scholarly journals Imaging of Bone Sarcomas and Soft-Tissue Sarcomas

Author(s):  
Jasminka Igrec ◽  
Michael H. Fuchsjäger

Background In the diagnosis of bone and soft-tissue sarcomas, the continuous advancement of various imaging modalities has improved the detection of small lesions, surgical planning, assessment of chemotherapeutic effects, and, importantly, guidance for surgery or biopsy. Method This review was composed based on a PubMed literature search for the terms “bone sarcoma,” “bone cancer” and “soft tissue sarcoma,” “imaging,” “magnetic resonance imaging”, “computed tomography”, “ultrasound”, “radiography”, and “radiomics” covering the publication period 2005–2020. Results and Conclusion As discussed in this review, radiography, ultrasound, CT, and MRI all play key roles in the imaging evaluation of bone and soft-tissue sarcomas. In daily practice, advanced MRI techniques complement standard MRI but remain underused, as they are considered time-consuming, technically challenging, and not reliable enough to replace biopsy and histology. PET/MRI and radiomics have shown promise regarding the imaging of sarcomas in the future. Key Points:  Citation Format

Bone sarcomas 296 Soft tissue sarcomas 300 Surgical treatments 302 Metastatic bone disease (MBD) 306 Bone sarcomas are extremely rare, with less than 550 new cases per annum in the UK. They account for only 0.2% of all new cancers, but 5% of childhood cancers. The main types of bone sarcoma/tumour are:...


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
Z h U Pyssanova ◽  
G A Serikbaev ◽  
D R Kaydarova ◽  
D A Tuleuova ◽  
A S Shinbolatova ◽  
...  

Abstract Background Sarcoma is a malignant tumor of soft tissues and bones. They make up 1% of all malignant tumors in adults and 15% in children. More common in men 1.1: 1. By age: 20.7% - up to 40 years old, 27.6% - 40-60 years old and 51.7% over 60 years old. In 2018, in the Kazakhstan, malignant tumor of connective and soft tissues of 444 (1.4%) cases was registered and ranks 19th in the structure of cancer, bones and articular cartilage 188 (0.6%), takes 22nd place. Of these, with sore cases, bone sarcomas were recorded - 12.7%, soft tissues - 9.5%. The mortality rate from soft tissue sarcoma is -177 (1.2%) people, bone sarcoma - 85 (0.6%) people. Five-year survival of patients from soft tissue sarcomas is 53.8%, from bone sarcomas - 67.3%. Methods from 2015 to 2019, 1,068 patients with malignant tumor of bones and articular cartilage, 963 patients with malignant tumor of connective and soft tissues addmited to KazNIIOiR. Of these, 225 patients underwent organ-sparing surgeries - endoprosthesis replacement of limbs. Results In Kazakhstan over the past 5 years there has been an increase in the incidence of sarcomas of bones and soft tissues. Conclusions in comparison with previous years, there is an increase in the incidence of malignant tumor of bones and articular cartilage, connective and soft tissues, and an increase in mortality from tumor of bones and articular cartilage in men by 16.7%, in women by 50%. Late reversal of patients at the IV stage and a high proportion posthumously recorded in patients with maliganan tumors. Key messages Purpose: Assessment of the epidemiological situation and incidence of sarcomas of the bones and soft tissues in Kazakhstan. Out of 25 localizations of cancer, detection is worsened during professional examinations in 10 localizations, of which bones and articular cartilage, connective and other soft tissues.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 11550-11550
Author(s):  
Varun Monga ◽  
Rebecca Dodd ◽  
Amanda Scherer ◽  
Wade Robert Gutierrez ◽  
Munir Tanas ◽  
...  

11550 Background: Sarcomas are a heterogeneous group of tumors and are associated with high rates of metastases leading to poor prognosis. Numerous epigenetic changes including hypermethylation have been identified in several sarcoma subtypes. Restoration of normal methylation patterns using DNA hypomethylating agent when combined with chemotherapy has shown to slow tumor growth in preclinical studies. Low continuous dosing of hypomethylating agent has epigenetic modulating effect with less toxicity. We conducted a Phase 1b study evaluating safety & tolerability and identifying the recommended phase 2 dose (RP2D) of subcutaneous (SQ) decitabine (DEC) given with fixed dose infusion gemcitabine (GEM) in patients with advanced soft tissue sarcomas (STS) and bone sarcomas. Methods: Eligible patients at least age 18 yrs with metastatic histologically confirmed STS or bone sarcoma after progression on one line or if refused adriamycin for STS were included. Prior GEM use was permitted. A modified 3+3 dose escalation design was used exploring two dose cohorts of DEC, 0.1 and 0.2 mg/kg SQ administered on a twice weekly schedule for three weeks and GEM given as 900 mg/m2, IV over 90 min on days 1, 8 & 15 of a 28-day cycle. Treatment was continued until disease progression or unacceptable toxicity. Dose limiting toxicity (DLT) was defined as any drug related non-hematological grade 3 or 4 toxicity per CTCAE v4.0. Disease assessment was performed every 8 weeks using RECIST v1.1. Results: 31 patients (25 STS & 6 bone sarcomas) were enrolled of which 7 were non-evaluable. There were 12 evaluable patients in each dosing cohort. Of the total 744 adverse events (AE) 17.2% were grade 3/4 and most were neutropenia without neutropenic fever. 45.7% AEs were possibly (44.6%) or probably (1.1%) attributed to DEC use. The toxicities were not significantly different between DEC doses. No DLTs were observed. One patient died due to progressive disease. Conclusions: Combination of fixed dose infusion GEM with low dose subcutaneous DEC is moderately toxic. Most toxicities were hematological. While there were few responses, the RP2D of DEC selected was 0.1 mg/kg as it showed prolonged disease stabilization. Clinical trial information: NCT02959164 . [Table: see text]


2011 ◽  
Author(s):  
Adam Lerner ◽  
Huihong Xu ◽  
Karen H Antman

Sarcomas originate from bone or soft tissue. The most common bone sarcomas are osteosarcomas, Ewing sarcomas, and chondrosarcomas. Soft tissue sarcomas develop in fibrous tissue, fat, muscle, blood vessels, and nerves. Historically, soft tissue sarcomas of the trunk and extremities were reported separately from those of visceral organs (e.g., gastrointestinal and gynecologic sarcomas). This chapter discusses the classification, epidemiology, diagnosis, staging, and treatment of sarcomas of bone and cartilage, and classic soft tissue sarcomas. Management of Kaposi sarcoma, gastrointestinal stromal tumors (GISTs), mesothelioma, and rhabdomyosarcoma is also described. Figures include images of patients with osteosarcoma, liposarcoma, uterine leiomyosarcoma, GIST, and osteosarcoma in a patient with Paget disease of bone. Tables list epidemiologic features of sarcomas, a summary of sarcomas by histology, familial syndromes associated with increased risk of sarcoma, survival rates in sarcoma patients, staging of soft tissue sarcomas, and results of a meta-analysis of doxorubicin-based adjuvant chemotherapy for localized resectable soft tissue sarcoma. This chapter contains 126 references.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10033-10033 ◽  
Author(s):  
M. Schlemmer ◽  
P. Reichardt ◽  
J. Verweij ◽  
J. T. Hartmann ◽  
I. Judson ◽  
...  

10033 Background: Angiosarcomas represent a heterogenous group of rare sarcomas with specific clinical behaviour and risk factors. Paclitaxel has been suggested to induce tumor control in a proportion of pts with angiosarcoma while being inactive in other soft tissue sarcomas subtypes. The objective of this retrospective study was to investigate the antitumor activity of this compound in a larger series and a multicenter setting. Patients and Methods: Data from pts with angiosarcoma treated with paclitaxel in centers of the EORTC Soft Tissue and Bone Sarcoma Group were collected using a standardized data collection form. Results: Data from 32 pts were collected from 10 centers. There were 17 males and 15 females with a median age of 60.4 years (range 24–91). Eight pts (25%) had angiosarcomas of the face and scalp, 24 pts (75%) at other primary sites. Ten (31 %) pts had a previous cancer history, 7 of whom had been irradiated for breast cancer. Ten (31 %) pts had received 1st line chemotherapy (ctx) and 3 pts 2nd line ctx prior to treatment with paclitaxel. All 13 (40%) pretreated pts had doxorubicin, 5 pts in combination with ifosfamide as 1st line and 3 pts ifosfamide as 2nd line ctx. 21 (66 %) pts received paclitaxel 175 mg/m2 every 3 weeks, and 11 (34 %) received 75–100 mg/m2weekly. The overall response rate (RR) was 62.5 % [including 1 CR (3%) and 19 PR (59%)]; in pts with face and scalp primary sites the RR was 75% (1CR, 5 PR), whereas pts with angiosarcoma at other sites achieved a response in 58% (14 PR). PFS was 7.6 months for all 32 pts. Conclusion: Paclitaxel was an active agent in angiosarcoma in this retrospective multicenter study, also in angiosarcoma originating at other sites than scalp and face. These results need to be confirmed in a controlled, prospective phase II study. No significant financial relationships to disclose.


Life ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 869
Author(s):  
Ruben I. Hack ◽  
Anton S. Becker ◽  
Beata Bode-Lesniewska ◽  
G. Ulrich Exner ◽  
Daniel A. Müller ◽  
...  

Introduction: The role of positron-emission tomography/computed-tomography (PET/CT) in the management of sarcomas and as a prognostic tool has been studied. However, it remains unclear which metric is the most useful. We aimed to investigate if volume-based PET metrics (Tumor volume (TV) and total lesions glycolysis (TLG)) are superior to maximal standardized uptake value (SUVmax) and other metrics in predicting survival of patients with soft tissue and bone sarcomas. Materials and Methods: In this retrospective cohort study, we screened over 52′000 PET/CT scans to identify patients diagnosed with either soft tissue, bone or Ewing sarcoma and had a staging scan at our institution before initial therapy. We used a Wilcoxon signed-rank to assess which PET/CT metric was associated with survival in different patient subgroups. Receiver-Operating-Characteristic curve analysis was used to calculate cutoff values. Results: We identified a total of 88 patients with soft tissue (51), bone (26) or Ewing (11) sarcoma. Median age at presentation was 40 years (Range: 9–86 years). High SUVmax was most significantly associated with short survival (defined as <24 months) in soft tissue sarcoma (with a median and range of SUVmax 12.5 (8.8–16.0) in short (n = 18) and 5.5 (3.3–7.2) in long survival (≥24 months) (n = 31), with (p = 0.001). Similar results were seen in Ewing sarcoma (with a median and range of SUVmax 12.1 (7.6–14.7) in short (n = 6) and 3.7 (3.5–5.5) in long survival (n = 5), with (p = 0.017). However, no PET-specific metric but tumor-volume was significantly associated (p = 0.035) with survival in primary bone sarcomas (with a median and range of 217 cm3 (186–349) in short survival (n = 4) and 60 cm3 (22–104) in long survival (n = 19), with (p = 0.035). TLG was significantly inversely associated with long survival only in Ewing sarcoma (p = 0.03). Discussion: Our analysis shows that the outcome of soft tissue, bone and Ewing sarcomas is associated with different PET/CT metrics. We could not confirm the previously suggested superiority of volume-based metrics in soft tissue sarcomas, for which we found SUVmax to remain the best prognostic factor. However, bone sarcomas should probably be evaluated with tumor volume rather than FDG PET activity.


SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 23
Author(s):  
Takuya Kakimoto ◽  
Akihiko Matsumine ◽  
Kunihiro Asanuma ◽  
Takao Matsubara ◽  
Tomoki Nakamura ◽  
...  

Introduction: Reconstruction using a total femur prosthesis (TFP) remains a challenging procedure in musculoskeletal tumor surgery. The purpose of this study was to show the clinical outcomes of total femur replacement (TFR) in our institute. Methods: Nine patients underwent reconstruction with a TFP after the wide resection of malignant bone and soft-tissue tumors of the femur between January 2003 and April 2014. The mean age of the patients at the time of TFR was 47.5 years, and the mean follow-up period was 52.9 months. The histological diagnoses were as follows: bone sarcoma (n = 4), soft-tissue sarcoma invading the femoral bones (n = 4), and metastatic bone tumor (n = 1). Results: The oncological outcomes were as follows: three patients achieved continuous disease free, two patients were alive with disease, and four patients died from disease. The 3- and 5-year overall survival rates were 88.9% and 55.6%, respectively. The rate of the overall survival in patients with primary bone tumors (100% at 5 years) was significantly better than that in patients with primary soft tissue sarcomas (0% at 5 years) (p = 0.015). A deep infection occurred postoperatively in one patient, but the patient was successfully treated with surgical debridement and revision surgery. There were no patients who showed dislocation or aseptic loosening. The mean Musculo-Skeletal Tumor Society functional score was 58.5% (46.7–80.0), with scores of 65.5% in patients with a primary bone tumor and 50.8% in those with a primary soft-tissue sarcoma. Discussion: In the present study, the patients who underwent TFR due to bone invasion by soft tissue sarcoma had a worse prognosis than the bone sarcoma patients.


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