A. D. Van den Abbeele,et al.  Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[83]  A. D. Van den Abbeele,et al.  Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. , 2002, The New England journal of medicine.

[84]  D H Leung,et al.  Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities. , 1996, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[85]  M. Brennan,et al.  Radiation-associated sarcoma of bone and soft tissue. , 1992, Archives of surgery.

[86]  M. Ballo,et al.  Brachytherapy for Locally Recurrent Soft-Tissue Sarcoma , 2002, American journal of clinical oncology.

[87]  H. Strander,et al.  A Systematic Overview of Radiation Therapy Effects in Soft Tissue Sarcomas , 2003, Acta oncologica.

[88]  M. Inbar,et al.  Is Forequarter Amputation Justified for Palliation of Intractable Cancer Symptoms? , 2000, Oncology.

[89]  Seth M Steinberg,et al.  A randomized trial of bevacizumab, an anti-vascular endothelial growth factor antibody, for metastatic renal cancer. , 2003, The New England journal of medicine.

[90]  Paul K. Marsden,et al.  PET-MR image fusion in soft tissue sarcoma: accuracy, reliability and practicality of interactive point-based and automated mutual information techniques , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[91]  C. la Vecchia,et al.  Descriptive epidemiology of soft tissue sarcomas in Vaud, Switzerland. , 1999, European journal of cancer.

[92]  L. Sobin,et al.  Diagnosis of gastrointestinal stromal tumors: A consensus approach. , 2002, Human pathology.

[93]  M. Oudkerk,et al.  31P magnetic resonance spectroscopy as predictor of clinical response in human extremity sarcomas treated by single dose TNF‐α+ melphalan isolated limb perfusion , 1995, NMR in biomedicine.

[94]  L. Anderson,et al.  High-dose-rate intraoperative radiation therapy (HDR-IORT) for retroperitoneal sarcomas. , 2000, International journal of radiation oncology, biology, physics.

[95]  J. Thomas,et al.  Amputation for soft-tissue sarcoma. , 2003, The Lancet. Oncology.

[96]  M. Leach,et al.  Potential role of magnetic resonance spectroscopy in assessment of tumour response in childhood cancer. , 2003, European journal of cancer.

[97]  M. van Glabbeke,et al.  Prognostic factors for the outcome of chemotherapy in advanced soft tissue sarcoma: an analysis of 2,185 patients treated with anthracycline-containing first-line regimens--a European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group Study. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[98]  J. Tepper,et al.  Radiation therapy alone for sarcoma of soft tissue , 1985, Cancer.