scholarly journals The Circulating Nucleic Acid Characteristics of Non-Metastatic Soft Tissue Sarcoma Patients

2020 ◽  
Vol 21 (12) ◽  
pp. 4483
Author(s):  
Nicholas Eastley ◽  
Aurore Sommer ◽  
Barbara Ottolini ◽  
Rita Neumann ◽  
Jin-Li Luo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tumour Size ◽  
Soft Tissue Sarcomas ◽  
Digital Pcr ◽  
Malignant Tumours ◽  
Single Nucleotide Variants ◽  
Whole Exome ◽  
Size Grade ◽  
Metastatic Soft Tissue Sarcoma ◽  
Ctdna Analysis

Soft tissue sarcomas (STS) are rare, malignant tumours with a generally poor prognosis. Our aim was to explore the potential of cell free DNA (cfDNA) and circulating tumour DNA (ctDNA) analysis to track non-metastatic STS patients undergoing attempted curative treatment. The analysed cohort (n = 29) contained multiple STS subtypes including myxofibrosarcomas, undifferentiated pleomorphic sarcomas, leiomyosarcomas, and dedifferentiated liposarcomas amongst others. Perioperative cfDNA levels trended towards being elevated in patients (p = 0.07), although did not correlate with tumour size, grade, recurrence or subtype, suggesting a limited diagnostic or prognostic role. To characterise ctDNA, an amplicon panel covering three genes commonly mutated in STSs was first trialled on serial plasma collected from nine patients throughout follow-up. This approach only identified ctDNA in 2.5% (one in 40) of the analysed samples. Next custom-designed droplet digital PCR assays and Ion AmpliSeq™ panels were developed to track single nucleotide variants identified in patients’ STSs by whole exome sequencing (1–6 per patient). These approaches identified ctDNA in 17% of patients. Although ctDNA was identified before radiologically detectable recurrence in two cases, the absence of demonstrable ctDNA in 83% of cases highlights the need for much work before circulating nucleic acids can become a useful means to track STS patients.

scholarly journals Trends in presentation of bone and soft tissue sarcomas over 25 years: little evidence of earlier diagnosis

2011 ◽  
Vol 93 (7) ◽  
pp. 542-547 ◽  
Author(s):  
GM Smith ◽  
GD Johnson ◽  
RJ Grimer ◽  
S Wilson
Keyword(s):  
Soft Tissue ◽  
Tumour Size ◽  
Soft Tissue Sarcomas ◽  
Symptom Duration ◽  
Malignant Tumours ◽  
Duration Of Symptoms ◽  
Delay In Diagnosis ◽  
Two Factors ◽  
Bone Sarcomas ◽  
Oncology Unit

Earlier diagnosis is a key aim in achieving improved outcomes for patients with cancer. Bone and soft tissue sarcomas represent approximately 1% of all malignant tumours. Delays in diagnosis are frequent both because of their rarity and because the clinical features are easily confused with other conditions. In 2000 advice on earlier diagnosis was widely publicised. This study investigates how two factors that may act as a proxy for delay in diagnosis have varied over a 25-year period and whether there is evidence of improvement. Data on symptom duration and tumour size were collected prospectively on all new sarcoma patients referred to an orthopaedic oncology unit over 25 years. Data were available for 2,568 patients with primary bone sarcomas and 2,366 with soft tissue sarcomas. The mean sarcoma size at diagnosis was 10.7cm and 9.9cm respectively. The size of bone sarcomas had not changed over time but there had been a slight decrease in the size of soft tissue sarcomas (10.3cm before 2000 vs 9.6cm after 2000, p=0.03). The duration of symptoms reported by patients varied widely with a median of 16 weeks for bone sarcomas and 26 weeks for soft tissue sarcomas. The median duration of symptoms for bone sarcomas had actually increased since 2000 (16 weeks before vs 20 weeks after 2000, p<0.01). It remained unchanged for soft tissue sarcomas. These data show there is huge room for improvement in diagnosing bone and soft tissue sarcomas. New strategies are needed urgently.

scholarly journals A Novel Four-Gene Prognostic Signature for Prediction of Survival in Patients with Soft Tissue Sarcoma

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5837
Author(s):  
Changwu Wu ◽  
Siming Gong ◽  
Georg Osterhoff ◽  
Nikolas Schopow
Keyword(s):  
Soft Tissue ◽  
Risk Score ◽  
Cox Regression ◽  
Soft Tissue Sarcomas ◽  
Gene Signature ◽  
Gene Set Enrichment Analysis ◽  
The Cancer Genome Atlas ◽  
Prognostic Models ◽  
Malignant Tumours ◽  
Free Survival

Soft tissue sarcomas (STS), a group of rare malignant tumours with high tissue heterogeneity, still lack effective clinical stratification and prognostic models. Therefore, we conducted this study to establish a reliable prognostic gene signature. Using 189 STS patients’ data from The Cancer Genome Atlas database, a four-gene signature including DHRS3, JRK, TARDBP and TTC3 was established. A risk score based on this gene signature was able to divide STS patients into a low-risk and a high-risk group. The latter had significantly worse overall survival (OS) and relapse free survival (RFS), and Cox regression analyses showed that the risk score is an independent prognostic factor. Nomograms containing the four-gene signature have also been established and have been verified through calibration curves. In addition, the predictive ability of this four-gene signature for STS metastasis free survival was verified in an independent cohort (309 STS patients from the Gene Expression Omnibus database). Finally, Gene Set Enrichment Analysis indicated that the four-gene signature may be related to some pathways associated with tumorigenesis, growth, and metastasis. In conclusion, our study establishes a novel four-gene signature and clinically feasible nomograms to predict the OS and RFS. This can help personalized treatment decisions, long-term patient management, and possible future development of targeted therapy.

Phase II Study of Doxorubicin and Bevacizumab for Patients With Metastatic Soft-Tissue Sarcomas

2005 ◽  
Vol 23 (28) ◽  
pp. 7135-7142 ◽  
Author(s):  
David R. D'Adamo ◽  
Sibyl E. Anderson ◽  
Karen Albritton ◽  
Jennifer Yamada ◽  
Elyn Riedel ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Stable Disease ◽  
Cardiac Toxicity ◽  
Single Agent ◽  
Soft Tissue Sarcomas ◽  
Close Monitoring ◽  
Future Studies ◽  
Metastatic Soft Tissue Sarcoma ◽  
Grade 3 ◽  
Line Of Therapy

Purpose To evaluate the antitumor activity and tolerability of bevacizumab and doxorubicin in patients with metastatic soft-tissue sarcoma (STS). Patients and Methods Patients may have had up to one nonanthracycline line of therapy. Seventeen patients with metastatic STS were treated with doxorubicin at 75 mg/m2 intravenous (IV) push followed by bevacizumab 15 mg/kg IV every 3 weeks. Dexrazoxane was started for total doxorubicin dose exceeding 300 mg/m2. Results A total of 85 cycles of doxorubicin/bevacizumab were administered, median four cycles (range, one to 11), with three patients receiving one to four cycles of bevacizumab maintenance after reaching 600 mg/m2 doxorubicin. All 17 patients were assessable for response. Two partial responses (12%, 95% CI = 1% to 36%) were observed, lasting seven and 12 cycles of therapy. Eleven patients (65%) had stable disease for four cycles or more. Six patients developed cardiac toxicity grade 2 or greater, with four patients grade 2 (cumulative doxorubicin 75, 150, 300, 300 mg/m2, respectively), one grade 3 (total doxorubicin 591 mg/m2), and one grade 4 (total doxorubicin 420 mg/m2). One patient with extensive lung disease died of recurrent bilateral pneumothoraces, possibly treatment-related. Conclusion The 12% response rate for these patients was no greater than that observed for single-agent doxorubicin. However, the 65% of patients with stable disease lasting four cycles or longer suggests further study is warranted in STSs. The observed cardiac toxicity, despite close monitoring and standard use of dexrazoxane, obliges a change in the dose and/or schedule in future studies of this combination.

scholarly journals One-year mortality in patients with bone and soft tissue sarcomas as an indicator of delay in presentation

2015 ◽  
Vol 97 (6) ◽  
pp. 425-433 ◽  
Author(s):  
R Nandra ◽  
N Hwang ◽  
GS Matharu ◽  
K Reddy ◽  
R Grimer
Keyword(s):  
Prognostic Factors ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Performance Indicator ◽  
Tumour Size ◽  
Soft Tissue Sarcomas ◽  
Mortality Data ◽  
Term Survival ◽  
Duration Of Symptoms ◽  
One Year

Introduction For many cancers, one-year mortality following diagnosis is a reflection of either advanced stage at diagnosis, multiple co-morbidities and/or complications of treatment. One-year mortality has not been reported for soft tissue or bone sarcomas. This study reports 1-year sarcoma mortality data over a 25-year period, investigates prognostic factors and considers whether a delay in presentation affects 1-year mortality. Methods A total of 4,945 newly diagnosed bone sarcoma and soft tissue sarcoma patients were identified from a prospectively maintained, single institution oncology database. Of these, 595 (12%) died within 1 year of diagnosis. Both patient factors and tumour characteristics available at diagnosis were analysed for effect. Results There was significant variation in one-year mortality between different histological subtypes. There has been no significant change in mortality rate during the last 25 years (mean: 11.7%, standard deviation: 2.8 percentage points). Soft tissue sarcoma patients who survived over one year reported a longer duration of symptoms preceding diagnosis than those who died (median: 26 vs 20 weeks, p<0.001). Prognostic factors identified in both bone and soft tissue sarcomas mirrored those for mid to long-term survival, with high tumour stage, large tumour size, metastases at diagnosis and increasing age having the greatest predictive effect. Conclusions One-year mortality in bone and soft tissue sarcoma patients is easy to measure, and could be a proxy for late presentation and therefore a potential performance indicator, similar to other cancers. It is possible to predict the risk of one-year mortality using factors available at diagnosis. Death within one year does not correlate with a long history but is associated with advanced disease at diagnosis.

Sarcoma

2021 ◽  
pp. 95-104
Author(s):  
Ian M. Smith ◽  
Vinay Itte
Keyword(s):  
Soft Tissue ◽  
Clinical Features ◽  
Multidisciplinary Team ◽  
Systematic Approach ◽  
Soft Tissues ◽  
Soft Tissue Sarcomas ◽  
Malignant Tumours ◽  
Staging Classification

Sarcomas are malignant tumours of the soft tissues or bone. Epidemiology, aetiology, pathology, clinical features, investigations, diagnosis, staging, classification, and management of soft tissue sarcomas are described in this chapter. These tumours are relatively uncommon but require a systematic approach to treatment involving a multidisciplinary team.

scholarly journals A case of marantic endocarditis with systemic emboli in a patient with metastatic soft tissue sarcoma

2019 ◽  
Vol 6 (3) ◽  
pp. 6
Author(s):  
Daniel Alexander Reikher ◽  
Mark Feldman
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Malignant Tumors ◽  
Tissue Injury ◽  
Clinical Manifestations ◽  
Soft Tissue Sarcomas ◽  
Mass Effect ◽  
Metastatic Soft Tissue Sarcoma ◽  
Rare Group ◽  
Marantic Endocarditis

Clinical manifestations of cancer can be categorized as resulting from direct tissue injury from the primary tumor, distant metastatic spread, or aberrant biological activity, also known as a paraneoplastic syndrome. Soft tissue sarcomas are a rare group of malignant tumors of mesenchymal origin which typically present with direct tissue injury, exerting their harmful potential by compression and mass effect. We describe a rare case of an occult retroperitoneal soft tissue sarcoma presenting with marantic endocarditis. To date, there is a paucity of available medical literature relating sarcoma to marantic endocarditis.

scholarly journals ‘‘Two-Week Waits’’—Are They Leading to Earlier Diagnosis of Soft-Tissue Sarcomas?

Sarcoma ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
W. St. J. Taylor ◽  
R. J. Grimer ◽  
S. R. Carter ◽  
R. M. Tillman ◽  
A. Abudu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Mass ◽  
Soft Tissue Sarcomas ◽  
Malignant Tumours ◽  
Tissue Mass ◽  
Borderline Lesion ◽  
Average Size ◽  
Malignant Diagnosis ◽  
Malignant Soft Tissue

Introduction. The ‘‘two-week wait’’ was established as a potential means of diagnosing malignant tumours earlier. This paper investigated whether these clinics are leading to earlier diagnosis of malignant soft-tissue lumps.Method. We identified all referrals to our centre from a database over a 4-year period.Results. 2225 patients were referred to our unit for investigation of a soft-tissue mass. 576 (26%) were referred under the ‘‘two-week wait’’ criteria. 153 (27%) of which were found to have a malignant or borderline malignant diagnosis. 1649 patients were referred nonurgently. 855 (52%) of which were diagnosed with a malignant or borderline lesion. The average size at diagnosis was 9.4 cm with no difference in size between the different referral routes.Conclusion. There is little evidence that the two-week wait clinic is leading to earlier diagnosis of soft-tissue sarcomas with the majority still being referred nonurgently.

Soft tissue sarcoma of the upper extremity: oncological and functional results after surgery

2021 ◽  
pp. 175319342199825
Author(s):  
Özgür Baysal ◽  
Canan Şanal Toprak ◽  
Berkin Günar ◽  
Bülent Erol
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Upper Extremity ◽  
Tumour Size ◽  
Functional Results ◽  
Level Of Evidence ◽  
Factors Affecting ◽  
Distant Organ ◽  
Size Grade ◽  
Grade 3

This retrospective study evaluates outcomes after treatment of upper-extremity soft tissue sarcoma in 44 patients. We re-resected 19 tumours that had been resected elsewhere without adequate preoperative planning, and we made 25 well-planned primary resections. Four patients in the unplanned group and five in the planned group eventually received amputations. Thirty-three patients were alive at a median follow-up time of 33 months (IQR 18 to 57). Tumour size > 7 cm, tumour Grade 3 and the presence of distant organ metastases were the main factors affecting the oncological outcomes. We found no statistical differences between the planning groups. Functional outcomes and quality of life were significantly worse after amputation or major nerve resections. We conclude with this sized sample that the lack of planning in itself did not influence the final results, but there were differences in tumour size, grade and localization between the groups that may play a role. Level of evidence: IV

Prognosis of Patients with Metastatic Soft Tissue Sarcoma: Advances in Recent Years

2020 ◽  
Vol 43 (11) ◽  
pp. 613-619
Author(s):  
Jakob Lochner ◽  
Franka Menge ◽  
Nikolaos Vassos ◽  
Peter Hohenberger ◽  
Bernd Kasper
Keyword(s):  
Soft Tissue ◽  
Metastatic Disease ◽  
Medical Center ◽  
Treatment Strategies ◽  
Soft Tissue Sarcomas ◽  
High Volume ◽  
Prognostic Indicators ◽  
Metastatic Soft Tissue Sarcoma ◽  
Using Data ◽  
Clinical Records

<b><i>Objective:</i></b> The objective of this study was to investigate the prognosis of patients with metastatic soft tissue sarcomas (STS) and to define prognostic indicators for overall survival (OS). <b><i>Methods:</i></b> All patients who were treated at the Sarcoma Unit at the Mannheim University Medical Center between 2010 and 2016 and who developed metastatic disease deriving from a STS were included in this retrospective analysis. OS was investigated using data from clinical records and German registry offices. Clinical and pathological characteristics were recorded and analyzed. <b><i>Results:</i></b> A total number of 212 patients developed metastatic disease from STS during that period. Median OS after first documentation of metastatic disease was 24 months (95% CI 21–33). 1-, 2-, and 5-year OS rates were 70.0% (95% CI 64–77), 49.9% (95% CI 43–58), and 24.8% (95% CI 19–33), respectively. In multivariate analysis, significant predictors for mortality appeared to be gender, age, location and size of the primary tumor, histology, and disease-free interval. <b><i>Conclusion:</i></b> Being treated in a high-volume STS reference center in Germany, patients with metastatic disease could demonstrate an increased OS compared to former analyses. These data can be used as a benchmark for upcoming studies and highlight that further research on treatment strategies in this rare disease is urgently needed.

scholarly journals Adult Head and Neck Soft Tissue Sarcomas: Treatment and Outcome

Sarcoma ◽  
2008 ◽  
Vol 2008 ◽  
pp. 1-5 ◽  
Author(s):  
Rabindra P. Singh ◽  
Robert J. Grimer ◽  
Nabina Bhujel ◽  
Simon R. Carter ◽  
Roger M. Tillman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Head And Neck ◽  
Metastatic Disease ◽  
Tumour Size ◽  
Soft Tissue Sarcomas ◽  
Histological Subtypes ◽  
Median Size ◽  
Adult Head

We have retrospectively analysed the experience of a musculoskeletal oncological unit in the management of adult head and neck soft tissue sarcomas from 1990 to 2005. Thirty-six patients were seen, of whom 24 were treated at this unit, the remainder only receiving advice. The median age of the patients was 46 years. Most of the sarcomas were deep and of high or intermediate grade with a median size of 5.5 cm. Eleven different histological subtypes were identified. Wide excision was possible only in 21% of the cases. 42% of the patients developed local recurrence and 42% developed metastatic disease usually in the lungs. Overall survival was 49% at 5 years. Tumour size was the most important prognostic factor. Adult head and neck soft tissue sarcomas have a high mortality rate with a high risk of local recurrence and metastatic disease. The rarity of the disease would suggest that centralisation of care could lead to increased expertise and better outcomes.

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