Primary tumors of the sartorial canal: limb sparing resection of soft-tissue sarcomas arising in a unique location

9551 Background: Sarcoma are rare tumors, with an incidence <1% of all neoplasms. Very few data are available on the clinical and psychological needs of the pts in terminal phase of these diseases. In terminal phase the goal is no more cure or prolongation of life, but the control of symptoms related to the disease progression. Methods: As a specialized interdisciplinary group we have started to treat the pts afflicted from soft tissue and bone sarcomas since 1994. We have recorded in a perspective study the problems of the terminal pts from 1998 until 2005. We have followed 178 pts with sarcomas in terminal phase for at least 3 months: 95 males and 83 females, median age 57 years, median PS 50 Karnofsky. Histologically 143 had soft tissue sarcomas, 28 osteosarcomas, 7 Ewing sarcomas. Extremities were the origin of the disease in 33.7% of the cases, abdomen in 29.2%, trunk in 21.9% and other sites in 15.2%. Site of recorded metastases: lung 48.3%, liver 18.5%, bone 15.7%, brain 7.9%, nodes 4.5%. Inoperable primary tumors or local relapse 30.9%. Results: During the last part (1 months) of their lives the pts complained with: pain 78.7%, dyspnoea 48.9%, anxiety 16.9%, gastrointestinal obstruction 24.7%, anorexia 51.1%, bleeding 7.9%. 57.3% of these pts died at home, 42.7% at the hospital. To control pain, dyspnoea and the other symptoms radiotherapy (43%), supportive care (100%) and palliative chemotherapy (36%) were used. Psycological support was offered to the majority of pts (63.5%) as well as physical rehabilitation (56.8%). Conclusions: Supportive care of pts with advanced sarcomas is an underestimated aspect in clinical oncology. We have demonstrated that these pts have specific needs, on some aspects, different from those of the pts afflicted from the most common cancers. A complex, multidisciplinary approach is necessary in order to improve the assistance and quality of life of these pts. No significant financial relationships to disclose.

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Cytogenetic evolution in primary tumors, local recurrences, and pulmonary metastases of two soft tissue sarcomas

Clinical & Experimental Metastasis ◽

10.1007/bf00132983 ◽

1993 ◽

Vol 11 (5) ◽

pp. 401-408 ◽

Cited By ~ 15

Author(s):

C. �rndal ◽

N. Mandahl ◽

H. Will�n ◽

A. Rydholm ◽

F. Mitelman

Keyword(s):

Soft Tissue ◽

Pulmonary Metastases ◽

Soft Tissue Sarcomas ◽

Primary Tumors ◽

Local Recurrences ◽

Cytogenetic Evolution

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Detection of MSC-like cells in soft tissue sarcoma cell lines and primary tumors

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.11000 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 11000-11000

Author(s):

S. Wirths ◽

E. Malenke ◽

T. Wiesner ◽

H. Buehring ◽

J. Hartmann ◽

...

Keyword(s):

Soft Tissue ◽

Cell Lines ◽

Primary Tumor ◽

Growth Factor Receptor ◽

Soft Tissue Sarcomas ◽

Proliferative Capacity ◽

Differentiation Potential ◽

Primary Tumors

11000 Background: Soft tissue sarcomas (STS) are a heterogeneous group of mesodermal tumors hypothetically originating from mesenchymal stem cells (MSC). While the expression profile of bone marrow derived MSCs and their in vitro differentiation potential have been examined extensively, knowledge regarding the in vivo counterparts of MSC is still evolving. We hypothesized that MSC-like cells within STS could represent sarcoma initiating cells. Methods: To target rare human cell populations including MSCs, an exclusive antibody panel was developed. The target antigens include platelet-derived growth factor receptor-β (CD140b), HER-2/erbB2 (CD340), TNFRSF16 (CD217), frizzled-4 (CD344), the recently described W8B2 antigen, as well as several surface antigens identified by novel antibodies. To define the expression pattern of MSC-markers in STS, both cell lines and primary tumor samples in suspension and in snap frozen sections were investigated. To reveal functional differences between identified rare tumor populations single cell proliferation kinetics were investigated after FACS-sorting. Results: All cell lines und primary tumor samples revealed expression of selected markers. Antigens identifying subpopulations within all sarcoma samples investigated, were selected for functional studies. These included frizzled-4, TNFRSF16, W5C5 and W8B2. Liposarcoma (SW872), leiomyosarcoma (SK-LMS) and fibrosarcoma (HT1080) cell lines enclosed subpopulations with differential expression of above markers and by FACS based limiting dilution it was demonstrated that only fractions of viable cells contained proliferative capacity. Cells lacking expression of CD271 had lower proliferative capacity compared to mock sorted HT1080 or SK-LMS, while CD271+ SW872 had significantly higher proliferation. The antigen defined by W5C5 identified cells with high proliferative capacity compared to control in SW872 and SK-LMS and its lack in HT1080 identified a subpopulation with largely reduced proliferation. Conclusions: Subpopulations within STS cell lines and primary sarcoma tissue express novel MSC-markers and display increased proliferative capacity, potentially reflecting the existence of sarcoma initiating cells. No significant financial relationships to disclose.

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Factors of angiogenesis (VEGF and CD34) in primary and recurrent soft tissue sarcomas.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e23545 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e23545-e23545

Author(s):

Evgeniya M. Nepomnyashchaya ◽

Elena P. Ulianova ◽

Aleksandr B. Sagakyants ◽

Inna A. Novikova ◽

Larisa N. Vashchenko ◽

...

Keyword(s):

Soft Tissue ◽

Blood Vessels ◽

Molecular Mechanisms ◽

Detection System ◽

Dynamic Balance ◽

Soft Tissue Sarcomas ◽

Field Of View ◽

Primary Tumors ◽

Group 2 ◽

Group 1

e23545 Background: The tumor ability to induce and maintain angiogenesis is one of the main stages of its development. Studies of molecular mechanisms of angiogenesis showed that the dynamic balance that ensures the formation and development of new vessels inside the tumor depends on pro- and anti-angiogenic factors. VEGF and the CD34 endothelial cell marker are considered among the main activators of angiogenesis. Our purpose was to study characteristics of angiogenesis in primary and recurrent soft tissue sarcomas. Methods: The study included 30 patients with primary sarcomas (group 1) and 26 patients with recurrent sarcomas (group 2). Sections of tissues embedded in paraffin blocks were studied by immunohistochemistry using the Thermo Scientific 480S automated stainer. The Reveal Polyvalent HRP-DAB Detection System was used for the visualization. The density of blood vessels stained with antibodies against VEGF and CD34 was determined. The statistical analysis of results was performed in the STATISTICA 10.0 program (StatSoftInc., USA). Results: The numbers of blood vessels ranged: CD34 in group 1 – 7-16 blood vessels in one field of view; in group 2 – 2-18 vessels. VEGF in group 1 – 2-20 vessels, with up to 40 vessels in 3 cases (11.5%) only; in group 2 – 5-11 vessels, with up to 20 vessels in 2 cases (7.7%). The average numbers of microcirculatory vessels stained with antibodies against VEGF and CD34 were: CD34 –12.2±1.04 and 8.4±1.4 (p = 0.0247) in groups 1 and 2, respectively; VEGF – 12.8±4.06 and 8.4±11.6 (p = 0.3074) in groups 1 and 2, respectively. Conclusions: The IHC analysis showed the minimal numbers of microcirculatory vessels in one field of view in patients with recurrent soft tissue sarcomas. The value was 1.5 times lower for both CD34 and VEGF, compared to patients with primary tumors. However, only CD34 value was statistically significant (the Mann–Whitney U-test). Probably, a certain decrease in angiogenesis factors in recurrent tumors can be explained by adjuvant chemotherapy suppressing tumor growth.

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Comparative analysis of cell cycle parameters in primary and recurrent soft tissue sarcomas.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e22538 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e22538-e22538

Author(s):

Inna Arnoldovna Novikova ◽

Evgeniya M. Nepomnyashchaya ◽

Timur Aliev ◽

Elena Yurievna Zlatnik ◽

Olesya N. Selyutina ◽

...

Keyword(s):

Cell Cycle ◽

Flow Cytometry ◽

Comparative Analysis ◽

Soft Tissue ◽

Dna Content ◽

Soft Tissue Sarcomas ◽

Disease Stage ◽

Primary Tumors ◽

Recurrent Tumors ◽

M Phase

e22538 Background: The purpose of the study was to determine DNA content and distribution of cells in cell cycle phases by flow cytometry in patients with primary and recurrent soft tissue sarcomas. Methods: 60 patients with soft tissue sarcomas (STS) were recruited: 30 with primary tumors and 30 with recurrent ones. Mean age of patients with primary STS was 56±5.4 years, with recurrent STS – 55±6.7 years. DNA content was determined using the BD Facs Cantoo II flow cytometer with CycleTEST PLUS DNA Reagent Kit (Becton Dickinson). The data were processed using ModFit LT program. Results: Comparative analysis of the cell cycle kinetics showed an increase in the percentage of cells in G2+M phase by 2 times in diploid and by 2.1 times in aneuploid recurrent tumors in comparison with primary ones (1.8±0.5% vs. 0.9±0.1% for diploid tumors; 5.4±2.2% vs. 2.6±0.7% for aneuploid tumors). An increase in the percentage of aneuploid tumors was found in recurrent G2 and G3 tumors (from 50% in primary to 66.7% in recurrent G2 tumors and from 63.25% in primary to 85% in recurrent G3 tumors). Mean content of aneuploid cells in recurrent G2 tumors was 2.2 times higher (p≤0.05), while the differences in primary and recurrent G3 tumors were not significant. The percentage of aneuploid tumors depended on the disease stage and increased in stages IIb and III in recurrent tumors, compared to primary ones (from 37.5% to 71.4% in recurrent st. IIb; and from 65% in primary st. III to 72.7% in recurrences) (p≤0.05). Conclusions: DNA analysis by flow cytometry demonstrated a high biologic potential of both primary and recurrent tumors. Some values in the mitotic cycle in recurrent tumors were probably associated with adjuvant therapy, as well as influenced by the coefficient of two parameters – the percentage of cells in G2+M phase and the cell loss factor determining a high malignant potential of these tumors.

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The Treatment and Outcome of Patients With Soft Tissue Sarcomas and Synchronous Metastases

Sarcoma ◽

10.1080/1357714021000022168 ◽

2002 ◽

Vol 6 (2) ◽

pp. 69-73 ◽

Cited By ~ 27

Author(s):

John M. Kane ◽

J. William Finley ◽

Deborah Driscoll ◽

William G. Kraybill ◽

John F. Gibbs

Keyword(s):

Overall Survival ◽

Soft Tissue ◽

Metastatic Disease ◽

Primary Tumor ◽

Strong Association ◽

Soft Tissue Sarcomas ◽

Poor Overall Survival ◽

Primary Tumors ◽

Synchronous Metastases ◽

Metastatic Sites

Introduction: There is a strong association between poor overall survival and a short disease-free interval for patients with soft tissue sarcomas (STS) and metastatic disease. Patients with STS and synchronous metastases should have a very dismal prognosis.The role of surgery in this subgroup of patients with STS has not been defined.Patients and Methods: A single-institution retrospective review was performed of 48 patients with STS and synchronous metastases in regard to patient demographics, presentation, tumor characteristics, metastatic sites, treatment, follow-up, and survival over a 27-year period.Results: Most primary tumors were ≥10 cm (58%), high-grade histology (77%), and located on the extremity (60%).The most frequent site of metastatic disease was the lung (63%); 27% of patients had metastases to ≥2 organ sites. Surgery to the primary tumor was performed in 94% of patients (n = 45) and 68% had additional radiation therapy (n = 32). Thirty- five percent of patients underwent at least one metastastectomy (n = 17). Chemotherapy was administered to 90% of patients (n = 43); 31% received ≥3 different regimens (n = 15) and 25% were given intra-arterial or intracavitary therapy (n = 12). Median overall survival was 15 months with a 21% 2-year survival. Local control of the primary tumor was achieved in 54% (n = 26), and metastastectomy was performed in 35% (n = 17). No analyzed factors were associated with an improvement in overall survivalConclusions: Despite multiple poor prognostic factors, the survival of patients with STS and metastases is comparable to those who develop delayed metastatic disease. However, unlike patients who present with metachronous disease, there was no improved survival observed for patients treated with metastastectomy. Consequently, treatment for patients with STS and synchronous metastases should be approached with caution. Surgical management of STS with synchronous metastases must be considered palliative and should be reserved for patients requiring palliation of symptoms. Patients must also be well informed of the noncurative nature of the procedure.

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Therapy for childhood soft-tissue sarcomas other than rhabdomyosarcoma: a review of 62 cases treated at a single institution.

Journal of Clinical Oncology ◽

10.1200/jco.1986.4.4.559 ◽

1986 ◽

Vol 4 (4) ◽

pp. 559-564 ◽

Cited By ~ 39

Author(s):

M E Horowitz ◽

C B Pratt ◽

B L Webber ◽

H O Hustu ◽

E Etcubanas ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcomas ◽

Response To Therapy ◽

Collaborative Group ◽

Treatment Modalities ◽

Malignant Schwannoma ◽

Single Institution ◽

Primary Tumors ◽

Histopathologic Diagnosis ◽

Aggressive Surgical Approach

The rarity and diverse characteristics of the nonrhabdomyosarcomatous soft-tissue sarcomas (NRSTS) in children have hindered study of their clinical presentations and response to therapy. Here we describe the findings of a retrospective analysis of 62 cases of NRSTS seen in a single institution from 1962 through 1983. The most common histopathologic diagnosis was synovial sarcoma, occurring in 18 patients, followed by malignant schwannoma in 12. The median age at diagnosis was 11 years (range, 2 months to 20 years). Anatomic sites of primary tumors were the trunk (28), extremity (24), and head and neck (10). Of the 31 patients whose tumors were completely resected, 26 (84%) survive with no evidence of disease. Postoperative chemotherapy, administered to nearly one half of this group, did not produce any demonstrable gains in survival. Only one of the 26 patients with local or metastatic gross tumor after resection survives. We conclude that an aggressive surgical approach is imperative in patients with NRSTS and that the contribution of other treatment modalities needs to be defined in a collaborative group trial.

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Genetic Profiling Differentiates Second Primary Tumors from Metastases in Adult Metachronous Soft Tissue Sarcoma

Sarcoma ◽

10.1155/2008/431019 ◽

2008 ◽

Vol 2008 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Josefin Fernebro ◽

Ana Carneiro ◽

Anders Rydholm ◽

Henryk A. Domanski ◽

Anna Karlsson ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcomas ◽

Hierarchical Cluster ◽

Comparative Genomic ◽

Second Primary ◽

Unsupervised Hierarchical Cluster ◽

Primary Tumors ◽

Therapeutic Implications ◽

Pairwise Correlation ◽

Increased Risk

Purpose. Patients with soft tissue sarcomas (STS) are at increased risk of second primary malignancies, including a second STS, but distinction between metastases and a second primary STS is difficult.Patients and Methods. Array-based comparative genomic hybridization (aCGH) was applied to 30 multiple STS of the extremities and the trunk wall from 13 patients. Different histotypes were present with malignant fibrous histiocytomas/undifferentiated pleomorphic sarcomas being the predominant subtype.Results. aCGH profiling revealed genetic complexity with multiple gains and losses in all tumors. In an unsupervised hierarchical cluster analysis, similar genomic profiles and close clustering between the first and subsequent STS were identified in 5 cases, suggesting metastatic disease, whereas the tumors from the remaining 8 patients did not cluster and showed only weak pairwise correlation, suggesting development of second primary STS.Discussion. The similarities and dissimilarities identified in the first and second STS suggest that genetic profiles can be used to distinguish soft tissue metastases from second primary STS. The demonstration of genetically different soft tissue sarcomas in the same patient suggests independent tumor origin and serves as a reminder to consider development of second primary STS, which has prognostic and therapeutic implications.

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