ISSN:8756-0437    

DOI:10.1002/ssu.2980100502

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractSoft tissue sarcoma is an extremely rare malignant disease that includes more than 15 distinct histologic subtypes. While all share a propensity for metastasis to the lungs, the clinical presentation and pattern of spread for the specific subtypes are remarkably viable. Little is known about the etiology of soft tissue sarcoma other than several well described epidemiological associations between ionizing and other toxic agents and several of the soft tissue sarcoma histologic subtypes. The key to understanding the etiologic factors driving soft tissue sarcoma proliferation and dissemination lies in understanding the molecular mechanisms underlying these oncologic processes. Progress in this regard has been difficult because of the rarity of this disease. This report reviews the current state of knowledge for three of the most important considerations involving the molecular etiology of soft tissue sarcoma: growth factors and their receptors, nuclear and cytoplas‐mic oncogenes, and tumor suppressor genes. As we learn more about these molecular mechanisms leading to proliferation and dissemination of soft tissue sarcoma, molecularly based genetic therapies will become a reality for this all too devastating, albeit rare, disease. © 1994 Wiley‐Liss,

ISSN:8756-0437    

DOI:10.1002/ssu.2980100503

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe diagnosis and preoperative evaluation of patients with a suspected soft tissue sarcoma involve several important considerations to ensure optimal treatment outcomes. Biopsy techniques must involve the retrieval of adequate tissue to establish the histologic diagnosis and grade of the tumor without compromising the subsequent definitive surgical resection. CT or MRI techniques represent the gold standard to evaluate the local extent of disease which is necessary to ascertain surgical resectability and/or the need for radiation therapy. CT scanning of the lungs is mandated for all patients with sarcomas to evaluate for metastatic disease and, for patients with abdominal or re‐troperitoneal tumors, scanning of the liver should also be included. Accurate staging of these patients will help define overall survival. © 1994 Wiley‐Liss,

ISSN:8756-0437    

DOI:10.1002/ssu.2980100504

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractA number of immunological markers and chromosomal abnormalities are described to aid in the diagnosis, prognosis and management of soft tissue sarcomas. Although the chromosomal abnormalities may be specific in some cases, they have only been reported in small series or single cases and their significance has not yet been established. None of the immunological markers described is either entirely specific or sensitive for a particular tumor type, and virtually none of these immunological reagents is currently approved for diagnostic use despite their widespread applications in pathology. They function in a supporting role to conventional tissue pathology, grading, and pathological and clinical staging of soft tissue sarcomas. Antibodies employed as an aid in diagnosis of soft tissue tumors should always be run in panels and never as single tests. New immunological markers and chromosomal abnormalities in soft tissue sarcomas should be carefully evaluated for their specificity and sensitivity and their usefulness in diagnosis and prognosis. © 1994 Wiley‐Liss, I

ISSN:8756-0437    

DOI:10.1002/ssu.2980100505

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractOperative management of soft tissue sarcomas begins with the surgical biopsy. Incisional biopsy of an undiagnosed soft tissue mass allows optimal later definitive resection, this resection including the entire biopsy wound, as well as accomplishing an “adequate” margin around the sarcoma. The principles employed for this resection are those that lead to adequate gross and microscopic margins of normal tissue around the sarcoma while considering the limitations, in terms of physical disability, from the procedure itself. This operative strategy is described for various anatomic locations, such as the extremities, trunk, retroperitoneum, and head and neck; special problems with each of these primary sites are discussed. © 1994 Wiley‐Lis

ISSN:8756-0437    

DOI:10.1002/ssu.2980100506

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractRadiation in moderate dose levels, viz. 60‐65 Gy at 2 Gy/fraction, administered in combination with conservative surgery, yields local control frequencies at least comparable to those achieved by radical resectional surgery alone. The clinical interest in this management strategy is the reduction in the scope of the resection and a consequent gain in cosmetic and functional status. This combined approach is favored for sarcomas so situated that resection with wide margin, ≧ 2 cm at the most narrow, cannot be realized unless there is a clinically important loss in function. Where radical surgery is planned, there must be great care in assessment of the probability of achieving good margins. The patient is ill served if there is radical surgery and then, because of close margins, postoperative radiation is required. There appears to be clinical gain for the patient with a large sarcoma by administering the radiation preoperatively. Advantages include smaller treatment volume and higher local control rates. The management of the surgical wound in the irradiated patient is discussed. Also, brief consideration is given to current use of brachytherapy, high linear energy transfer (LET) radiation, and combination of radiation and chemotherapy. © 1994 Wiley‐Lis

ISSN:8756-0437    

DOI:10.1002/ssu.2980100507

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractConventional chemotherapy for adult type soft tissue sarcomas is not very effective. Rarely are patients with advanced soft tissue sarcomas curable by systemic chemotherapy. Thus, the benefits from chemotherapy have been equivocal even when treatment is given postoperatively to patients whose primary sarcomas have been excised. Current research is directed toward the achievement of a high percentage of complete tumor regressions in patients with advanced metastatic disease in hope that this can be translated into truly effective adjuvant therapy. Several recent new approaches to systemic treatment for soft tissue sarcomas are assessed including prospects for possible enhancement of chemotherapy by agents which stimulate cellular immunity. Some unexpectedly favorable responses to chemotherapy + granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) in an ongoing study are discussed. © 1994 Wiley‐L

ISSN:8756-0437    

DOI:10.1002/ssu.2980100508

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractRetroperitoneal sarcomas are rare malignant tumors, accounting for approximately 10‐20% of all soft tissue sarcomas. Because of their anatomic location and indolent nature, these tumors are usually quite extensive when first detected with little hope of improvement in the early detection rate. Improved survival rates will therefore depend on obtaining better local control through an aggressive surgical approach, making every effort to achieve a complete resection with histologic negative margins, which in most cases will require the resection of adjacent organs or vascular structures. Even with such aggressive surgical approach, continued problems with local recurrence are reported and it is important to follow patients who had undergone surgical resection very carefully in order to identify those who would benefit from reresection. The results of postoperative adjuvant irradiation and/or chemotherapy have so far been discouraging. Until there is a national registry and a national intergroup study to develop strategies and innovative trials for the effective treatment of these tumors, it is unlikely that there will be much improvement in the current survival rates. © 1994 Wiley‐Liss,

ISSN:8756-0437    

DOI:10.1002/ssu.2980100509

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractSarcomas of the uterus, ovary and lower genital tract are fortunately rare, since the prognosis is quite often poor. The most frequent are sarcomas of the uterine corpus, and these account for only 4% of all uterine tumors. Ovarian sarcomas are less frequent, and the prognosis is even poorer when compared to the uterus. Sarcoma of the lower genital tract (vagina and vulva) in adults in often published as a case report, given their very infrequent occurrence. © 1994 Wiley‐Liss, I

ISSN:8756-0437    

DOI:10.1002/ssu.2980100510

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractSoft tissue sarcoma is the most common malignant neoplasm of the heart, pericardium, and great vessels. Its presentation is infrequent, nonspecific, and subtle. For example, emboli from these tumors to the lungs or peripheral arteries may mimic thrombotic embolic disease. New noninvasive techniques such as echocardiography and magnetic resonance imaging (MRI) aid in diagnosis and preoperative assessment. Angiosarcoma, the most common cardiac sarcoma, is aggressive and usually arises in the right atrium. Kaposi's sarcoma of the heart has been found in patients with AIDS and in immunosuppressed organ transplant recipients. Most primary sarcomas of the aorta and pulmonary artery (the elastic arteries) show minimal differentiation and are classified as “intimal sarcomas,” whereas leiomyosarcomas predominate in the muscular arteries and great veins. Surgical resection of any sarcoma of the vasculature, when feasible, is technically challenging but may result in cure or palliation. Adjuvant chemotherapy and radiation therapy can also relieve symptoms and prolong survival. © 1994 Wiley‐Lis

ISSN:8756-0437    

DOI:10.1002/ssu.2980100511

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY