Pathology of Soft Tissue Sarcoma

The evaluation and treatment of soft tissue sarcomas has never been more demanding than it is today. The pathologist plays a central role in this process and is an integral member of the multidisciplinary sarcoma treatment team. This article provides a brief summary of the role of the soft tissue pathologist and includes sections on methods of diagnosis, frozen section, classification of sarcomas, expert consultation, molecular pathology, grading, assessment of treatment response, and tumor banking.

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Classification of Soft Tissue Sarcoma Specimens with Raman Spectroscopy as Smart Sensing Technology

Cyborg and Bionic Systems ◽

10.34133/2021/9816913 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Liming Li ◽

Vamiq M. Mustahsan ◽

Guangyu He ◽

Felix B. Tavernier ◽

Gurtej Singh ◽

...

Keyword(s):

Raman Spectroscopy ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Real Time ◽

Frozen Section ◽

Margin Status ◽

Resection Margins ◽

Analytical Methodology ◽

Sensing Technology

Intraoperative confirmation of negative resection margins is an essential component of soft tissue sarcoma surgery. Frozen section examination of samples from the resection bed after excision of sarcomas is the gold standard for intraoperative assessment of margin status. However, it takes time to complete histologic examination of these samples, and the technique does not provide real-time diagnosis in the operating room (OR), which delays completion of the operation. This paper presents a study and development of sensing technology using Raman spectroscopy that could be used for detection and classification of the tumor after resection with negative sarcoma margins in real time. We acquired Raman spectra from samples of sarcoma and surrounding benign muscle, fat, and dermis during surgery and developed (i) a quantitative method (QM) and (ii) a machine learning method (MLM) to assess the spectral patterns and determine if they could accurately identify these tissue types when compared to findings in adjacent H&E-stained frozen sections. High classification accuracy (>85%) was achieved with both methods, indicating that these four types of tissue can be identified using the analytical methodology. A hand-held Raman probe could be employed to further develop the methodology to obtain spectra in the OR to provide real-time in vivo capability for the assessment of sarcoma resection margin status.

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Soft Tissue Sarcoma: The Important Role of Initial MRI Reports for Disease Control

10.1055/s-0040-1717271 ◽

2020 ◽

Author(s):

S Weiß ◽

A Korthaus ◽

K-H Frosch ◽

C Schlickewei ◽

M Priemel

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Disease Control

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Translating Molecular Profiling of Soft Tissue Sarcomas into Daily Clinical Practice

Diagnostics ◽

10.3390/diagnostics11030512 ◽

2021 ◽

Vol 11 (3) ◽

pp. 512

Author(s):

Celine Jacobs ◽

Lore Lapeire

Keyword(s):

Soft Tissue ◽

Unmet Need ◽

Soft Tissue Sarcomas ◽

Molecular Profiling ◽

Point Of View ◽

Molecular Techniques ◽

Mesenchymal Tumors ◽

The Past ◽

Cancer Types ◽

Sarcoma Treatment

Soft tissue sarcomas are a group of rare mesenchymal tumors with more than 70 subtypes described. Treatment of these subtypes in an advanced setting is mainly according to a one-size-fits-all strategy indicating a high unmet need of new and more targeted therapeutic options in order to optimize survival. The introduction of advanced molecular techniques in cancer has led to better diagnostics and identification of new therapeutic targets, leading to more personalized treatment and improved prognosis for several cancer types. In sarcoma, a likewise evolution is seen, albeit at a slower pace. This manuscript describes how in the past years advanced molecular profiling in soft tissue sarcomas was able to identify specific and often pathognomonic aberrations, deferring standard sarcoma treatment in favor of more targeted treatment from an oncologist’s point of view.

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Primary Soft Tissue Sarcoma of the Heart: An Emerging Chapter in Cardio-Oncology

Biomedicines ◽

10.3390/biomedicines9070774 ◽

2021 ◽

Vol 9 (7) ◽

pp. 774

Author(s):

Pietro Scicchitano ◽

Maria Chiara Sergi ◽

Matteo Cameli ◽

Marcelo H. Miglioranza ◽

Marco Matteo Ciccone ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Soft Tissue Sarcomas ◽

Cardiac Tumors ◽

Malignant Cells ◽

Future Perspectives ◽

Histological Differentiation ◽

Biological Features ◽

Literature Overview ◽

Primary Localization

Primary malignant cardiac tumors are rare, with a prevalence of about 0.01% among all cancer histotypes. At least 60% of them are primary soft tissue sarcomas of the heart (pSTS-h) that represent almost 1% of all STSs. The cardiac site of origin is the best way to classify pSTS-h as it is directly linked to the surgical approach for cancer removal. Indeed, histological differentiation should integrate the classification to provide insights into prognosis and survival expectancy of the patients. The prognosis of pSTS-h is severe and mostly influenced by the primary localization of the tumor, the difficulty in achieving complete surgical and pharmacological eradication, and the aggressive biological features of malignant cells. This review aims to provide a detailed literature overview of the most relevant issues on primary soft tissue sarcoma of the heart and highlight potential diagnostic and therapeutic future perspectives.

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Role of centers with different patient volumes in the management of rhabdomyosarcoma. An analysis by the Italian Pediatric Soft Tissue Sarcoma Committee

Pediatric Blood & Cancer ◽

10.1002/pbc.29234 ◽

2021 ◽

Author(s):

Gianni Bisogno ◽

Giovanna Congiu ◽

Maria Carmen Affinita ◽

Giuseppe Maria Milano ◽

Ilaria Zanetti ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma

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Outcome and Toxicity of an Ifosfamide-Based Soft Tissue Sarcoma Treatment Protocol in Children. The Importance of Local Therapy

Sarcoma ◽

10.1080/13577149877939 ◽

1998 ◽

Vol 2 (3-4) ◽

pp. 171-177

Author(s):

S. Murray Yule ◽

Roderick Skinner ◽

Martin W. English ◽

Mike Cole ◽

Andrew D. J. Pearson ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Primary Tumour ◽

Treatment Protocol ◽

Disease Free Survival ◽

Local Therapy ◽

Complete Response ◽

One Year ◽

Sarcoma Treatment

Background.Although the survival of children with soft tissue sarcoma (STS) has improved considerably, the outcome of patients with metastatic disease, and those with primary tumours of the extremities or parameningeal sites remains disappointing. We describe the clinical outcome of an ifosfamide-based regimen with local therapy directed only to children who failed to achieve a complete response to initial chemotherapy.Patients and Methods.Twenty-one children with STS (16 rhabdomyosarcoma) who presented with unresectable tumours were treated with five courses of ifosfamide (9 g/m2) and etoposide (600 mg/m2). Patients who did not achieve a complete response then received local therapy. Chemotherapy with ifosfamide combined with etoposide, vincristine (1.5 mg/m2and doxorubicin (60 mg/m2) or vincristine and actinomycin D (1.5 mg/m2) was continued for one year.Results and Discussion.Objective responses to five courses of ifosfamide and etoposide were seen in all patients. Disease free survival (DFS) at a median follow up of 59 months was 57% (95% CI 29–75%). The DFS of children who received local therapy was 89% compared with 33% in those who received chemotherapy alone (p=0.027). Locoregional recurrences did not occur in children who received radiotherapy to the site of the primary tumour. Ifosfamide-based chemotherapy does not reduce the incidence of loco-regional recurrence in children who do not receive local therapy.

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