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Tsukamoto S, Righi A, Mavrogenis AF, Masunaga T, Honoki K, Fujii H, Kido A, Tanaka Y, Tanaka Y, Errani C. Effect of adjuvant chemotherapy on localized dedifferentiated low-grade osteosarcoma: a systematic review. Musculoskelet Surg 2024; 108:241-249. [PMID: 38709428 DOI: 10.1007/s12306-024-00821-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/23/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE Dedifferentiated low-grade osteosarcomas, which are considered high grade malignancies, can arise from the dedifferentiation of parosteal and low-grade osteosarcomas. Usually, localized dedifferentiated low-grade osteosarcomas are treated by wide resection, and the efficacy of adjuvant chemotherapy is controversial. We conducted a systematic review of studies that investigated the rates of mortality and significant events, such as recurrence and metastases, in localized dedifferentiated low-grade osteosarcoma patients who received wide resection only and in those who received wide resection and (neo-)adjuvant chemotherapy. METHODS We identified 712 studies through systematic searches of Embase, PubMed, and the Cochrane Central Register of Controlled Trials databases. Of those studies, seven were included in this review and none were randomized controlled trials. In the seven studies, 114 localized dedifferentiated low-grade osteosarcoma patients were examined. RESULTS Mortality rates of the resection plus chemotherapy (R + C) and the resection only (Ronly) groups were 20.3% and 11.4%, respectively [overall pooled odds ratio, 1.59 (P = 0.662); heterogeneity I2, 0%]. The local recurrence or distant metastasis rate in the R + C group was 36.7% and that in the Ronly group was 28.6% [overall pooled odds ratio, 1.37 (P = 0.484); heterogeneity I2 was 0%]. CONCLUSIONS Results show a limited efficacy of adjuvant chemotherapy for localized dedifferentiated low-grade osteosarcoma. However, because this was a systematic review of retrospective studies that examined a small number of patients, future randomized controlled trials are needed.
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Affiliation(s)
- S Tsukamoto
- Department of Orthopedic Surgery, Nara Medical University, 840, Shijo-Cho, Kashihara-City, Nara, 634-8521, Japan.
| | - A Righi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136, Bologna, Italy
| | - A F Mavrogenis
- First Department of Orthopedics, School of Medicine, National and Kapodistrian University of Athens, 41 Ventouri Street, 15562, Holargos, Athens, Greece
| | - T Masunaga
- Department of Orthopedic Surgery, Nara Medical University, 840, Shijo-Cho, Kashihara-City, Nara, 634-8521, Japan
| | - K Honoki
- Department of Orthopedic Surgery, Nara Medical University, 840, Shijo-Cho, Kashihara-City, Nara, 634-8521, Japan
| | - H Fujii
- Department of Orthopedic Surgery, Nara Medical University, 840, Shijo-Cho, Kashihara-City, Nara, 634-8521, Japan
| | - A Kido
- Department of Rehabilitation Medicine, Nara Medical University, 840, Shijo-Cho, Kashihara-City, Nara, 634-8521, Japan
| | - Y Tanaka
- Department of Rehabilitation Medicine, Wakayama Professional University of Rehabilitation, 3-1, Minamoto-Cho, Wakayama-City, 640-8222, Japan
| | - Y Tanaka
- Department of Orthopedic Surgery, Nara Medical University, 840, Shijo-Cho, Kashihara-City, Nara, 634-8521, Japan
| | - C Errani
- Department of Orthopedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy
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Gervais MK, Basile G, Dulude JP, Mottard S, Gronchi A. Histology-Tailored Approach to Soft Tissue Sarcoma. Ann Surg Oncol 2024:10.1245/s10434-024-15981-8. [PMID: 39174839 DOI: 10.1245/s10434-024-15981-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/23/2024] [Indexed: 08/24/2024]
Abstract
Soft tissue sarcomas are a diverse and heterogeneous group of cancers of mesenchymal origin. Each histological type of soft tissue sarcoma has unique clinical particularities, which makes them challenging to diagnose and treat. Multidisciplinary management of these rare diseases is thus key for improved survival. The role of surgery has been well established, and it represents the cornerstone curative treatment for soft tissue sarcomas. To date, local recurrence is the leading cause of death in low-grade sarcomas located at critical sites, and distant metastasis in high-grade sarcomas, regardless of the site of origin. Management must be tailored to each individual histologic type. We describe the most common types of extremity, trunk, abdominal, and retroperitoneal soft tissue sarcoma along with characteristics to consider for optimized management.
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Affiliation(s)
- Mai-Kim Gervais
- Division of Surgical Oncology, Department of Surgery, Maisonneuve-Rosemont Hospital, Université de Montréal, Montreal, QC, Canada
| | - Georges Basile
- Division of Orthopedic Oncology, Department of Surgery, Maisonneuve-Rosemont Hospital, Université de Montréal, Montreal, QC, Canada
| | - Jean-Philippe Dulude
- Division of Surgical Oncology, Department of Surgery, Maisonneuve-Rosemont Hospital, Université de Montréal, Montreal, QC, Canada
| | - Sophie Mottard
- Division of Orthopedic Oncology, Department of Surgery, Maisonneuve-Rosemont Hospital, Université de Montréal, Montreal, QC, Canada
| | - Alessandro Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Nishikawa T, Kakunaga S, Tamura K, Ando M, Ozaki T, Kawai A, Ueda T, Kawasaki M, Tomatsuri S, Okamura N, Kamikura M, Hamada A, Yoshida A, Hirakawa A, Shibata T, Nakamura K, Yonemori K. Efficacy and safety of nivolumab monotherapy in patients with unresectable clear cell sarcoma and alveolar soft part sarcoma (OSCAR Trial/NCCH1510). Cancer 2024. [PMID: 39077795 DOI: 10.1002/cncr.35483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/07/2024] [Accepted: 06/21/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND Clear cell sarcoma (CCS) and alveolar soft part sarcoma (ASPS) are rare, and standard systemic therapy is not established except for sunitinib in ASPS. It is known that CCS and ASPS have a common biological feature of melanoma and Xp11.2/TFE3 translocation renal cell carcinoma, and immune-checkpoint inhibitors (ICIs) are effective in these tumors. The authors conducted a phase 2 trial to evaluate the efficacy and safety of nivolumab for CCS and ASPS. METHODS The number of patients expected to be enrolled was 15-25 and was determined based on the Bayesian design. The primary end point was the confirmed objective response rate (ORR) according to the central review and the secondary end points included ORR, progression-free survival (PFS), overall survival (OS), and safety. RESULTS A total of 26 patients (CCS, 12; ASPS, 14) were enrolled. Efficacy and safety were analyzed on 25 and 26 patients, respectively. The minimum number of responses required for a positive conclusion regarding the efficacy was four. However, only one patient (4.0%) with ASPS had a partial response. Complete response, stable disease, progression disease, and not evaluable were 0%, 60%, 32%, and 4.0%, respectively. Adverse events of grade 3 or 4 occurred in 57.7% (15 of 26). The median PFS was 4.9 months (95% confidence interval [CI], 3.7-8.6 months) and the median OS was 15.8 months (95% CI, 8.2-not reached). CONCLUSIONS The primary end point of the ORR was not met for CCS and ASPS on the central review. Further studies are needed to evaluate ICIs in patients with ASPS.
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Affiliation(s)
- Tadaaki Nishikawa
- Department of Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Shigeki Kakunaga
- Department of Orthopedic Surgery, National Hospital Organization Osaka National Hospital, Chuo-ku, Osaka, Japan
- Department of Orthopedic Surgery, Osaka International Cancer Institute, Chuo-ku, Osaka, Japan
| | - Kenji Tamura
- Department of Medical Oncology, Shimane University, Izumo, Shimane, Japan
| | - Masashi Ando
- Department of Medical Oncology, Aichi Cancer Center, Chikusa-ku, Nagoya, Aichi, Japan
| | - Toshifumi Ozaki
- Department of Orthopedic Surgery, Okayama University, Kita-ku, Okayama, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology and Rehabilitation Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Takafumi Ueda
- Department of Orthopedic Surgery, Kodama Hospital, Takarazuka, Hyogo, Japan
| | - Mamiko Kawasaki
- Clinical Research Support Office, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Sawako Tomatsuri
- Clinical Research Support Office, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Nobuko Okamura
- Clinical Research Support Office, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Masahisa Kamikura
- Clinical Research Support Office, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Akinobu Hamada
- Division of Molecular Pharmacology, National Cancer Center Research Institute, Tokyo, Japan
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Akihiro Hirakawa
- Department of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Taro Shibata
- Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Kenichi Nakamura
- Clinical Research Support Office, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Kan Yonemori
- Department of Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
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Kopp L, Garner M, Priest K. Rhabdomyosarcoma in a Rabbit. Top Companion Anim Med 2024; 61:100892. [PMID: 38972503 DOI: 10.1016/j.tcam.2024.100892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/09/2024]
Abstract
A geriatric Holland Lop rabbit presented for acute lameness. A pathologic fracture of the right distal femur associated with a pleomorphic rhabdomyosarcoma was diagnosed, and staging radiographs showed no overt metastasis upon initial presentation. The limb was amputated and submitted for microscopic examination. Immunohistochemical evaluation revealed the neoplastic cells were positive for desmin and MyoD1, and negative for cytokeratin AE1/AE3, CD204, IBA-1, and SMA. Gross, histologic, and immunohistochemical evaluation confirmed a diagnosis of pleomorphic rhabdomyosarcoma. The patient died 396 days after amputation, and a post-mortem examination showed metastatic sarcoma to multiple organs.
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Affiliation(s)
- Logan Kopp
- Priest Lake Veterinary Hospital, 2445 Morris Gentry Blvd, Nashville, TN 37013, USA.
| | - Michael Garner
- Northwest ZooPath, 654 West Main Street, Monroe, WA 98272, USA
| | - Kara Priest
- Idexx Laboratories, 1 Idexx Dr, Westbrook, ME 04092, USA
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5
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Chen Y, Gokavarapu S, Abdelrehem A, Ji T. Head and Neck Soft Tissue Sarcoma Patient: Age and Tumor Region Are Predictive in Disease-Free Survival and Overall Survival. J Oral Maxillofac Surg 2024; 82:719-727. [PMID: 38513711 DOI: 10.1016/j.joms.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Head and neck soft tissue sarcoma (HNSTS), rare and heterogeneous malignancies, are treated primarily treated with surgery. However, prognostic indicators that might guide HNSTS management are poorly defined. PURPOSE Main purpose of this study is to find variables linked to HNSTS patients' prognosis. Assessment of the Tumor, Node, Metastatis (TNM) system is the secondary purpose. STUDY DESIGN, SETTING, SAMPLE This study is a retrospective cohort performed on HNSTS patients who received surgery at the Department of Oral and Maxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital School of Medicine, Shanghai Jiao Tong University from January 1, 2006, to December 31, 2014. Strict inclusion criteria were applied. PREDICTOR VARIABLE The predictor variable was a set of heterogenous risk factors and were grouped into the following categories: demographic (age and gender), clinical (primary tumor, tumor region, tumor size, and TNM stage), and treatment (surgical margin, treatment therapy). MAIN OUTCOME VARIABLE(S) The primary outcome variables were time to 5-year disease-free survival (DFS) and 5-year overall survival (OS). The secondary outcome variables were time to 5-year tumor local recurrence and metastasis. COVARIATES Not applicable. ANALYSES Descriptive statistical analysis was carried out. Pearson χ2 test was employed in univariate analysis. Cox regression was modified for multiple variable analysis with components that had significant P values in univariate analysis or variables with potential prognostic value. Log-rank test was applied to compare survival situations under various variables. P value less than .05 was statistically significant. RESULTS The sample was composed of 100 subjects with a mean age of 43.47 (standard deviation: 16.15) years old and 56 (56%) were male. The 5-year DSF and OS were 59 and 60%, respectively. Variables associated with poor DFS and OS were age > 60 years (P = .003, hazard ratio [HR]: 4.95, 95% confidence interval [CI]: 1.71,14.1; P = .005, HR: 4.48, 95% CI: 1.57,12.8) and non-primary tumors (P<.001, HR: 8.41, 95% CI: 2.85,24.8; P = .002, HR: 6.90, 95% CI: 2.46,19.4), respectively. Maxilla and skull base cancers had local recurrence (12/18, 66.7%) more common. T2 (TNM) tumor displayed higher tendency in DFS(P = .009, HR: 4.20, 95% CI: 1.42,12.4) and metastasis(P = .09, HR: 3.51, 95% CI: 0.82,15.0) than T1 (TNM) tumors. CONCLUSION AND RELEVANCE Poor prognosis is associated with maxilla and skull base tumors as well as patients over 60 years. TNM stage appeared to have limited prognostic significance.
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Affiliation(s)
- YiMing Chen
- Resident, Department of Oral and Maxillofacial- Head and Neck Oncology, Shanghai Stomatology Key Laboratory, Ninth People's Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Sandhya Gokavarapu
- Fellow, Department of Oral Maxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Disease; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Ahmed Abdelrehem
- Fellow, Department of Oral and Maxillofacial- Head and Neck Oncology, Shanghai Stomatology key laboratory, Ninth People's Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Tong Ji
- Professor, Department of Oral and Maxillofacial- Head and Neck Oncology, Shanghai Stomatology key laboratory, Ninth People's Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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6
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Kucinski JP, Calderon D, Kendall GC. Biological and therapeutic insights from animal modeling of fusion-driven pediatric soft tissue sarcomas. Dis Model Mech 2024; 17:dmm050704. [PMID: 38916046 PMCID: PMC11225592 DOI: 10.1242/dmm.050704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
Survival for children with cancer has primarily improved over the past decades due to refinements in surgery, radiation and chemotherapy. Although these general therapies are sometimes curative, the cancer often recurs, resulting in poor outcomes for patients. Fusion-driven pediatric soft tissue sarcomas are genetically defined by chromosomal translocations that create a chimeric oncogene. This distinctive, almost 'monogenic', genetic feature supports the generation of animal models to study the respective diseases in vivo. This Review focuses on a subset of fusion-driven pediatric soft tissue sarcomas that have transgenic animal tumor models, which includes fusion-positive and infantile rhabdomyosarcoma, synovial sarcoma, undifferentiated small round cell sarcoma, alveolar soft part sarcoma and clear cell sarcoma. Studies using the animal models of these sarcomas have highlighted that pediatric cancers require a specific cellular state or developmental stage to drive tumorigenesis, as the fusion oncogenes cause different outcomes depending on their lineage and timing of expression. Therefore, understanding these context-specific activities could identify targetable activities and mechanisms critical for tumorigenesis. Broadly, these cancers show dependencies on chromatin regulators to support oncogenic gene expression and co-opting of developmental pathways. Comparative analyses across lineages and tumor models will further provide biological and therapeutic insights to improve outcomes for these children.
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Affiliation(s)
- Jack P. Kucinski
- Center for Childhood Cancer Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH 43215, USA
- Molecular, Cellular, and Developmental Biology PhD Program, The Ohio State University, Columbus, OH 43210, USA
| | - Delia Calderon
- Center for Childhood Cancer Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH 43215, USA
- Molecular, Cellular, and Developmental Biology PhD Program, The Ohio State University, Columbus, OH 43210, USA
| | - Genevieve C. Kendall
- Center for Childhood Cancer Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH 43215, USA
- Molecular, Cellular, and Developmental Biology PhD Program, The Ohio State University, Columbus, OH 43210, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43215, USA
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7
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Fan P, Tao P, Wang J, Wang Z, Hou Y, Zhou Y, Lu W, Ma L, Zhang Y, Tong H. Clinical and surgical effectiveness of the multi-disciplinary standardized management model in the treatment of retroperitoneal liposarcoma: Evidence-based clinical practice experience from Fudan Zhongshan. Surgery 2024; 175:1368-1376. [PMID: 38395638 DOI: 10.1016/j.surg.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/26/2023] [Accepted: 09/14/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND To assess the correlation between clinical outcomes and diagnostic accuracy of evaluations carried out by a preoperative multidisciplinary team versus standard surgical care for patients with retroperitoneal liposarcoma undergoing surgery. METHODS This comparative study was conducted retrospectively at a specialist assessment center within Zhongshan Hospital, Fudan University, China, between April 2011 and March 2021. Patients were assigned to a multidisciplinary team or nonmultidisciplinary team cohort based on referral to the multidisciplinary team. The primary outcome measured was long-term clinical prognosis, with other outcomes including diagnostic accuracy, 30-day reoperation, duration of stay, perioperative mortality, and medical complications. To mitigate selection bias, we conducted propensity-score matching. Uni- and multivariable Cox proportional hazard models were then used to evaluate the effect of multidisciplinary teams on postoperative survival. The previously specified questionnaire was used to measure the enhancement of awareness and treatment adherence facilitated by multidisciplinary team management. Data analysis was carried out between January 2023 and August 2023. RESULTS Of the 521 records that were screened, 139 patients were deemed eligible for inclusion and defined as the multidisciplinary team cohort. At the same time, 382 patients without multidisciplinary team management were also included during that period and defined as the nonmultidisciplinary team cohort. The multidisciplinary team cohort exhibited lower numbers of primary retroperitoneal liposarcoma but a higher tumor grade and a greater proportion of R2 resection. After propensity-score matching, the 1-, 3-, and 5-year overall survival rates were 89.5%, 70.5%, and 62.9%, respectively, in the multidisciplinary team cohort, and 77.1%, 49.8%, and 45.1% in the nonmultidisciplinary team cohort. The diagnostic consistency of the multidisciplinary team group was significantly superior to that of the nonmultidisciplinary cohort (92.5% vs 83.6%, P = .042). Although no significant links were shown with duration of stay (P = .232) and 30-day reoperation (P = .447), the multidisciplinary team participation was linked to a substantial decrease in perioperative mortality (P = .036) and postoperative complications (P = .002). Additionally, the multidisciplinary team group indicated stronger illness awareness and postoperative adherence among individuals with retroperitoneal liposarcoma. CONCLUSION The study's findings indicate that multidisciplinary team management could result in improved clinical outcomes, higher diagnostic accuracy, and reduced duration of postoperative stays, complications, and perioperative mortality. The intervention may also enhance disease awareness and postoperative compliance in retroperitoneal liposarcoma patients who undergo surgery. However, evidence quality was deemed low, and prospective studies with robust designs are required. Nonetheless, these results are worth considering.
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Affiliation(s)
- Peidang Fan
- School of Medicine, Anhui University of Science and Technology, Huainan, Anhui 232000, China
| | - Ping Tao
- Department of Laboratory Medicine, Shanghai Traditional Chinese Medicine-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiongyuan Wang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhenyu Wang
- Department of General Surgery, Jinshan Hospital, Fudan University, Shanghai, China
| | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuhong Zhou
- Department of Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Weiqi Lu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lijie Ma
- Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yong Zhang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China; Department of General Surgery, Zhongshan Hospital (Xiamen), Fudan University; Xiamen Clinical Research Center for Cancer Therapy, Xiamen, China
| | - Hanxing Tong
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
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8
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Blay JY, Penel N, Valentin T, Anract P, Duffaud F, Dufresne A, Verret B, Cordoba A, Italiano A, Brahmi M, Henon C, Amouyel T, Ray-Coquard I, Ferron G, Boudou-Rouquette P, Tlemsani C, Salas S, Rochwerger R, Faron M, Bompas E, Ducassou A, Gangloff D, Gouin F, Firmin N, Piperno-Neumann S, Rios M, Ropars M, Kurtz JE, Le Nail LR, Bertucci F, Carrere S, Llacer C, Watson S, Bonvalot S, Leroux A, Perrin C, Gantzer J, Pracht M, Narciso B, Monneur A, Lebbe C, Hervieu A, Saada-Bouzid E, Dubray-Longeras P, Fiorenza F, Chaigneau L, Nevieres ZM, Soibinet P, Bouché O, Guillemet C, Spano JP, Ruzic JC, Isambert N, Vaz G, Meeus P, Karanian M, Ngo C, Coindre JM, De Pinieux G, Le Loarer F, Ducimetiere F, Chemin C, Morelle M, Toulmonde M, Le Cesne A. Improved nationwide survival of sarcoma patients with a network of reference centers. Ann Oncol 2024; 35:351-363. [PMID: 38246351 DOI: 10.1016/j.annonc.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND We investigated the impact of the implementation of a network of reference centers for sarcomas (NETSARC) on the care and survival of sarcoma patients in France since 2010. PATIENTS AND METHODS NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor boards (MDTBs), funded by the French National Cancer Institute (INCa) since 2010. Its aims are to improve the quality of diagnosis and care of sarcoma patients. Patients' characteristics, treatments, and outcomes are collected in a nationwide database. The objective of this analysis was to compare the survival of patients in three periods: 2010-2012 (non-exhaustive), 2013-2015, and 2016-2020. RESULTS A total of 43 975 patients with sarcomas, gastrointestinal stromal tumors (GISTs), or connective tissue tumors of intermediate malignancy were included in the NETSARC+ database since 2010 (n = 9266 before 2013, n = 12 274 between 2013 and 2015, n = 22 435 in 2016-2020). Median age was 56 years, 50.5% were women, and 13.2% had metastasis at diagnosis. Overall survival was significantly superior in the period 2016-2020 versus 2013-2015 versus 2010-2012 for the entire population, for patients >18 years of age, and for both metastatic and non-metastatic patients in univariate and multivariate analyses (P < 0.0001). Over the three periods, we observed a significantly improved compliance to clinical practice guidelines (CPGs) nationwide: the proportion of patients biopsied before surgery increased from 62.9% to 72.6%; the percentage of patients presented to NETSARC MDTBs before first surgery increased from 31.7% to 44.4% (P < 0.0001). The proportion of patients with R0 resection on first surgery increased (from 36.1% to 46.6%), while R2 resection rate decreased (from 10.9% to 7.9%), with a better compliance and improvement in NETSARC centers. CONCLUSIONS The implementation of the national reference network for sarcoma was associated with an improvement of overall survival and compliance to guidelines nationwide in sarcoma patients. Referral to expert networks for sarcoma patients should be encouraged, though a better compliance to CPGs can still be achieved.
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Affiliation(s)
- J Y Blay
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon.
| | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - T Valentin
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - P Anract
- Department of Orthopedics, Hôpital Cochin Saint Vincent de Paul, Paris
| | - F Duffaud
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - A Dufresne
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - B Verret
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - A Cordoba
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - A Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - M Brahmi
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Henon
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - T Amouyel
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - I Ray-Coquard
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - G Ferron
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | | | - C Tlemsani
- Department of Orthopedics, Hôpital Cochin Saint Vincent de Paul, Paris
| | - S Salas
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - R Rochwerger
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - M Faron
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - E Bompas
- Department of Medical Oncology, Cochin Hospital, Paris; Department of Medical Oncology, Centre René Gauducheau, Nantes St. Herblain
| | - A Ducassou
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - D Gangloff
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - F Gouin
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Service Orthopedie, CHU Nantes, Nantes
| | - N Firmin
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - S Piperno-Neumann
- INSERM U1194, IRCM, Univ Montpellier, Montpellier; Department of Medical Oncology, Institut Curie, Paris; Department of Surgical Oncology, Institut Curie, Paris
| | - M Rios
- Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - M Ropars
- Department of Orthopedics, CHU Rennes, Rennes
| | | | | | - F Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - S Carrere
- Service Orthopedie, CHU Nantes, Nantes
| | - C Llacer
- Service Orthopedie, CHU Nantes, Nantes
| | - S Watson
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - S Bonvalot
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - A Leroux
- INSERM U1194, IRCM, Univ Montpellier, Montpellier
| | - C Perrin
- Department of Medical Oncology, Eugene Marquis Comprehensive Cancer Center, Rennes
| | - J Gantzer
- Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - M Pracht
- Department of Medical Oncology, Eugene Marquis Comprehensive Cancer Center, Rennes
| | - B Narciso
- Department of Orthopedic Surgery, Tours
| | - A Monneur
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - C Lebbe
- Department of Dermatology, INSERM U976 University Paris Diderot Saint Louis Hospital, Paris; Department of CIC, INSERM U976 University Paris Diderot Saint Louis Hospital, Paris
| | - A Hervieu
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon
| | - E Saada-Bouzid
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice
| | - P Dubray-Longeras
- Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand
| | - F Fiorenza
- Department of Orthopedic Surgery, CHU Limoges, Limoges
| | - L Chaigneau
- Department of Medicine, CHU Besancon, Besancon
| | | | - P Soibinet
- Department of Medicine, Centre Francois Baclesse, Caen
| | - O Bouché
- Department of Gastroenterology, CHU Reims, Reims
| | - C Guillemet
- Department of Medical Oncology, Centre J Godinot Reims, Reims
| | - J P Spano
- Department of Oncology, Hôpital Pitié-Salpétriere, Paris
| | - J C Ruzic
- Departement d'oncologie, CHU, La Reunion
| | - N Isambert
- Service d'oncologie, CHU Poitiers, Poitiers, France
| | - G Vaz
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - P Meeus
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Karanian
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Ngo
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - J M Coindre
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | | | - F Le Loarer
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - F Ducimetiere
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Chemin
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Morelle
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Toulmonde
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - A Le Cesne
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
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9
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Liu Z, Gao J, Zeng C, Chen Y. Development and validation of a preoperative risk nomogram prediction model for gastric gastrointestinal stromal tumors. Surg Endosc 2024; 38:1933-1943. [PMID: 38334780 DOI: 10.1007/s00464-024-10674-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/30/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND AND STUDY AIMS Gastrointestinal stromal tumors (GIST) carry a potential risk of malignancy, and the treatment of GIST varies for different risk levels. However, there is no systematic preoperative assessment protocol to predict the malignant potential of GIST. The aim of this study was to develop a reliable and clinically applicable preoperative nomogram prediction model to predict the malignant potential of gastric GIST. PATIENTS AND METHODS Patients with a pathological diagnosis of gastric GIST from January 2015 to December 2021 were screened retrospectively. Univariate and multivariate logistic analyses were used to identify independent risk factors for gastric GIST with high malignancy potential. Based on these independent risk factors, a nomogram model predicting the malignant potential of gastric GIST was developed and the model was validated in the validation group. RESULTS A total of 494 gastric GIST patients were included in this study and allocated to a development group (n = 345) and a validation group (n = 149). In the development group, multivariate logistic regression analysis revealed that tumor size, tumor ulceration, CT growth pattern and monocyte-to- lymphocyte ratio (MLR) were independent risk factors for gastric GIST with high malignancy potential. The AUC of the model were 0.932 (95% CI 0.890-0.974) and 0.922 (95% CI 0.868-0.977) in the development and validation groups, respectively. The best cutoff value for the development group was 0.184, and the sensitivity and specificity at this value were 0.895 and 0.875, respectively. The calibration curves indicated good agreement between predicted and actual observed outcomes, while the DCA indicated that the nomogram model had clinical application. CONCLUSIONS Tumor size, tumor ulceration, CT growth pattern and MLR are independent risk factors for high malignancy potential gastric GIST, and a nomogram model developed based on these factors has a high ability to predict the malignant potential of gastric GIST.
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Affiliation(s)
- Zide Liu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
| | - Jiaxin Gao
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
| | - Chunyan Zeng
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China.
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi, China.
| | - Youxiang Chen
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China.
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi, China.
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10
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Huang RS, Mihalache A, Nafees A, Hasan A, Ye XY, Liu Z, Leighl NB, Raman S. The impact of multidisciplinary cancer conferences on overall survival: a meta-analysis. J Natl Cancer Inst 2024; 116:356-369. [PMID: 38123515 DOI: 10.1093/jnci/djad268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Multidisciplinary cancer conferences consist of regular meetings between diverse specialists working together to share clinical decision making in cancer care. The aim of this study was to systematically review and meta-analyze the effect of multidisciplinary cancer conference intervention on the overall survival of patients with cancer. METHODS A systematic literature search was conducted on Ovid MEDLINE, EMBASE, and the Cochrane Controlled Register of Trials for studies published up to July 2023. Studies reporting on the impact of multidisciplinary cancer conferences on patient overall survival were included. A standard random-effects model with the inverse variance-weighted approach was used to estimate the pooled hazard ratio of mortality (multidisciplinary cancer conference vs non-multidisciplinary cancer conference) across studies, and the heterogeneity was assessed by I2. Publication bias was examined using funnel plots and the Egger test. RESULTS A total of 134 287 patients with cancer from 59 studies were included in our analysis, with 48 467 managed by multidisciplinary cancer conferences and 85 820 in the control arm. Across all cancer types, patients managed by multidisciplinary cancer conferences had an increased overall survival compared with control patients (hazard ratio = 0.67, 95% confidence interval = 0.62 to 0.71, I2 = 84%). Median survival time was 30.2 months in the multidisciplinary cancer conference group and 19.0 months in the control group. In subgroup analysis, a positive effect of the multidisciplinary cancer conference intervention on overall survival was found in breast, colorectal, esophageal, hematologic, hepatocellular, lung, pancreatic, and head and neck cancer. CONCLUSIONS Overall, our meta-analysis found a significant positive effect of multidisciplinary cancer conferences compared with controls. Further studies are needed to establish nuanced guidelines when optimizing multidisciplinary cancer conference integration for treating diverse patient populations.
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Affiliation(s)
- Ryan S Huang
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Andrew Mihalache
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Asad Hasan
- University of British Columbia, Vancouver, BC, Canada
| | - Xiang Y Ye
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Zhihui Liu
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Natasha B Leighl
- Department of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Srinivas Raman
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
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11
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He J, Wang J, Yang L, Wang K, Wang M, Li J. Synovial sarcoma of the viscera (lung and jejunum): a case report. J Int Med Res 2024; 52:3000605241233953. [PMID: 38534077 PMCID: PMC10981226 DOI: 10.1177/03000605241233953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/29/2024] [Indexed: 03/28/2024] Open
Abstract
We report the case of a woman nearing 70 years old who was admitted to the hospital with a complaint of "epigastric distension for 1 month". Her main signs and symptoms were progressive abdominal distension and occasional abdominal pain. Computed tomography suggested an abdominal mass. She had a surgical history of synovial sarcoma (SS) of the lungs. After admission, she was diagnosed with jejunal SS following a puncture biopsy and laparoscopic surgery. This disease usually occurs in the soft tissues of the limbs, and it is extremely rare for SS to originate in the jejunum. The morphologic heterogeneity of SS overlaps with other tumors and makes the diagnosis particularly difficult. Imaging studies usually lack specificity; however, measuring multiple immunohistochemical markers can greatly assist in the diagnosis and differential diagnosis of SS. This case not only enriches our understanding of SS and describes a rare site of origin, but also emphasizes the importance and challenges of achieving an accurate diagnosis. Immunohistochemical and molecular biological testing have important roles in the definitive diagnosis, highlighting the need for precise and innovative diagnostic and therapeutic approaches in SS.
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Affiliation(s)
- Jixin He
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Jiwei Wang
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Lina Yang
- Operation Room of the Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Kai Wang
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Maijian Wang
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Jianguo Li
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
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12
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Liu Y, Cui M, Zhou X, Zhai D, Qin M, Fan G, Cai W. A Case report: Synovial sarcoma of the mediastinum in an 18-year-old teenager. Front Oncol 2024; 14:1288213. [PMID: 38434682 PMCID: PMC10904483 DOI: 10.3389/fonc.2024.1288213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
Synovial sarcomas (SSs) are a rare group of malignant tumors originating from pluripotential mesenchymal cells, which commonly occur as the primary tumor in the soft tissues near the articular surface, tendons, and articular synovium. Herein, we report a rare case of mediastinal SS in an 18-year-old teenager who initially presented with cough as the primary symptom. In this case, plain chest CT and contrast-enhanced CT clearly revealed the lesion presenting as a round-like and uneven density mass in the mediastinum with heterogeneous enhancement, which compressed the trachea and invaded the adjacent vessels. Based on the results of immunohistochemistry and fluorescence in situ hybridization (FISH), combined with the differential diagnosis with other types of tumors in the mediastinum on imaging, we were able to diagnose the tumor as an SS located in the mediastinum. Subsequent resection of the lesion coupled with chemotherapy and immunotherapy led to an improvement in the patient's symptoms.
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Affiliation(s)
- Yan Liu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Manman Cui
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiuzhi Zhou
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Duchang Zhai
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Mingyu Qin
- Suzhou Medical College, Soochow University, Suzhou, China
| | - Guohua Fan
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Wu Cai
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
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13
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Revia S, Budzinska MA, Bogatyrova O, Neumann F, Zimmermann A, Amendt C, Albers J. DNA-Dependent Protein Kinase Inhibitor Peposertib Potentiates the Cytotoxicity of Topoisomerase II Inhibitors in Synovial Sarcoma Models. Cancers (Basel) 2023; 16:189. [PMID: 38201616 PMCID: PMC10778103 DOI: 10.3390/cancers16010189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/25/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Synovial sarcoma is a rare and highly aggressive subtype of soft tissue sarcoma. The clinical challenge posed by advanced or metastatic synovial sarcoma, marked by limited treatment options and suboptimal outcomes, necessitates innovative approaches. The topoisomerase II (Topo II) inhibitor doxorubicin has remained the cornerstone systemic treatment for decades, and there is pressing need for improved therapeutic strategies for these patients. This study highlights the potential to enhance the cytotoxic effects of doxorubicin within well-characterized synovial sarcoma cell lines using the potent and selective DNA-PK inhibitor, peposertib. In vitro investigations unveil a p53-mediated synergistic anti-tumor effect when combining doxorubicin with peposertib. The in vitro findings were substantiated by pronounced anti-tumor effects in mice bearing subcutaneously implanted tumors. A well-tolerated regimen for the combined application was established using both pegylated liposomal doxorubicin (PLD) and unmodified doxorubicin. Notably, the combination of PLD and peposertib displayed enhanced anti-tumor efficacy compared to unmodified doxorubicin at equivalent doses, suggesting an improved therapeutic window-a critical consideration for clinical translation. Efficacy studies in two patient-derived xenograft models of synovial sarcoma, accurately reflecting human metastatic disease, further validate the potential of this combined therapy. These findings align with previous evidence showcasing the synergy between DNA-PK inhibition and Topo II inhibitors in diverse tumor models, including breast and ovarian cancers. Our study extends the potential utility of combined therapy to synovial sarcoma.
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Affiliation(s)
- Steffie Revia
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
| | | | - Olga Bogatyrova
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
| | - Felix Neumann
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
| | - Astrid Zimmermann
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
| | - Christiane Amendt
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
| | - Joachim Albers
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
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14
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Guo Y, Lin C, Li XX, Zhou JJ, Wang J. Synovial sarcoma in the prevertebral space can mimic malignant neurogenic neoplasm: Case report and literature review. Radiol Case Rep 2023; 18:4195-4201. [PMID: 37753502 PMCID: PMC10518339 DOI: 10.1016/j.radcr.2023.08.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
Synovial sarcoma, a rare malignant neoplasm with a poor prognosis, accounts for approximately 5%-10% of all primary soft-tissue malignancies worldwide. Typically affecting adolescents and young adults, it primarily manifests near the joints of the lower extremities. This study aimed to demonstrate that this tumor can also affect the prevertebral space. A 32-year-old male patient presented at our outpatient clinic with a 2-month history of upper limb numbness and a 1-month complaint of palpable neck mass. Imaging studies revealed a bulky, lobulated, and heterogeneous mass exhibiting heterogeneous enhancement. Furthermore, the mass caused expansion of the neuroforamen in the neck, initially suggesting a diagnosis of malignant schwannoma. However, a histopathologic examination suggested synovial sarcoma. The article provided a comprehensive review of the clinical, pathological, and radiological features of this condition. Additionally, it explored current treatment options and prognoses by referencing relevant literature.
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Affiliation(s)
- Yi Guo
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Fujian Province, China
| | - Chong Lin
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Fujian Province, China
| | - Xiao-xia Li
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Fujian Province, China
| | - Jian-jun Zhou
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Fujian Province, China
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Xiamen Municipal Clinical Research Center for Medical Imaging, Fujian Province, China
| | - Jian Wang
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Fujian Province, China
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
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15
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Cho EB, Lee SK, Kim JY, Kim Y. Synovial Sarcoma in the Extremity: Diversity of Imaging Features for Diagnosis and Prognosis. Cancers (Basel) 2023; 15:4860. [PMID: 37835554 PMCID: PMC10571652 DOI: 10.3390/cancers15194860] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/15/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
Synovial sarcomas are rare and highly aggressive soft-tissue sarcomas, primarily affecting adolescents and young adults aged 15-40 years. These tumors typically arise in the deep soft tissues, often near the large joints of the extremities. While the radiological features of these tumors are not definitely indicative, the presence of calcification in a soft-tissue mass (occurring in 30% of cases), adjacent to a joint, strongly suggests the diagnosis. Cross-sectional imaging characteristics play a crucial role in diagnosing synovial sarcomas. They often reveal significant characteristics such as multilobulation and pronounced heterogeneity (forming the "triple sign"), in addition to features like hemorrhage and fluid-fluid levels with septa (resulting in the "bowl of grapes" appearance). Nevertheless, the existence of non-aggressive features, such as gradual growth (with an average time to diagnosis of 2-4 years) and small size (initially measuring < 5 cm) with well-defined margins, can lead to an initial misclassification as a benign lesion. Larger size, older age, and higher tumor grade have been established as adverse predictive indicators for both local disease recurrence and the occurrence of metastasis. Recently, the prognostic importance of CT and MRI characteristics for synovial sarcomas was elucidated. These include factors like the absence of calcification, the presence of cystic components, hemorrhage, the bowl of grape sign, the triple sign, and intercompartmental extension. Wide surgical excision remains the established approach for definitive treatment. Gaining insight into and identifying the diverse range of presentations of synovial sarcomas, which correlate with the prognosis, might be helpful in achieving the optimal patient management.
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Affiliation(s)
- Eun Byul Cho
- Department of Radiology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu 11765, Republic of Korea
| | - Seul Ki Lee
- Department of Radiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jee-Young Kim
- Department of Radiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Yuri Kim
- Department of Radiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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16
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Fadavi P, Garousi M, Soltani S, Montazer F, Abolhasani M, Asgari S, Mirzaee E. The uterine adenosarcoma with postoperative residual in a woman treated by total abdominal hysterectomy/bilateral salpingo-oophorectomy: A case report and review of literature. Cancer Rep (Hoboken) 2023; 6:e1891. [PMID: 37592402 PMCID: PMC10598255 DOI: 10.1002/cnr2.1891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/09/2023] [Accepted: 07/22/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND In patients with uterine adenosarcoma, a total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO) is typically recommended as an initial treatment. There is no consensus on adjuvant therapies. CASE We report the case of a patient with uterine adenosarcoma with postoperative residual disease. We performed four courses of adjuvant chemotherapy, including Ifosfamide, Mesna, and Adriamycin, and whole pelvic radiation with a dose of 50.4 Gy/28 Fr. CONCLUSION A combination of chemotherapy and radiotherapy may be a promising treatment option for uterine adenosarcoma with postoperative residual disease.
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Affiliation(s)
- Pedram Fadavi
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
| | - Maryam Garousi
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
| | - Sepideh Soltani
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
| | - Fatemeh Montazer
- Department of Pathology, School of MedicineIran University of Medical SciencesTehranIran
| | - Maryam Abolhasani
- Oncopathology Research Center, School of MedicineIran University of Medical SciencesTehranIran
| | - Salar Asgari
- Department of Pathology, School of MedicineIran University of Medical SciencesTehranIran
| | - Elahe Mirzaee
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
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17
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Tuan HX, Dung TN, Lieu DQ, Long TB, Anh TN, Dung LQ, Duc NM. A rare case of perineal synovial sarcoma. Radiol Case Rep 2023; 18:3603-3607. [PMID: 37577075 PMCID: PMC10415828 DOI: 10.1016/j.radcr.2023.07.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/22/2023] [Accepted: 07/23/2023] [Indexed: 08/15/2023] Open
Abstract
Synovial sarcoma is a malignant mesenchymal neoplasm that is frequently misdiagnosed due to its slow growth and small size. This tumor presents as a nonspecific heterogeneous mass on cross-sectional imaging. Biopsy and histopathological assessments are required to differentiate synovial sarcoma from other sarcoma subtypes and to define the tumor grade. This article presents the case of a 17-year-old male patient with perineal synovial sarcoma.
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Affiliation(s)
- Ho Xuan Tuan
- Department of Medical Imaging, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam
| | - Tran Ngoc Dung
- Department of General Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam
- Department of Experimental Surgery, Hanoi Medical University, Hanoi, Vietnam
| | - Dau Quang Lieu
- Department of Internal Medicine, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Tran Bao Long
- Department of General Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Tran Ngoc Anh
- Department of Internal Medicine, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Luu Quang Dung
- Department of General Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
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18
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Schiltz D, Sokolow AJ, Minck N, Schreml S, Moser L, von Fritschen U. The phyllodes menace-Variation in course, therapy, and appearance of phyllodes tumors in a case series of three patients. Clin Case Rep 2023; 11:e7836. [PMID: 37663819 PMCID: PMC10474313 DOI: 10.1002/ccr3.7836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/13/2023] [Accepted: 08/07/2023] [Indexed: 09/05/2023] Open
Abstract
Key Clinical Message Early and complete surgical resection is the most important therapeutic and diagnostic measure. Adjuvant radiation is suggested for malign phyllode tumors, phyllode tumors larger than 10 cm or those with a low distance to the resection margins. Abstract Phyllodes tumors are rare fibroepithelial tumors of the breast. Histologically, they are usually classified as benign, borderline or malignant, though these classifications do not necessarily reflect the clinical course of the disease. These tumors may stay undetected for years, or show sudden and rapid progression. There is currently no consistent therapy recommendation based upon histological findings, the localization of the tumor and/or whether it is recurrent. Using the examples of three patients, we show how courses and therapy may differ widely, and discuss this in the context of the current state of the literature.
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Affiliation(s)
- Daniel Schiltz
- Department of Plastic and Aesthetic Surgery, Hand SurgeryHelios Hospital Emil von BehringBerlinGermany
| | - Alexander Jan Sokolow
- Department of Plastic and Aesthetic Surgery, Hand SurgeryHelios Hospital Emil von BehringBerlinGermany
| | - Natalya Minck
- Department of PathologyHelios Hospital Emil von BehringBerlinGermany
| | - Stephan Schreml
- Department of DermatologyUniversity Hospital RegensburgGermany
| | - Lutz Moser
- Department of RadiotherapyHelios Hospital Emil von BehringBerlinGermany
| | - Uwe von Fritschen
- Department of Plastic and Aesthetic Surgery, Hand SurgeryHelios Hospital Emil von BehringBerlinGermany
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Farzaliyev F, Steinau HU, Ring A, Beck P, Hardes J, Streitbürger A, Podleska LE. Classic Type of Epithelioid Sarcoma of the Distal Upper Extremity: Clinical and Oncological Characteristics. Hand (N Y) 2023; 18:1037-1043. [PMID: 35187970 PMCID: PMC10470246 DOI: 10.1177/15589447221075745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The classic type of epithelioid sarcoma (ES) is a rare, aggressive soft tissue neoplasm that most commonly affects the distal upper extremities of young patients. This study aimed to assess clinical features and provide a long-term report of the oncological outcome. METHODS We retrospectively analyzed our clinical database for patients with ES of the distal upper extremities. RESULTS Twenty-three patients with ES of the distal upper extremity were treated surgically between January 1990 and August 2018. ES affected most commonly the palmar side of young patients. The most common site affected by a sarcoma was the wrist in 47.8% of cases, followed by metacarpals and fingers with 34.8% and 17.4%, respectively. Most of the patients were treated according to the protocols of interdisciplinary tumor boards with multimodal therapy. A local recurrence was observed in 7 patients (30.4%). The 5 - and 10-year recurrence-free survival was 80.4% (95% confidence interval [CI]: 68.6-76.8) and 60.9% (95% CI: 53.5-68.3), respectively. The 5- and 10-years disease-specific survival was 89.9% (95% CI: 87-92.8) and 61.9% (95% CI: 56.5-67.3), respectively. Five patients (21.7%) had metastasis in regional lymph nodes. CONCLUSION The classic type of ES represents a group of high-grade sarcomas, which affect the dominantly distal upper extremity. Specific clinical, diagnostic, and oncological characteristics make it difficult to diagnose and therapy. Wide tumor resection as a part of multimodal therapy remains a more viable and common treatment option for patients with ES on distal extremities. High rates of lymph node metastasis are typical for ES.
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Affiliation(s)
- Farhad Farzaliyev
- Department of Trauma, Hand and Reconstructive Surgery/Division Plastic and Reconstructive Surgery, University Hospital Essen, Germany
- Department of Tumor Orthopedics and Sarcoma Surgery, University Hospital Essen, Germany
| | - Hans-Ulrich Steinau
- Department of Trauma, Hand and Reconstructive Surgery/Division Plastic and Reconstructive Surgery, University Hospital Essen, Germany
| | - Andrej Ring
- Department of Plastic and Reconstructive Surgery, St. Rochus-Hospital, Castrop-Rauxel, Germany
- Ruhr-University Bochum, Germany
| | - Paula Beck
- Department of Trauma, Hand and Reconstructive Surgery/Division Plastic and Reconstructive Surgery, University Hospital Essen, Germany
| | - Jendrik Hardes
- Department of Tumor Orthopedics and Sarcoma Surgery, University Hospital Essen, Germany
| | - Arne Streitbürger
- Department of Tumor Orthopedics and Sarcoma Surgery, University Hospital Essen, Germany
| | - Lars Erik Podleska
- Department of Tumor Orthopedics and Sarcoma Surgery, University Hospital Essen, Germany
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Endara SA, De la Torre JS, Terán FJ, Alarcón JP, Tovar CE. Multidisciplinary management of recurrent synovial sarcoma of the chest wall. NORTH AMERICAN SPINE SOCIETY JOURNAL 2023; 15:100243. [PMID: 37575880 PMCID: PMC10415753 DOI: 10.1016/j.xnsj.2023.100243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/14/2023] [Accepted: 07/05/2023] [Indexed: 08/15/2023]
Abstract
Background Synovial sarcoma (SS) is part of soft tissue sarcomas (STS). An incidence between 5% to 10% is estimated. The origin is mesenchymal mainly affecting the extremities. Being even rarer at the chest level and vertebral body, representing around 1%. Histologically, it consists of 3 variants: monophasic, biphasic, and poorly differentiated. Surgical resection is a priority when it comes to multidisciplinary management. The prognosis of patients with SS over the years has improved markedly. Purpose Understand and evaluate the multidisciplinary management of SS considering that the SS has a lowe prevalence and highly malignancy. Study Design We present a case of a 31-year-old male who has a history of monophasic synovial sarcoma diagnosed in 2019 and underwent surgery. Patient came back after two years without symptoms and posterior to a control MRI we observed a local recurrence of SS. Methods The literature was reviewed with a focus on best clinical and surgical strategy for recurrence of SS. Results The patient recovered well with return to his normal daily activities. The review of the literature shows us the importance of the multidisciplinary management for the optimal clinical and surgical approach of SS recurrence. Conclusions SS represents a unique variant of STS, with malignant and metastatic potential. Being a rare pathology, an adequate multidisciplinary management is essential when providing optimal care for the patient.
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Affiliation(s)
- Santiago A. Endara
- Cardiovascular and Thoracic surgeon, Hospital Metropolitano, Quito, Ecuador
| | | | - Fernando J. Terán
- Orthopedic surgery senior resident, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Juan Pablo Alarcón
- General Surgery resident, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Carla E. Tovar
- Oncologist surgeon, Hospital Metropolitano. Quito, Ecuador
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21
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Racem T, Mehdi D, Ahmed G, Faten S, Amen D, Adnen C. Synovial sarcoma of the abdominal wall: A case report for a rare entity with a challenging treatment. Int J Surg Case Rep 2023; 109:108596. [PMID: 37527598 PMCID: PMC10407252 DOI: 10.1016/j.ijscr.2023.108596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Synovial Sarcoma is an intriguing disease, it represents a distinctive subtype of soft tissue sarcoma that does not exceed 10 % of all STS. This tumor can arise from the abdominal wall in very rare cases. Due to its unique presentation (occurring at a young age, various anatomical locations, and slow evolutionary kinetics), diagnosis can be challenging. The mainstay of treatment remains wide surgical excision with negative margins. CASE PRESENTATION We herein report a challenging diagnosis of synovial sarcoma with exceptional location, presented as a slowly evolving abdominal mass of the right iliac fossa. Soft tissue MRI confirmed the presence of a sub cutaneous mass without signs of local invasion. Surgical management as indicated. Anatomopathological findings were in favor of a synovial sarcoma of the abdominal wall. The patient was discharged. No complication was observed after 3 months follow up. CLINICAL DISCUSSION Patients with synovial sarcoma of the abdominal wall is a very rare entity, therefor positive pre operative diagnosis is hard to achieve, because of the lack of specific clinical and radiological signs. No standard treatment is advised, beside surgical management wish is the main course of management. CONCLUSION Synovial sarcoma is an infrequent pathology, with no specific signs in both clinical and radiological findings. The main course of management is surgery with healthy resection margins. Long term follow up is advised because of the high risk of recurrence.
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Affiliation(s)
- Trigui Racem
- Departement of General Surgery, Internal Security Forces Hospital, Marsa, Tunisia.
| | - Debaibi Mehdi
- Departement of General Surgery, Internal Security Forces Hospital, Marsa, Tunisia; Faculty of Medicine of Tunis, University of Tunis el Manar, Tunisia
| | - Guermazi Ahmed
- Departement of General Surgery, Internal Security Forces Hospital, Marsa, Tunisia
| | - Souai Faten
- Departement of General Surgery, Internal Security Forces Hospital, Marsa, Tunisia; Faculty of Medicine of Tunis, University of Tunis el Manar, Tunisia
| | - Dhaoui Amen
- Departement of General Surgery, Internal Security Forces Hospital, Marsa, Tunisia; Departement of Anatomical Pathology, Internal Security Forces Hospital, Marsa, Tunisia
| | - Chouchen Adnen
- Departement of General Surgery, Internal Security Forces Hospital, Marsa, Tunisia; Faculty of Medicine of Tunis, University of Tunis el Manar, Tunisia
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22
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Ghimire S, Pokhrel P, Thapa S. Limb conservation surgery in biphasic synovial sarcoma of thigh with vascular involvement: A race against time. Int J Surg Case Rep 2023; 109:108646. [PMID: 37566986 PMCID: PMC10432812 DOI: 10.1016/j.ijscr.2023.108646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION Synovial sarcomas are malignant soft tissue neoplasm representing 5 to 10 % of all Soft tissue sarcoma with incidence of 2.75 per 100,000. It is presented in particular along with extra articular location with no as such relation to synovial structures. Among various histological pattern biphasic synovial sarcoma (SS) is considered classical type. Involvement of neurovascular structures in synovial sarcoma is least noted and such invasion by malignant cells is considered an indication for amputation. However vessel reconstructive surgeries have also resulted in conservation of limb hence providing good quality of life. CASE PRESENTATION 13 years old Asian female presented with complaint of exposed synthetic vessel graft from her previous surgical site where femoral vessel reconstruction was carried out for SS of thigh with femoral vessel involvement. Following her (wide local excision) WLE and femoral vessel reconstruction in another center she suffered thrombosis of her femoral vessel following which emergency thrombectomy was also carried out. Later in our center vertical rectus abdominis myocutaneous flap (VRAM) flap was used to manage her exposed synthetic graft. At subsequent follow up patient was ambulating well with no signs of radiological metastasis. CLINICAL DISCUSSION Surgical resections of mass along with synthetic graft placement of the concomitant vascular bundle have also shown significant improvement in reducing the burden of the severe diseases such as synovial sarcoma. CONCLUSION SS with its malignant pathophysiology have impacted severely the quality of life of even among the pediatrics group of population. It is utmost need to set up proper and definitive muscular oncological care to reduce the morbidity and mortality associated with such malignancies.
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Affiliation(s)
- Sagun Ghimire
- KIST Medical College and Teaching Hospital, Lalitpur, Nepal.
| | | | - Samir Thapa
- KIST Medical College and Teaching Hospital, Lalitpur, Nepal
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Cui W, Liao YJ, Su P, Yang H, Zhang N. Synovial sarcoma of female urethra: a case report and review of the literature. Diagn Pathol 2023; 18:78. [PMID: 37400856 DOI: 10.1186/s13000-023-01367-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023] Open
Abstract
Synovial sarcoma (SS) is a rare malignant soft tissue sarcoma that originates from primitive mesenchymal cells with epithelial differentiation potential. It is most commonly found in the limbs and trunk. In the urinary system, it is mostly found in the kidneys. However, synovial sarcomas originating from the external urethra are extremely rare. Only one case of synovial sarcoma arising from the vulvar urethral orifice has been reported previously, and we report a second case of synovial sarcoma of the urethral orifice. In addition, a total of 16 vulvar synovial sarcomas were identified and the literature are analyzed in this report reviews from 1966 to the present.
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Affiliation(s)
- Wei Cui
- Department of Urology, The Affiliated Hospital of Zunyi Medical University, No.149 Dalian Road, Zunyi, Guizhou, China
| | - Yuan-Jian Liao
- Department of Urology, The Affiliated Hospital of Zunyi Medical University, No.149 Dalian Road, Zunyi, Guizhou, China
| | - Peng Su
- Department of Urology, The Affiliated Hospital of Zunyi Medical University, No.149 Dalian Road, Zunyi, Guizhou, China
| | - Hua Yang
- Department of Pathology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
| | - Neng Zhang
- Department of Urology, The Affiliated Hospital of Zunyi Medical University, No.149 Dalian Road, Zunyi, Guizhou, China.
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Perivoliotis K, Baloyiannis I, Samara AA, Koutoukoglou P, Ntellas P, Dadouli K, Ioannou M, Tepetes K. Microvessel density in patients with gastrointestinal stromal tumors: A systematic review and meta-analysis. World J Methodol 2023; 13:153-165. [PMID: 37456971 PMCID: PMC10348082 DOI: 10.5662/wjm.v13.i3.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/30/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Gastrointestinal stromal tumors (GISTs) are considered the most common mesenchymal tumors of the gastrointestinal tract. Microvessel density (MVD) constitutes a direct method of vascularity quantification and has been associated with survival rates in multiple malignancies.
AIM To appraise the effect of MVD on the survival of patients with GIST.
METHODS This study adhered to Systematic reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Electronic scholar databases and grey literature repositories were systematically screened. The Fixed Effects or Random Effects models were used according to the Cochran Q test.
RESULTS In total, 6 eligible studies were identified. The pooled hazard ratio (HR) for disease free survival (DFS) was 8.52 (95%CI: 1.69-42.84, P = 0.009). The odds ratios of disease-free survival between high and low MVD groups at 12 and 60 mo did not reach statistical significance. Significant superiority of the low MVD group in terms of DFS was documented at 36 and 120 mo (OR: 8.46, P < 0.0001 and OR: 22.71, P = 0.0003, respectively) as well as at metastases rate (OR: 0.11, P = 0.0003).
CONCLUSION MVD significantly correlates with the HR of DFS and overall survival rates at 36 and 120 mo. Further prospective studies of higher methodological quality are required.
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Affiliation(s)
| | - Ioannis Baloyiannis
- Department of Surgery, University Hospital of Larissa, Larissa 41110, Greece
| | - Athina A Samara
- Department of Surgery, University Hospital of Larissa, Larissa 41110, Greece
| | - Prodromos Koutoukoglou
- Research Methodology in Biomedicine, Biostatistics and Clinical Bioinformatics, University of Thessaly, 41110 41110, Greece
| | - Panagiotis Ntellas
- Department of Pathology, University Hospital of Larissa, Larissa 41110, Greece
| | - Katerina Dadouli
- Research Methodology in Biomedicine, Biostatistics and Clinical Bioinformatics, University of Thessaly, 41110 41110, Greece
| | - Maria Ioannou
- Department of Pathology, University Hospital of Larissa, Larissa 41110, Greece
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Jaouani L, Zaimi A, Al Jarroudi O, Brahmi SA, Afqir S. Undifferentiated Sarcoma: A Rare Tumor of the Prostate. Cureus 2023; 15:e41056. [PMID: 37519507 PMCID: PMC10374467 DOI: 10.7759/cureus.41056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Prostate cancer is the most common malignant tumor in men. The vast majority of prostate tumors are represented by prostatic adenocarcinomas (up to 95%). Sarcoma is a very rare tumor in adults with a formidable prognosis. Early diagnosis and radical surgery offer patients the best chance of a cure. We report the case of a 44-year-old patient with stage VI unresectable high-grade undifferentiated prostate sarcoma, initially presenting with urinary disorders and a large pelvic mass of prostatic origin, with normal Prostate-specific antigen (PSA) levels. The patient was managed by palliative chemotherapy.
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Affiliation(s)
- Laila Jaouani
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
| | - Adil Zaimi
- Medical Oncology, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
| | | | | | - Said Afqir
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
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26
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Virji SN, Pirzada MA, Siddiqui NA, Idrees R, Zeeshan S. Axillary synovial sarcoma recurrence involving brachial plexus, a rare case report from Pakistan. Int J Surg Case Rep 2023; 107:108325. [PMID: 37224725 DOI: 10.1016/j.ijscr.2023.108325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION Synovial sarcomas are rare tumors, and the incidence of axillary synovial sarcoma involving the brachial plexus has been reported as 2.9 % among all axillary soft tissue tumors. However, the recurrence of axillary synovial sarcomas has not been reported in literature. CASE PRESENTATION A 36-years-old Afghan female presented in Karachi, Pakistan with a history of persistently increasing, recurrent, right axillary mass for 6 months. Initially diagnosed as a spindle-cell tumor on excision in Afghanistan, she had received ifosfamide and doxorubicin, but the lesion recurred. On examination, it was a 5 × 6 cm, hard mass palpable in right axilla. After radiological work-up and a multidisciplinary team discussion, she underwent complete excision of the tumor with successful preservation of brachial plexus. The final diagnosis was reported as monophasic synovial sarcoma FNCLCC Grade 3. DISCUSSION Our patient presented with a recurrent right axillary synovial sarcoma that was involving the axillary neurovascular bundle and brachial plexus, which was initially diagnosed as a spindle cell sarcoma. Pre-operative core-needle biopsy was unable to provide a definitive diagnosis. MRI scan was useful in delineating the proximity of the neurovascular structures. Re-excision of the tumor was performed which is the mainstay of treatment for axillary synovial sarcomas, combined with radiotherapy depending on the disease grading, staging and patient factors. CONCLUSION Axillary synovial sarcoma recurrence with involvement of the brachial plexus is an extremely rare presentation. Our patient was successfully managed through a multidisciplinary approach with complete surgical excision and preservation of the brachial plexus followed by adjuvant radiotherapy.
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Affiliation(s)
- Safna Naozer Virji
- Section of General Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
| | - Muhammad Ammar Pirzada
- Section of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Nadeem Ahmed Siddiqui
- Section of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
| | - Romana Idrees
- Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan.
| | - Sana Zeeshan
- Section of Breast Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
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27
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Hua R, Zhao L, Xu L, Sun J, Huang J, Hua Q. Recurrent paratesticular giant liposarcoma: A case report and literature review. Front Surg 2023; 10:1171952. [PMID: 37181598 PMCID: PMC10172677 DOI: 10.3389/fsurg.2023.1171952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/31/2023] [Indexed: 05/16/2023] Open
Abstract
Background Primary paratesticular liposarcoma is rarely diagnosed among urinary tumors. In this study, through the retrospective analysis of clinical data and literature review, a case of recurrent paratesticular liposarcoma with lymph node metastasis after radical resection has been reported to explore novel strategies for the diagnosis, treatment and prognosis of this rare disease. Case summary The present case involved a patient who was misdiagnosed as a left inguinal hernia for the first time two years ago, but was later diagnosed as mixed liposarcoma by using postoperative pathology. Currently, he is readmitted to the hospital with a recurrence of the left scrotal mass for more than 1 year. Combined with the patient's past medical history, we performed radical resection of the left inguinal and scrotal tumors and lymphadenectomy of left femoral vein. The postoperative pathology indicated that well-differentiated liposarcoma was accompanied by mucinous liposarcoma (about 20%), and lymph node metastasis of left femoral vein both of which occurred at the same time. After the operation, we recommended the patient to receive further radiation therapy, but the patient and his family refused, hence we followed up the patient closely for a long time. During the recent follow-up, the patient reported no complaints of discomfort, and no recurrence of mass in the left scrotum and groin area. Conclusion After conducting extensive review of literature, we conclude that radical resection remains the key to treat primary paratesticular liposarcoma, while the significance of the lymph node metastasis is still unclear. The potential effects of postoperative adjuvant therapy depends on the pathological type, and hence close follow-up observation is essential.
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Affiliation(s)
- Runmiao Hua
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Liwei Zhao
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Li Xu
- Department of Urology, School of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Ji Sun
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Jiaguo Huang
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Qiyan Hua
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
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Chen HH, Hao PH, Zhang FY, Zhang TN. Non-coding RNAs in metabolic reprogramming of bone and soft tissue sarcoma: Fundamental mechanism and clinical implication. Biomed Pharmacother 2023; 160:114346. [PMID: 36738505 DOI: 10.1016/j.biopha.2023.114346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Sarcomas, comprising approximately 1% of human malignancies, show a poor response to treatment and easy recurrence. Metabolic reprogramming play an important role in tumor development in sarcomas. Accumulating evidence shows that non-coding RNAs (ncRNAs) participate in regulating the cellular metabolism of sarcomas, which improves the understanding of the development of therapy-resistant tumors. This review addresses the regulatory roles of metabolism-related ncRNAs and their implications for sarcoma initiation and progression. Dysregulation of metabolism-related ncRNAs is common in sarcomas and is associated with poor survival. Emerging studies show that abnormal expression of metabolism-related ncRNAs affects cellular metabolism, including glucose, lipid, and mitochondrial metabolism, and leads to the development of aggressive sarcomas. This review summarizes recent advances in the roles of dysregulated metabolism-related ncRNAs in sarcoma development and stemness and describes their potential to serve as biological biomarkers for disease diagnosis and prognosis prediction, as well as therapeutic targets for treating refractory sarcomas.
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Affiliation(s)
- Huan-Huan Chen
- Department of Oncology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China.
| | - Peng-Hui Hao
- Department of Pediatrics, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China.
| | - Fang-Yuan Zhang
- Department of General Surgery, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China.
| | - Tie-Ning Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China.
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29
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Ni L, Liu X, Wu A, Yu C, Zou C, Xu G, Wang C, Gao X. Endoscopic full‑thickness resection with clip‑ and snare‑assisted traction for gastric submucosal tumours in the fundus: A single‑centre case series. Oncol Lett 2023; 25:151. [PMID: 36936023 PMCID: PMC10018235 DOI: 10.3892/ol.2023.13737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Exposed endoscopic full-thickness resection (Eo-EFTR) has been recognized as a feasible therapy for gastrointestinal submucosal tumours (SMTs) originating deep in the muscularis propria layer; however, Eo-EFTR is difficult to perform in a retroflexed fashion in the gastric fundus. As a supportive technique, clip- and snare-assisted traction may help expose the surgical field and shorten the operation time in endoscopic resection of difficult regions. However, the application of clip- and snare-assisted traction in Eo-EFTR of SMTs in the gastric fundus is limited. Between April 2018 and December 2021, Eo-EFTR with clip- and snare-assisted traction was performed in 20 patients with SMTs in the gastric fundus at The First Affiliated Hospital of Soochow University. The relevant clinical data were collected retrospectively for all of the patients and analysed. All 20 patients underwent Eo-EFTR successfully without conversion to open surgery or severe adverse events. The en bloc resection rate and R0 resection rate were both 100%. Two patients had abdominal pain and fever after the operation, and five patients had fever, which recovered with medical therapy. No complications, such as delayed bleeding or delayed perforation, were observed. The postoperative pathology indicated that 19 cases were gastrointestinal stromal tumours and one case was leiomyoma. During the follow-up, no residual tumour, local recurrence or distant metastasis was detected by endoscopy or abdominal computed tomography. In conclusion, Eo-EFTR with clip- and snare-assisted traction appears to be a relatively safe and effective treatment for gastric SMTs in the fundus. However, prospective studies on a larger sample size are required to verify the effect of the clip- and snare-assisted traction in Eo-EFTR.
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Affiliation(s)
- Liujing Ni
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China
| | - Xiaolin Liu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China
| | - Airong Wu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China
| | - Chenyan Yu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China
| | - Chentao Zou
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China
| | - Guoting Xu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China
| | - Chao Wang
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China
| | - Xin Gao
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China
- Correspondence to: Dr Xin Gao, Department of Gastroenterology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Gusu, Suzhou, Jiangsu 215000, P.R. China, E-mail:
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Almodumeegh AS, Nouri MT, Mortada H, AlHasan MO, Obeid FM, Kattan AE. The potential pitfalls of synovial sarcoma mimicking intraneural ganglion cyst: A case report and literature review. Int J Surg Case Rep 2023; 104:107916. [PMID: 36791526 PMCID: PMC9950915 DOI: 10.1016/j.ijscr.2023.107916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Synovial sarcoma is a rare soft tissue sarcoma (STS) that accounts for 5-10 % of all STS. Synovial sarcoma of the peripheral nerve is very rare, with only 26 cases reported in the literature. Hence, this case report describes an unusual presentation of synovial sarcoma mimicking intraneural ganglion cysts and a literature review. PRESENTATION OF CASE We describe a 36-year-old female who presented to our clinic complaining of left leg pain for six years. MRI was done, which revealed a cystic lesion. With an impression of intraneural ganglion cyst versus nerve sheath tumor of the common peroneal nerve. The patient underwent exploration surgery and mass excision. The mass was sent for histopathology following excision, where the results indicated monophasic synovial sarcoma. An additional surgery, an epineurectomy of the common peroneal nerve and tumor bed excision, was followed by adjuvant chemotherapy with a Doxorubicin-based regimen. Following surgery, our patient's neurological symptoms improved. CLINICAL DISCUSSION The mainstay of treatment in synovial sarcoma is surgical excision with a Doxorubicin-based regimen of chemotherapy and/or radiotherapy based on tumor characteristics. Tumors smaller than 5 cm in MRI usually show homogenous enhancement and can be mistaken for benign tumors. Hence, a biopsy should be done before surgery to avoid misdiagnosis. CONCLUSION Even though it is extremely rare, synovial sarcoma of the lower extremity should be considered when a painful swelling of the lower leg is associated with a long duration of symptoms. Such lesions are best managed by surgical excision and postoperative chemotherapy.
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Affiliation(s)
| | | | - Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia.
| | | | - Faisal M Obeid
- Department of Surgery, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdullah E Kattan
- Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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31
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Hemerková P, Matulová H, Vališ M, Soukup J, Kanta M, Jandura J. Synovial sarcoma of the tibial nerve - case report of a rare tumor in a rare location requiring early diagnosis. BMC Neurol 2023; 23:65. [PMID: 36765281 PMCID: PMC9912578 DOI: 10.1186/s12883-023-03061-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/15/2022] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND We present the case of a patient with a rare synovial sarcoma (SS) of the tibial nerve. So far, only 4 cases of patients with SS originating from the tibial nerve have been described in the literature, and our patient is only the second patient whose limb was saved during treatment. Synovial sarcomas are malignant mesenchymal tumors, i.e., tumors arising from connective tissue. Synovial sarcomas account for 5-10% of all soft tissue sarcomas. However, the name synovial sarcoma is misleading, because the tumor does not originate from synovial cells, but rather from primitive mesenchymal cells. The name most likely originated from the localization around the large joints on the limbs, more often on the lower ones, in the area of the knee joints. We point out the aspects of correct and quick diagnosis and subsequent treatment, which has very important effect on the patient's prognosis. Primary less radical excision without prior biopsy verification leads to a higher risk of local recurrence, even if a proper reexcision was performed immediately after biopsy verification of the sarcoma. CASE PRESENTATION A woman born in 1949 began to suffer at the end of 2020 with escalating pain under the left inner ankle with a projection to the sole and fingers. Her personal, family work and social history were insignificant. After the initial neurological examination, the patient was sent for an ultrasound examination of the ankle, which showed a lobular mass measuring 50 × 22 × 16 mm and according magnetic resonance imaging, the finding appeared to be a suspicious neurinoma of the tibial nerve. The tumor was surgically excised, without prior biopsy verification: a 50 × 20 mm tumor was dissected in the distal part of the tarsal canal, which grew through the structure of the tibial nerve and in some places into the surrounding area and appeared intraoperatively as a neurofibroma. But histologically the tumor was classified as monophasic synovial sarcoma. The patient was indicated for a wide reexcision of the skin with the subcutaneous tissue of size 91 × 20 × 15 mm. Now the patient is being treated with external radiotherapy to the tumor bed and she is able to walk. CONCLUSION This report draws attention to a rare type of malignant nerve tumor, which both clinically and radiologically can mimic benign peripheral nerve sheath tumors. Synovial sarcoma should be considered in very painful resistances, typically located around the joints of the lower limbs, the growth of which can be slow. Because the size of the tumor is a negative prognostic factor, it is necessary to make a timely diagnosis using MR imaging and a biopsy with histological examination and to start treatment quickly. Surgical treatment should take place only after a biopsy with histological examination of the tumor so that it is sufficiently radical and does not have to undergo an additional reoperation, as happened in the case of our patient.
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Affiliation(s)
- Pavlína Hemerková
- Department of Neurology, University Hospital Hradec Králové, Hradec Králové, Czech Republic.
| | - Hana Matulová
- Department of Neurology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Martin Vališ
- Department of Neurology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Jiří Soukup
- The Fingerland department of Pathology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Martin Kanta
- Department of Neurosurgery, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Jiří Jandura
- Department of Radiology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
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Kubicek P, Cesne AL, Lervat C, Toulmonde M, Chevreau C, Duffaud F, Le Nail LR, Morelle M, Gaspar N, Vérité C, Castex MP, Penel N, Saada E, Causeret S, Bertucci F, Perrin C, Bompas E, Orbach D, Laurence V, Piperno-Neumann S, Anract P, Rios M, Gentet JC, Mascard É, Pannier S, Blouin P, Carrère S, Chaigneau L, Soibinet-Oudot P, Corradini N, Boudou-Rouquette P, Ruzic JC, Lebrun-Ly V, Dubray-Longeras P, Varatharajah S, Lebbe C, Ropars M, Kurtz JE, Guillemet C, Lotz JP, Berchoud J, Cherrier G, Ducimetière F, Chemin C, Italiano A, Honoré C, Desandes E, Blay JY, Gouin F, Marec-Bérard P. Management and outcomes of adolescent and young adult sarcoma patients: results from the French nationwide database NETSARC. BMC Cancer 2023; 23:69. [PMID: 36670431 PMCID: PMC9854049 DOI: 10.1186/s12885-023-10556-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The initial management of patients with sarcoma is a critical issue. We used the nationwide French National Cancer Institute-funded prospective sarcoma database NETSARC to report the management and oncologic outcomes in adolescents and young adults (AYAs) patients with sarcoma at the national level. PATIENTS AND METHODS NETSARC database gathers regularly monitored and updated data from patients with sarcoma. NETSARC was queried for patients (15-30 years) with sarcoma diagnosed from 2010 to 2017 for whom tumor resection had been performed. We reported management, locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS) in AYA treated in French reference sarcoma centers (RSC) and outside RSC (non-RSC) and conducted multivariable survival analyses adjusted for classical prognostic factors. RESULTS Among 3,227 patients aged 15-30 years with sarcoma diagnosed between 2010 and 2017, the study included 2,227 patients with surgery data available, among whom 1,290 AYAs had been operated in RSC, and 937 AYAs in non-RSC. Significant differences in compliance to guidelines were observed including pre-treatment biopsy (RSC: 85.9%; non-RSC 48.1%), pre-treatment imaging (RSC: 86.8%; non-RSC: 56.5%) and R0 margins (RSC 57.6%; non-RSC: 20.2%) (p < 0.001). 3y-OS rates were 81.1% (95%CI 78.3-83.6) in AYA in RSC and 82.7% (95%CI 79.4-85.5) in AYA in non-RSC, respectively. Whereas no significant differences in OS was observed in AYAs treated in RSC and in non-RSC, LRFS and PFS were improved in AYAs treated in RSC compared to AYAs treated in non-RSC (Hazard Ratios (HR): 0.58 and 0.83, respectively). CONCLUSIONS This study highlights the importance for AYA patients with sarcoma to be managed in national sarcoma reference centers involving multidisciplinary medical teams with paediatric and adult oncologists.
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Affiliation(s)
- Pierre Kubicek
- grid.418191.40000 0000 9437 3027Department of Medical Oncology, Institut de Cancérologie de l’Ouest, Angers, France ,grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France
| | - Axel Le Cesne
- grid.14925.3b0000 0001 2284 9388Gustave Roussy, Villejuif, France
| | - Cyril Lervat
- grid.452351.40000 0001 0131 6312Centre Oscar Lambret, Lille, France
| | - Maud Toulmonde
- grid.476460.70000 0004 0639 0505Institut Bergonié, Bordeaux, France
| | - Christine Chevreau
- grid.417829.10000 0000 9680 0846Institut Claudius Régaud IUCT Toulouse, Toulouse, France
| | | | | | - Magali Morelle
- grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France
| | - Nathalie Gaspar
- grid.14925.3b0000 0001 2284 9388Gustave Roussy, Villejuif, France
| | - Cécile Vérité
- grid.476460.70000 0004 0639 0505Institut Bergonié, Bordeaux, France
| | | | - Nicolas Penel
- grid.452351.40000 0001 0131 6312Centre Oscar Lambret, Lille, France
| | - Esma Saada
- grid.417812.90000 0004 0639 1794Centre Antoine Lacassagne, Nice, France
| | - Sylvain Causeret
- grid.418037.90000 0004 0641 1257Centre Georges François Leclerc, Dijon, France
| | - François Bertucci
- grid.418443.e0000 0004 0598 4440Institut Paoli-Calmettes, Marseille, France
| | - Christophe Perrin
- grid.417988.b0000 0000 9503 7068Centre Eugène Marquis, Rennes, France
| | - Emmanuelle Bompas
- grid.418191.40000 0000 9437 3027Institut de Cancérologie de l’Ouest, Nantes, France
| | - Daniel Orbach
- grid.418596.70000 0004 0639 6384SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Valérie Laurence
- grid.418596.70000 0004 0639 6384SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Sophie Piperno-Neumann
- grid.418596.70000 0004 0639 6384SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Philippe Anract
- grid.411784.f0000 0001 0274 3893Hôpital Cochin, Paris, France
| | - Maria Rios
- grid.452436.20000 0000 8775 4825Institut de Cancérologie de Lorraine, Nancy, France
| | | | - Éric Mascard
- grid.412134.10000 0004 0593 9113Hôpital Necker, Paris, France
| | | | - Pascale Blouin
- grid.411777.30000 0004 1765 1563CHU Tours, Tours, France
| | - Sébastien Carrère
- grid.418189.d0000 0001 2175 1768Centre Val d’Aurelle ICM, Montpellier, France
| | - Loïc Chaigneau
- grid.411158.80000 0004 0638 9213CHU Besançon, Besançon, France
| | | | | | | | | | | | | | | | - Céleste Lebbe
- grid.413328.f0000 0001 2300 6614Hôpital Saint-Louis, Paris, France
| | - Mickaël Ropars
- grid.411154.40000 0001 2175 0984CHU Rennes, Rennes, France
| | - Jean-Emmanuel Kurtz
- grid.512000.6Institut de Cancérologie Strasbourg-Europe ICANS, Strasbourg, France
| | - Cécile Guillemet
- grid.418189.d0000 0001 2175 1768Centre Henri Becquerel, Rouen, France
| | | | | | | | | | - Claire Chemin
- grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France
| | - Antoine Italiano
- grid.14925.3b0000 0001 2284 9388Gustave Roussy, Villejuif, France ,grid.476460.70000 0004 0639 0505Institut Bergonié, Bordeaux, France
| | - Charles Honoré
- grid.14925.3b0000 0001 2284 9388Gustave Roussy, Villejuif, France
| | - Emmanuel Desandes
- CHRU Nancy, Centre de Recherche en Epidémiologie et en Statistique Sorbonne-Paris Cité (CRESS), UMR 1153, INSERM, Université de Paris-Descartes, Paris, France
| | - Jean-Yves Blay
- grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France
| | - François Gouin
- grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France ,grid.277151.70000 0004 0472 0371CHU Nantes, Nantes, France
| | - Perrine Marec-Bérard
- grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France ,Institute of Pediatric Hematology and Oncology, Lyon, France
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Desmoid-type fibromatosis: imaging features and course. Skeletal Radiol 2023; 52:1293-1303. [PMID: 36646850 DOI: 10.1007/s00256-023-04275-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 12/30/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023]
Abstract
Desmoid-type fibromatosis (DF) is a soft tissue tumor characterized by infiltrative growth and a tendency toward local recurrence, while it exhibits self-limiting behavior and shows spontaneous regression. With its unpredictable behavior, a change in treatment strategies from initial surgery to nonsurgical management has been proposed, and active surveillance is currently widely chosen as the initial treatment strategy for DF. We reviewed the imaging features of DF regarding its clinical course, focusing on regression cases, postoperative cases, and imaging changes after systemic treatment.
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34
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Dreher RD, Theisen ER. Lysine specific demethylase 1 is a molecular driver and therapeutic target in sarcoma. Front Oncol 2023; 12:1076581. [PMID: 36686841 PMCID: PMC9846348 DOI: 10.3389/fonc.2022.1076581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/07/2022] [Indexed: 01/05/2023] Open
Abstract
Sarcomas are a diverse group of tumors with numerous oncogenic drivers, and display varied clinical behaviors and prognoses. This complexity makes diagnosis and the development of new and effective treatments challenging. An incomplete understanding of both cell of origin and the biological drivers of sarcomas complicates efforts to develop clinically relevant model systems and find new molecular targets. Notably, the histone lysine specific demethylase 1 (LSD1) is overexpressed in a number of different sarcomas and is a potential therapeutic target in these malignancies. With the ability to modify histone marks, LSD1 is a key player in many protein complexes that epigenetically regulate gene expression. It is a largely context dependent enzyme, having vastly different and often opposing roles depending on the cellular environment and which interaction partners are involved. LSD1 has been implicated in the development of many different types of cancer, but its role in bone and soft tissue sarcomas remains poorly understood. In this review, we compiled what is known about the LSD1 function in various sarcomas, to determine where knowledge is lacking and to find what theme emerge to characterize how LSD1 is a key molecular driver in bone and soft tissue sarcoma. We further discuss the current clinical landscape for the development of LSD1 inhibitors and where sarcomas have been included in early clinical trials.
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Affiliation(s)
- Rachel D. Dreher
- Abigail Wexner Research Institute, Center for Childhood Cancer and Blood Diseases, Nationwide Children’s Hospital, Columbus, OH, United States
- Biomedical Sciences Graduate Program, College of Medicine, the Ohio State University, Columbus, OH, United States
| | - Emily R. Theisen
- Abigail Wexner Research Institute, Center for Childhood Cancer and Blood Diseases, Nationwide Children’s Hospital, Columbus, OH, United States
- Biomedical Sciences Graduate Program, College of Medicine, the Ohio State University, Columbus, OH, United States
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, United States
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35
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Blay JY, Italiano A, Penel N, Le Loarer F, Karanian M, De Pinieux G, Coindre JM, Ducimetiere F, Chemin C, Morelle M, Gouin F, Toulmonde M, Le Cesne A. Impact d’un réseau de centre de référence pour le diagnostic et la prise en charge des patients atteints de sarcomes en France depuis 2010. BULLETIN DE L'ACADÉMIE NATIONALE DE MÉDECINE 2023. [DOI: 10.1016/j.banm.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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36
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Mishra AK, Singhal A, Rathod R, Bansal V, Panda NK, Negi S, Rana P. Surgical Challenges in a Case of a Recurrent Giant Pleomorphic Liposarcoma of Neck And Mediastinum in a Child: A Rare Occurrence. Indian J Otolaryngol Head Neck Surg 2022; 74:6151-6154. [PMID: 34466403 PMCID: PMC8396137 DOI: 10.1007/s12070-021-02837-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/21/2021] [Indexed: 02/07/2023] Open
Abstract
Liposarcomas are rare in childhood, representing < 1% of all childhood soft tissue sarcomas. The most frequent site of involvement are the extremities with the involvement of head and neck being an absolute rarity. Pleomorphic subtype of liposarcoma is pretty aggressive and hence portends a poor prognosis. Here, we present the case of a child who presented with a recurrence of liposarcoma in the neck and mediastinum within 3 months of the index surgery. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-021-02837-w.
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Affiliation(s)
- Anand Kumar Mishra
- Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankit Singhal
- Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ramya Rathod
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vidur Bansal
- Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Kumar Panda
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunder Negi
- Department of Anesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pratyaksha Rana
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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37
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Castillo-Flores S, Gonzalez MR, Bryce-Alberti M, de Souza F, Subhawong TK, Kuker R, Pretell-Mazzini J. PET-CT in the Evaluation of Neoadjuvant/Adjuvant Treatment Response of Soft-tissue Sarcomas: A Comprehensive Review of the Literature. JBJS Rev 2022; 10:01874474-202212000-00003. [PMID: 36639875 DOI: 10.2106/jbjs.rvw.22.00131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
➢ In soft-tissue sarcomas (STSs), the use of positron emission tomography-computed tomography (PET-CT) through a standardized uptake value reduction rate correlates well with histopathological response to neoadjuvant treatment and survival. ➢ PET-CT has shown a better sensitivity to diagnose systemic involvement compared with magnetic resonance imaging and CT; therefore, it has an important role in detecting recurrent systemic disease. However, delaying the use of PET-CT scan, to differentiate tumor recurrence from benign fluorodeoxyglucose uptake changes after surgical treatment and radiotherapy, is essential. ➢ PET-CT limitations such as difficult differentiation between benign inflammatory and malignant processes, inefficient discrimination between benign soft-tissue tumors and STSs, and low sensitivity when evaluating small pulmonary metastases must be of special consideration.
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Affiliation(s)
- Samy Castillo-Flores
- Medical Student at Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Marcos R Gonzalez
- Medical Student at Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mayte Bryce-Alberti
- Medical Student at Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Felipe de Souza
- Division of Musculoskeletal Radiology, Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Ty K Subhawong
- Division of Musculoskeletal Radiology, Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Russ Kuker
- Division of Musculoskeletal Radiology, Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Juan Pretell-Mazzini
- Division of Orthopedic Oncology, Miami Cancer Institute, Baptist Health System South Florida, Plantation, Florida
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38
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Zhang S, Zhou Z, Xu J. Undifferentiated pleomorphic sarcoma of the lateral thigh with KRAS/NF1 co-mutation recurred after repetitive surgical resection: A case report and review of the literature. Front Surg 2022; 9:842054. [PMID: 36338647 PMCID: PMC9633863 DOI: 10.3389/fsurg.2022.842054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 09/27/2022] [Indexed: 11/23/2022] Open
Abstract
Undifferentiated pleomorphic sarcoma (UPS), a rare soft tissue sarcoma subtype, mainly occurs in the deep parts of the limbs and trunk, observed as rapidly growing painless lumps, rarely located under the skin or protrudes from the skin surface. The risk of recurrence and metastasis is associated with multiple factors. Mutation of tumor gene, tumor occurrence, location and depth of invasion, and tumor size have great influence on prognosis. In this study, we described a case of UPS with KRAS/NF1 co-mutation. This case had undergone UPS extended resection for four times combined with chemotherapy in another hospital. The resection area was more than 3 cm, and tumor relapsed after all operations. This time, the tumor protruded from the left lateral surface with ulceration and infection. Due to multiple surgeries, the anatomy of the lateral femoral vessels has been seriously damaged. We performed expanded tumor resection and adjacent flap transfer repair; meanwhile, vacuum sealing drainage (VSD)-negative pressure closed the drainage, and the patient recovered well after surgery. After surgery, the patient was transferred to the Department of Oncology for chemotherapy. There was no recurrence after 6 months of follow-up. Gene mutation plays an important role in UPS recurrence and metastasis. At the same time, occurrence and location, depth, and size of UPS have great influence on the prognosis. Deeper exploration and expanded resection are important for the prognosis of UPS.
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Affiliation(s)
- Shuo Zhang
- Department of Plastic Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Zimo Zhou
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Xu
- Department of Plastic Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China,Correspondence: Jing Xu
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Raquib AR, Hofvander J, Ta M, Nielsen TO. Expanding the Use of an SS18-SSX Antibody for Molecular Assays in Synovial Sarcoma. Appl Immunohistochem Mol Morphol 2022; 30:531-539. [PMID: 35880992 PMCID: PMC9444294 DOI: 10.1097/pai.0000000000001049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022]
Abstract
Synovial sarcoma is an aggressive malignancy that generally affects adolescents and young adults and is characterized by high rates of recurrence and metastasis, with a 10-year survival rate of about 50%. The fusion oncoprotein SS18-SSX, the product of a pathognomonic chromosomal translocation t(X;18), is the oncogenic driver of this sarcoma, disrupting differentiation through widespread epigenetic dysregulation. Experimental research into SS18-SSX biology has been limited by the lack of an antibody that specifically detects the endogenous fusion oncoprotein as opposed to its native SS18 or SSX components. Recently, a rabbit monoclonal antibody was developed and made commercially available, which specifically detects the fusion junction site epitope of SS18-SSX as found in at least 95% of synovial sarcomas. Here, we characterize a suite of molecular biology assays using this new antibody, both confirming existing and reporting on novel applications. We demonstrate its high sensitivity and specificity for synovial sarcoma diagnosis on patient samples through positive immunohistochemical staining on synovial sarcoma, tissue microarray, and full face sections. In addition, we demonstrate detection of the human SS18-SSX protein when expressed in a genetically engineered mouse model of synovial sarcoma. We also demonstrate nuclear staining of SS18-SSX in synovial sarcoma cells using immunofluorescence, and visualize the interaction between SS18-SSX and the BAF complex member BRG1 through a proximity ligation assay. Lastly, we confirm the interaction between SS18-SSX and promoter regions of target genes through chromatin immunoprecipitation. This antibody represents a breakthrough in sarcoma research and has value in multiple applications to expand the knowledge of synovial sarcoma biology.
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40
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Endoscopic full-thickness resection with through-the-scope suture closure for gastrointestinal stromal tumor. VideoGIE 2022; 7:296-298. [PMID: 36034071 PMCID: PMC9416306 DOI: 10.1016/j.vgie.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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41
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Hariri O, Al Laham O, Ibrahim Basha Z, Hamzeh H. A rare incidence of primary Synovial Spindle Cell Sarcoma in a 46-year-old male, successfully managed by surgical intervention-A Case Report. Int J Surg Case Rep 2022; 97:107442. [PMID: 35926380 PMCID: PMC9403278 DOI: 10.1016/j.ijscr.2022.107442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/17/2022] [Accepted: 07/17/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Synovial sarcoma (SS) is a rare form of Soft Tissue Sarcoma (STS) which results from the malignant proliferation of mesenchymal cells. Specific etiologies are not yet known, and its incidence rate ranges between 0.81 and 1.42 per 1 million individuals. Its gender-specific prevalence is almost the same between males and females and it is unique from other subtypes of STS in that it's slow growing and in almost half the cases, patients present with distant metastasis at the time of diagnosis. CASE PRESENTATION We present the case of a 46-year-old previously healthy male patient, who complained from a right lower extremity painless bulge, which began to be visibly noticeable by the patient 2 months prior to admission. There were no signs of allocated inflammation nor lower limb ischemia. Radiology revealed an irregular mass formation conformant with neoplasia. CLINICAL DISCUSSION Surgical resection of the mass along with synthetic graft replacement of the concomitant vascular bundle. Histopathological analysis of the resected mass revealed a monophasic synovial spindle cell sarcoma. CONCLUSION SS is a rare neoplasm poses a grave risk for patients due to its malignant pathophysiology and the wide margin of misdiagnoses. It is pivotal to set-up proper preoperative diagnostic guidelines for it and maintain high clinical suspicion so that we can bring down the high rates of the morbidity and mortality which ensue from this malignancy.
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Affiliation(s)
- Omar Hariri
- Department of Surgery, Al-Mouwasat University Hospital, Damascus, Syria,Department of Surgery, Al Assad University Hospital, Damascus, Syria
| | - Omar Al Laham
- Department of Surgery, Al-Mouwasat University Hospital, Damascus, Syria,Department of Surgery, Al Assad University Hospital, Damascus, Syria,Corresponding author at: Department of Surgery, Al Assad University Hospital, Damascus, Syria.
| | | | - Hisham Hamzeh
- Department of Vascular Surgery, Al-Mouwasat University Hospital, Damascus, Syria
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42
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Establishment and characterization of NCC-SS5-C1: a novel patient-derived cell line of synovial sarcoma. Hum Cell 2022; 35:1290-1297. [PMID: 35655041 DOI: 10.1007/s13577-022-00721-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/09/2022] [Indexed: 11/04/2022]
Abstract
Synovial sarcoma (SS) is a rare and aggressive mesenchymal malignancy driven by a unique chromosomal translocation that generates the expression of the SS18:SSX fusion protein. It occurs at almost any anatomical site and most commonly in young adults. The standard curative treatment for primary SS is a wide surgical resection combined with radiotherapy and/or neoadjuvant chemotherapy. The prognosis of SS varies among patients, with the 5 years survival rate ranging from 50 to 60% in adults and 90% in children. Although patient-derived cell lines are a useful resource for the development of new therapies, only a few are available from public cell banks. Therefore, this study aimed to establish and characterize a novel SS cell line. We successfully established a novel cell line, NCC-SS5-C1, harboring an SS18-SSX1 fusion gene. NCC-SS5-C1 cells demonstrated constant growth and invasion ability. We performed integrative drug screening using eight SS cell lines, including NCC-SS5-C1 cells, and examined the response spectrum of existing anticancer agents. We conclude that NCC-SS5-C1 is a useful resource for studying SS.
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Tsukamoto S, Mavrogenis AF, Angelelli L, Righi A, Filardo G, Kido A, Honoki K, Tanaka Y, Tanaka Y, Errani C. The Effect of Adjuvant Chemotherapy on Localized Extraskeletal Osteosarcoma: A Systematic Review. Cancers (Basel) 2022; 14:cancers14102559. [PMID: 35626164 PMCID: PMC9139294 DOI: 10.3390/cancers14102559] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Background: Extraskeletal osteosarcoma (ESOS) is a malignant tumor characterized by the production of bone or bone matrix by tumor cells without any continuity into the skeletal bones. The standard treatment for localized ESOS is wide resection; however, the effect of (neo)adjuvant chemotherapy remains unclear. To investigate the effect of (neo)adjuvant chemotherapy for localized ESOS, we conducted a systematic review of studies comparing the 5-year disease-free survival rate between patients who underwent surgery combined with (neo)adjuvant chemotherapy and those who underwent surgery alone. (2) Methods: Of the 210 studies identified by systematically searching the PubMed, Embase, and Cochrane Central Register of Controlled Trials databases, 12 were included in the final analysis. These 12 articles were not randomized controlled trials, but retrospective studies. In total, 761 patients with localized ESOS were included in this study. (3) Results: The 5-year disease-free survival rate was 47.9% (187 of 390 patients) in the surgery and (neo)adjuvant chemotherapy group and 40.4% (150 of 371 patients) in the surgery alone group. The overall pooled odds ratio was 1.23 (95% confidence interval, 0.69-2.19; p = 0.479) and the heterogeneity I2 was 37%. (4) Conclusions: The effect of adjuvant chemotherapy on localized ESOS seems to be limited. Therefore, routine use of adjuvant chemotherapy for localized ESOS should be avoided. However, further randomized controlled trials are required to confirm these results.
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Affiliation(s)
- Shinji Tsukamoto
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-Cho, Kashihara 634-8521, Japan; (S.T.); (K.H.); (Y.T.)
| | - Andreas F. Mavrogenis
- First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, Athens 15562, Greece
- Correspondence: ; Tel./Fax: +30-210-654-2800
| | - Lucia Angelelli
- Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (L.A.); (G.F.)
| | - Alberto Righi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
| | - Giuseppe Filardo
- Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (L.A.); (G.F.)
| | - Akira Kido
- Department of Rehabilitation Medicine, Nara Medical University, 840, Shijo-Cho, Kashihara 634-8521, Japan;
| | - Kanya Honoki
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-Cho, Kashihara 634-8521, Japan; (S.T.); (K.H.); (Y.T.)
| | - Yuu Tanaka
- Department of Rehabilitation Medicine, Wakayama Professional University of Rehabilitation, 3-1, Minamoto-Cho, Wakayama 640-8222, Japan;
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-Cho, Kashihara 634-8521, Japan; (S.T.); (K.H.); (Y.T.)
| | - Costantino Errani
- Department of Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy;
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Martin E, Pendleton C, Verhoef C, Spinner RJ, Coert JH. Morbidity and Function Loss After Resection of Malignant Peripheral Nerve Sheath Tumors. Neurosurgery 2022; 90:354-364. [PMID: 34528095 DOI: 10.1093/neuros/nyab342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 07/16/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive soft tissue sarcomas. Their resection may lead to serious morbidity. Incidence of postoperative motor and sensory deficits is unknown, and reconstruction aimed at restoring such deficits is infrequently carried out. OBJECTIVE To identify the incidence and risk factors of postoperative morbidity in MPNST as well as the use and outcomes of functional reconstructions in these patients. METHODS Postoperative function and treatment of MPNSTs diagnosed from 1988 to 2019 in 10 cancer centers was obtained. Two models were constructed evaluating factors independently associated with postoperative motor (<M3) or critical sensory loss. Critical sensation was defined as partial or complete loss of hand, foot, or buttocks sensation. RESULTS A total of 756 patients (33.4% neurofibromatosis type 1, NF1) were included. MPNSTs originated in 34.4% from a major nerve. Of 658 surgically treated patients, 27.2% had <M3 muscle power and 24.3% critical sensory loss. Amputations were carried out in 61 patients. Independent risk factors for motor and sensory loss included patients with NF1, symptomatic, deep-seated, extremity, or plexus tumors originating from major nerves (all P < .05). A total of 26 patients underwent functional reconstructions. The majority (64%) of these patients regained at least M3 muscle power and 33% M4 despite 86% receiving multimodal therapy. CONCLUSION Resection of MPNSTs commonly results in motor and sensory deficits. Patients with NF1, symptomatic, deep-seated tumors, arising from major nerves were associated with a higher risk for developing postoperative morbidity. Functional reconstructions are infrequently performed but can improve functional outcomes.
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Affiliation(s)
- Enrico Martin
- Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht , the Netherlands
- Department of Surgical Oncology, Erasmus Medical Center , Rotterdam , the Netherlands
| | | | - Cornelis Verhoef
- Department of Surgical Oncology, Erasmus Medical Center , Rotterdam , the Netherlands
| | - Robert J Spinner
- Department of Neurosurgery, Mayo Clinic , Rochester , Minnesota , USA
| | - J Henk Coert
- Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht , the Netherlands
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Yu M, Li K, Liu D, Tan Y. Safety and Efficacy of Endoscopic Treatment of Solitary Gastric Neurofibroma. Int J Gen Med 2022; 15:279-289. [PMID: 35023965 PMCID: PMC8747736 DOI: 10.2147/ijgm.s339564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/16/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose The studies on solitary gastric neurofibroma (GN) consist of only individual case reports, with little data and relevant information. We aimed to summarize the clinical features, endoscopic features, imaging findings, and pathological features and study the safety and efficacy of endoscopic treatment of solitary GN. Patients and Methods We retrospectively collected and analyzed clinical data of patients who underwent endoscopic treatment in Department of Gastroenterology of a well-known tertiary hospital from August 2007 to September 2019 and were accurately diagnosed as having solitary GN. Results A total of 788 patients with gastric submucosal tumors underwent endoscopic treatment, among whom 11 patients were found to have solitary GNs. The incidence of solitary GNs was 1.4%. All 11 patients were treated with endoscopy. Five patients underwent endoscopic full-thickness resection (EFTR) and six patients underwent endoscopic submucosal excavation (ESE). The en bloc resection rate of the 11 lesions was 100.0%. The median endoscopic operation time was 80 minutes. Average length of hospital stay was 6.4 ± 1.6 days. The median follow-up time was 29 months. No recurrence, distant metastasis, or disease-related death occurred during the follow-up. Conclusion EFTR and ESE can serve as feasible, safe, and effective treatments for solitary GN.
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Affiliation(s)
- Meihong Yu
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.,Research Center of Digestive Disease, Central South University, Changsha, Hunan, People's Republic of China
| | - Kaixuan Li
- Department of Urology, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Deliang Liu
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.,Research Center of Digestive Disease, Central South University, Changsha, Hunan, People's Republic of China
| | - Yuyong Tan
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.,Research Center of Digestive Disease, Central South University, Changsha, Hunan, People's Republic of China
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Shao M, Niu Z, He L, Fang Z, He J, Xie Z, Cheng G, Wang J. Building Radiomics Models Based on Triple-Phase CT Images Combining Clinical Features for Discriminating the Risk Rating in Gastrointestinal Stromal Tumors. Front Oncol 2021; 11:737302. [PMID: 34950578 PMCID: PMC8689687 DOI: 10.3389/fonc.2021.737302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/15/2021] [Indexed: 12/24/2022] Open
Abstract
We aimed to build radiomics models based on triple-phase CT images combining clinical features to predict the risk rating of gastrointestinal stromal tumors (GISTs). A total of 231 patients with pathologically diagnosed GISTs from July 2012 to July 2020 were categorized into a training data set (82 patients with high risk, 80 patients with low risk) and a validation data set (35 patients with high risk, 34 patients with low risk) with a ratio of 7:3. Four diagnostic models were constructed by assessing 20 clinical characteristics and 18 radiomic features that were extracted from a lesion mask based on triple-phase CT images. The receiver operating characteristic (ROC) curves were applied to calculate the diagnostic performance of these models, and ROC curves of these models were compared using Delong test in different data sets. The results of ROC analyses showed that areas under ROC curves (AUC) of model 4 [Clinic + CT value of unenhanced (CTU) + CT value of arterial phase (CTA) + value of venous phase (CTV)], model 1 (Clinic + CTU), model 2 (Clinic + CTA), and model 3 (Clinic + CTV) were 0.925, 0.894, 0.909, and 0.914 in the training set and 0.897, 0.866, 0,892, and 0.892 in the validation set, respectively. Model 4, model 1, model 2, and model 3 yielded an accuracy of 88.3%, 85.8%, 86.4%, and 84.6%, a sensitivity of 85.4%, 84.2%, 76.8%, and 78.0%, and a specificity of 91.2%, 87.5%, 96.2%, and 91.2% in the training set and an accuracy of 88.4%, 84.1%, 82.6%, and 82.6%, a sensitivity of 88.6%, 77.1%, 74.3%, and 85.7%, and a specificity of 88.2%, 91.2%, 91.2%, and 79.4% in the validation set, respectively. There was a significant difference between model 4 and model 1 in discriminating the risk rating in gastrointestinal stromal tumors in the training data set (Delong test, p < 0.05). The radiomic models based on clinical features and triple-phase CT images manifested excellent accuracy for the discrimination of risk rating of GISTs.
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Affiliation(s)
- Meihua Shao
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Zhongfeng Niu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Linyang He
- Hangzhou Jianpei Technology Company, Hangzhou, China
| | - Zhaoxing Fang
- Hangzhou Jianpei Technology Company, Hangzhou, China
| | - Jie He
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zongyu Xie
- Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Guohua Cheng
- Hangzhou Jianpei Technology Company, Hangzhou, China
| | - Jian Wang
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, China
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Clinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors, and the significance of neoadjuvant therapy. BMC Surg 2021; 21:400. [PMID: 34798856 PMCID: PMC8603575 DOI: 10.1186/s12893-021-01397-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/04/2021] [Indexed: 02/06/2023] Open
Abstract
Objective To investigate the clinicopathological features and clinical efficacy among 101 cases of rectal gastrointestinal stromal tumors (GISTs) and to investigate the significance of imatinib mesylate (IM) neoadjuvant therapy. Methods The clinicopathological features, treatment methods, perioperative data, and prognosis of the patients were summarized and analysed in 101 patients with rectal GISTs who received treatment in the Gastrointestinal Surgery of West China Hospital of Sichuan University and the Affiliated Hospital of Guizhou Medical University from August 2002 to November 2020 in China. Results A total of 101 patients, including 64 males and 37 females, were aged from 22 to 79 years (55.4 ± 12.2 years). Among the 70 patients who underwent direct surgery, 8 were very low risk cases, 10 were low risk cases, 7 were intermediate risk cases, and 45 were high risk cases. Cox regression analysis showed that postoperative IM adjuvant treatment improved the disease-free survival (DFS) and overall survival (OS) of 52 intermediate and high risk patients. Among the 31 patients who received neoadjuvant therapy, the objective response rate (ORR) was 83.9% (26/31), and the disease control rate (DCR) reached 96.8% (30/31). Subgroup analysis was also conducted based on the tumour diameter. (1) Among the 36 patients with a diameter ≤ 5 cm, two patients received IM neoadjuvant therapy, while 34 patients received direct surgery. Neither univariate nor Cox regression analysis found that neoadjuvant therapy affected DFS and OS. (2) Among the 65 patients with a diameter > 5 cm, 29 received IM neoadjuvant therapy, and 36 received direct surgery. Patients who underwent neoadjuvant therapy had less blood loss (P = 0.022), shorter postoperative hospital stay (P = 0.001), increased anal retention rate (93.1% vs. 72.2%, P = 0.031), and decreased enterostomy rate (10.3% vs. 33.3%, P = 0.037) than those who underwent direct surgery. Cox regression analysis suggested that neoadjuvant therapy and postoperative IM adjuvant therapy improved DFS. Conclusion Rectal GISTs are relatively rare and highly malignant tumors. Postoperative oral IM therapy can improve the DFS and OS of intermediate and high risk patients. In patients with rectal GISTs with diameters > 5 cm, IM neoadjuvant therapy can improve anal retention rate, preserve the structure and function of the organs, reduce enterostomy rate, and improve prognosis.
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Fujiwara T, Evans S, Stevenson J, Tsuda Y, Gregory J, Grimer R, Abudu A. Impact of the national sarcoma guidelines on the prevalence and outcome of inadvertent excisions of soft tissue sarcomas: An observational study from a UK tertiary referral centre. Eur J Surg Oncol 2021; 48:533-540. [PMID: 34838395 DOI: 10.1016/j.ejso.2021.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/29/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES This study aims to investigate the impact of the national guideline on the prevalence and outcome in patients with soft-tissue sarcoma (STS) who had undergone inadvertent excisions. METHODS A total of 2336 patients were referred to a tertiary sarcoma centre from six regions (North East, North West, East Midlands, West Midlands, Wales, and South West) in the United Kingdom with a diagnosis of STS between 1996 and 2016, of whom 561 patients (24.0%) had undergone inadvertent excisions. Patients were categorised into two groups of 10-year periods pre and post the National Institute for Health and Clinical Excellence (NICE) guideline implementation in 2006. RESULTS The proportion of inadvertent excisions decreased after the NICE guideline implementation: 27.2% (pre-NICE) versus 19.8% (post-NICE) (p = 0.001). A substantial regional variation (17.4%-34.5%) in the proportion of inadvertent excisions in the pre-NICE era was reduced in the post-NICE era (14.3%-22.4%). The 5-year disease-specific survival was 77.7% (pre-NICE) versus 75.6% (post-NICE) (p = 0.961) and there was a trend toward lower incidence of local recurrence in the post-NICE era; 13.5% (pre-NICE) versus 10.5% (post-NICE) (p = 0.522). Multivariate analyses revealed that residual tumours in re-resection specimens were independently associated with an increased risk of disease-specific mortality (HR, 3.35; p < 0.001) and local recurrence (HR, 1.99; p = 0.017), which was significantly reduced after the NICE guideline implementation (53.2% versus 42.0%; p = 0.022). CONCLUSIONS The NICE guideline implementation reduced the proportion of patients with STS who had undergone inadvertent excisions and residual tumour in re-resection specimens, indicating an improved pre-referral management of STSs.
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Affiliation(s)
- Tomohiro Fujiwara
- Oncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK; Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
| | - Scott Evans
- Oncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Jonathan Stevenson
- Oncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Yusuke Tsuda
- Oncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Jonathan Gregory
- Oncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Robert Grimer
- Oncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Adesegun Abudu
- Oncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
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Fiore M, Sambri A, Spinnato P, Zucchini R, Giannini C, Caldari E, Pirini MG, De Paolis M. The Biology of Synovial Sarcoma: State-of-the-Art and Future Perspectives. Curr Treat Options Oncol 2021; 22:109. [PMID: 34687366 PMCID: PMC8541977 DOI: 10.1007/s11864-021-00914-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 12/22/2022]
Abstract
New molecular insights are being achieved in synovial sarcoma (SS) that can provide new potential diagnostic and prognostic markers as well as therapeutic targets. In particular, the advancement of research on epigenomics and gene regulation is promising. The concrete hypothesis that the pathogenesis of SS might mainly depend on the disruption of the balance of the complex interaction between epigenomic regulatory complexes and the consequences on gene expression opens interesting new perspectives. The standard of care for primary SS is wide surgical resection combined with radiation in selected cases. The role of chemotherapy is still under refinement and can be considered in patients at high risk of metastasis or in those with advanced disease. Cytotoxic chemotherapy (anthracyclines, ifosfamide, trabectedin, and pazopanib) is the treatment of choice, despite several possible side effects. Many possible drug-able targets have been identified. However, the impact of these strategies in improving SS outcome is still limited, thus making current and future research strongly needed to improve the survival of patients with SS.
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Affiliation(s)
- Michele Fiore
- Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Andrea Sambri
- Alma Mater Studiorum - University of Bologna, Bologna, Italy. .,IRCCS Azienda Ospedaliero Universitaria di Bologna, via Massarenti 9, 40138, Bologna, Italy.
| | | | | | | | - Emilia Caldari
- IRCCS Azienda Ospedaliero Universitaria di Bologna, via Massarenti 9, 40138, Bologna, Italy
| | - Maria Giulia Pirini
- IRCCS Azienda Ospedaliero Universitaria di Bologna, via Massarenti 9, 40138, Bologna, Italy
| | - Massimiliano De Paolis
- IRCCS Azienda Ospedaliero Universitaria di Bologna, via Massarenti 9, 40138, Bologna, Italy
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Cheng HC, Kuo CY, Huang CW, Shih HH, Lin CH, Wang JY. Unusual paediatric sigmoid perivascular epithelioid cell tumour with regional lymph node metastasis treated using gemcitabine and docetaxel: a case report and literature review. J Int Med Res 2021; 49:3000605211041509. [PMID: 34510959 PMCID: PMC8442492 DOI: 10.1177/03000605211041509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Perivascular epithelioid cell tumour (PEComa) is an extremely rare neoplasm with
distinctive morphology and specific expression of immunohistochemical markers.
The lesion is typically diagnosed in middle-aged women, with few reports of
paediatric cases, and there is no standardized treatment for the tumour type.
Here, the case of a 17-year-old female, who presented with painless
haematochezia for 2 days and was diagnosed with gastrointestinal PEComa of the
sigmoid colon with regional lymph node metastasis after serial examination, is
presented. She was treated by surgical resection of the tumour and cytotoxic
chemotherapy comprising 900 mg/m2 gemcitabine and 100
mg/m2 docetaxel every 3 weeks for six cycles. Haematochezia did
not recur, and complete response was achieved, with progression-free survival at
the 24-month follow-up examination. Surgical resection with adjuvant
conventional cytotoxic chemotherapy may be considered as an option for treating
gastrointestinal PEComa.
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Affiliation(s)
- Hsiu-Chung Cheng
- School of Medicine, College of Medicine, Kaohsiung Medical University
| | - Chia-Yu Kuo
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University
| | - Ching-Wen Huang
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University
| | - Hsiang-Hung Shih
- Division of General Paediatrics, Department of Paediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University
| | - Chih-Hung Lin
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University
| | - Jaw-Yuan Wang
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University.,Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University.,Graduate Institute of Clinical Medicine, Centre for Cancer Research, Kaohsiung Medical University.,Ministry of Health and Welfare Pingtun Hospital
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