• 제목/요약/키워드: Soft tissue sarcomas

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주요 혈관을 침범한 연부조직 종양의 사지구제술 - 치험 3례 보고 - (Limb-salvage Operations for Sarcomas of the Extremities Involving Critical Artery)

  • 김재도;최성운;박정호;손영찬;홍영기;손정환
    • 대한골관절종양학회지
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    • 제1권1호
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    • pp.105-112
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    • 1995
  • Soft tissue sarcomas are malignant tumors that arise in the extraskeletal connective tissues of the body. And the clinical behavior of soft tissue sarcomas is characterized by a tendency to extensively invade surrounding soft tissues as well as early metastatic dissemination. Difficulties were encounted when soft tissue sarcomas invade the major vessels. There are a few reprots about the reconstruction of the major vessels after resection of soft tissue sarcomas. We have treated 3 cases of the soft tissue sarcomas involving the major artery. After marginal excision of the tumor mass, the involved major artery was reconstructed with Gortex artificial vessel graft and we could salvage the patient's extremity.

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연부 조직 육종의 예후 인자 (Prognostic Factors of Soft Tissue Sarcomas - A Review of 94 Cases of Soft Tissue Sarcoma -)

  • 김재도;정철윤;손정환;홍영기;손영찬;박정호
    • 대한골관절종양학회지
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    • 제1권2호
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    • pp.210-219
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    • 1995
  • Many different factors which may affect the prognosis of the soft tissue sarcomas have been reported by many authors ; Generally, tumor size, histologic type, surgical margin, and multi modality therapy therapy as the prognostic factors were reported. The objectives of this retrospective study of soft tissue sarcomas are : 1) to define more clearly prognostic variables that have significant predictive value for disease-free and overall survival ; and 2) to evaluate tumor histologic grade based upon extent of tumor necrosis as a means of stratifying more aggressive soft tissue sarcomas(grade II & III) of the extremities. We treated 94 patients who had soft tissue sarcoma of the extremities and trunk from May 1984 to September 1994(average duration of follow-up was 5 years ranging from 2 months to 10 years) and evaluated the prognostic factors of the soft tissue sarcomas; age, sex, depth, size, location, histologic type and grade, stage, therapy modality, surgical margin, local recurrence and distant metastasis. The results were as follows. 1. The patients with poorer prognosis were over the age of fifty, whose mass was deeply located, size of the mass was over 10cm in diameter, grade III in histology, who had local recurrence, metastasis, and received only surgery. 2. Among these prognostic factors, the most significant prognostic factor was histologic grade base upon extent of tumor necrosis.

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Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

  • Ngan, Roger;Wang, Edward;Porter, David;Desai, Jayesh;Prayogo, Nugroho;Devi, Beena;Quek, Richard
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6821-6832
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    • 2013
  • Background: Soft-tissue sarcomas require tailored and multidisciplinary treatment and management. However, little is known about how sarcomas are treated and managed throughout the Asia-Pacific region. Materials and Methods: MEDLINE was systematically searched using prespecified criteria. Publications (previous 10 years) that reported tumour characteristics, treatment patterns, survival outcomes, and/or safety outcomes of patients with soft-tissue sarcoma were selected. Exclusion criteria were studies of patients <18 years of age; ${\leq}10$ patients; countries other than Australia, Hong Kong, Indonesia, Korea, Malaysia, New Zealand, Philippines, Singapore, Taiwan, or Thailand; >20% benign tumours; sarcomas located in bones or joints; gastrointestinal stromal tumour; Kaposi's sarcoma; or not reporting relevant outcomes. Results: Of the 1,822 publications retrieved, 35 (32 studies) were included. Nearly all patients (98%, 1,992/2,024; 31 studies) were treated with surgery, and more studies used adjuvant radiotherapy than chemotherapy (24 vs 17 studies). Survival outcomes and recurrence rates varied among the studies because of the different histotypes, sites, and disease stages assessed. Only 5 studies reported safety findings. Conclusions: These findings highlight the lack of specific data available about soft-tissue sarcomas in the Asia-Pacific region. Better efforts to understand how the sarcoma is managed and treated will help improve patient outcomes in the region.

중등도 악성화 경향을 보이는 연부 조직 종양 환자의 치험례 (Case Reports of Patients having Intermediate Soft Tissue Tumors)

  • 김기웅;김정태;김연환;백승삼
    • Archives of Plastic Surgery
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    • 제36권3호
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    • pp.344-347
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    • 2009
  • Purpose: Malignant soft tissue tumors, known as sarcomas, are well known to be locally aggressive, frequently metastatic, and highly recurrent. In other hands, intermediate soft tissue tumors often recur locally with adjacent tissue infiltration so the clinical management is difficult as sarcoma. In the present study, we evaluate the clinical course of the intermediate soft tissue tumors and consider the management plan for those. Methods: From March, 1998 to April 2008, total 3 patients of intermediate soft tissue tumors underwent operations. A patient with fibrohistiocytic neoplasm, a free flap reconstruction was performed, and he underwent several more operations because of recurrences. Other patients with desmoids - type fibromatosis showed local invasion and adhesion, and one of them underwent reoperation due to local recurrence. Results: 2 of 3 patients underwent recurrences of tumors and reoperations were performed. In another patient with no recurrence, follow-up period was just 5 months, so there may be recurrence of tumor in long term follow-up. Conclusion: The clinical course of intermediate soft tissue tumors shows high recurrence rate. So clinically, intermediate soft tissue tumors should be considered as sarcomas. The successful management requires wide resection, carefully planned reconstruction, and close follow up with radiologic evaluation.

연부조직 육종들의 세침흡인 세포학적 소견 (Cytologic Features of Soft Tissue Sarcomas in the Aspiration Biopsy Cytology)

  • 손진희;김덕환;강경하;김인숙;서정일
    • 대한세포병리학회지
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    • 제5권1호
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    • pp.28-34
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    • 1994
  • Aspiration biopsy cytology is a convenient, easy and non-invasive method for diagnosis of tumors. The results and cytologic features of carcinoma in various organs have been reported frequently, however, those of soft tissue sarcoma are relatively rare to find. Here we describe fine needle aspiration cytologic features of various soft tissue sarcomas and discuss cytologic differential points. The material is 6 cases of soft tissue sarcoma that were confirmed by histologic examination. They are composed of 2 cases of dermatofibrosarcoma protuberans and one case of malignant fibrous histiocytoma, synovial sarcoma, alveolar soft pan sarcoma, and malignant schwannoma respectively.

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Characterization and predictive value of volume changes of extremity and pelvis soft tissue sarcomas during radiation therapy prior to definitive wide excision

  • Gui, Chengcheng;Morris, Carol D.;Meyer, Christian F.;Levin, Adam S.;Frassica, Deborah A.;Deville, Curtiland;Terezakis, Stephanie A.
    • Radiation Oncology Journal
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    • 제37권2호
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    • pp.117-126
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    • 2019
  • Purpose: The purpose of this study was to characterize and evaluate the clinical significance of volume changes of soft tissue sarcomas during radiation therapy (RT), prior to definitive surgical resection. Materials and Methods: Patients with extremity or pelvis soft tissue sarcomas treated at our institution from 2013 to 2016 with RT prior to resection were identified retrospectively. Tumor volumes were measured using cone-beam computed tomography obtained daily during RT. Linear regression evaluated the linearity of volume changes. Kruskal-Wallis tests, Mann-Whitney U tests, and linear regression evaluated predictors of volume change. Logistic and Cox regression evaluated volume change as a predictor of resection margin status, histologic treatment response, and tumor recurrence. Results: Thirty-three patients were evaluated. Twenty-nine tumors were high grade. Prior to RT, median tumor volume was 189 mL (range, 7.2 to 4,885 mL). Sixteen tumors demonstrated significant linear volume changes during RT. Of these, 5 tumors increased and 11 decreased in volume. Myxoid liposarcoma (n = 5, 15%) predicted decreasing tumor volume (p = 0.0002). Sequential chemoradiation (n = 4, 12%) predicted increasing tumor volume (p = 0.008) and corresponded to longer times from diagnosis to RT (p = 0.01). Resection margins were positive in three cases. Five patients experienced local recurrence, and 7 experienced distant recurrence, at median 8.9 and 6.9 months post-resection, respectively. Volume changes did not predict resection margin status, local recurrence, or distant recurrence. Conclusion: Volume changes of pelvis and extremity soft tissue sarcomas followed linear trends during RT. Volume changes reflected histologic subtype and treatment characteristics but did not predict margin status or recurrence after resection.

폐에 전이된 거대 연조직 육종(혈관외피세포종, 활막육종) -수술치험 2례- (Metastatic Giant Pulmonary Soft Tissue Sarcomas (Hemangiopericytoma, Synovial Sarcoma) -Two Case Report-)

  • 김길동;정경영;신동환
    • Journal of Chest Surgery
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    • 제27권1호
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    • pp.63-67
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    • 1994
  • We report two cases of giant soft tissue sarcomas metastatic to the lung from lower extremities. The lung metastasis occurred 2 years later from original diagnosis in 27-year-old woman with hemangiopericytoma and 8 years later in 54-year-old woman with synovial sarcomtt. We had performed pleuropneumonectomies with partial resection of pericardium involved. The postoperative courses were uneventful and postoperative adjuvant therapy was begun.

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사지 악성 육종에서 보존적 수술후 방사선 치료의 역할 (The Role of Conservative Surgery and Radiation Therapy for the Extremity Soft Tissue Sarcomas)

  • 김우철;서창옥;김귀언;박광화;신동환;이경희
    • Radiation Oncology Journal
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    • 제11권2호
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    • pp.411-419
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    • 1993
  • A total of 44 patients with extremity soft tissue sarcomas had received conservative surgery and radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine between Jan. 1980 and Dec. 1990. Initial surgical treatment consisted of intracapsular excision in 33 patients $(75\%),$ marginal excision in 9 patients, and wide excision in two patients. Total radiation doses were between 40Gy and 65Gy (median 60 Gy). Median follow-up period was 47 months. Overall actuarial 5-year survival rate was $76.9\%$ and 5-year recurrence free survival rate was $39.3\%.$ There was no statistically significant prognostic factors but the 5-year survival rates tended to be decreased in the patients with high grade tumors and treated with narrow surgical extent. Sixteen patients recurred during fellow-up (16/31, $51.6\%).$ The incidence of initial local recurrence was $22.6\%$ (7/31) and distant metastasis was $29\%(9/31).$ Of the 7 who did not have metastasis at diagnosis of local recurrence, 5 were submitted to a salvage treatment. All of them achieved local control and distant metastasis appeared in three of them. In conclusion, conservative surgery and radiation therapy in the patients with extremity soft tissue sarcomas was the effective treatment modality.

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연조직 육종의 종양 가장자리 침윤: 3T 자기공명영상 텍스처 분석을 통한 예측 (Tumor Margin Infiltration in Soft Tissue Sarcomas: Prediction Using 3T MRI Texture Analysis)

  • 김민지;지원희;이영준;홍지현;정찬권;정양국;이소연
    • 대한영상의학회지
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    • 제83권1호
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    • pp.112-126
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    • 2022
  • 목적 연조직 육종의 종양 가장자리 침윤을 예측하기 위한 3T 자기공명영상 텍스처 분석의 가치를 규명한다. 대상과 방법 3T 자기공명영상을 시행하고, 병리학적으로 연조직 육종으로 확인된 31명의 환자를 대상으로 하고, 병리학적인 가장자리 침윤을 표준으로 사용하였다. 연조직 육종에 대한 텍스처 분석은 축상 T1 강조영상, T2 강조영상, 지방억제 조영증강 T1 강조영상, 확산강조영상(b = 800 sec/mm2) 및 현성확산계수 지도 영상에서 이루어졌다. 텍스처 분석에서 얻어진 정량적 변수가 침윤성(infiltrative) 육종과 국한성(circumscribed) 육종에서 차이가 있는지 비교하였다. 결과 총 23명의 연조직 육종에서 병리학적인 가장자리 침윤을 보였다. 침윤성 육종과 국한성 육종은, T1 강조영상 공간 스케일 인자(spatial scaling factor; 이하 SSF) 0, 6에서의 첨도(kurtosis), 조영증강 T1 강조영상(SSF, 0)에서의 첨도, 확산강조영상(SSF, 0)에서의 왜도(skewness), 현성확산계수 지도(SSF 2, 4)에서의 왜도에서 유의한 차이가 있었다(p ≤ 0.046). 자기공명영상 텍스처 소견을 이용한 종양 가장자리 침윤을 예측하는 정확도는 수신자운영특성곡선(receiver operating characteristic; 이하 ROC)의 곡선하 면적(area under the ROC curve) 0.951 (p < 0.001)이었다. 결론 자기공명영상 텍스처 분석은 연조직 육종의 침윤성 가장자리를 예측하는 데 있어 신뢰 할 수 있으며 정확하다.

Sarcoma Immunotherapy: Confronting Present Hurdles and Unveiling Upcoming Opportunities

  • Sehan Jeong;Sharmin Afroz;Donghyun Kang;Jeonghwan Noh;Jooyeon Suh;June Hyuk Kim;Hye Jin You;Hyun Guy Kang;Yi-Jun Kim;Jin-Hong Kim
    • Molecules and Cells
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    • 제46권10호
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    • pp.579-588
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    • 2023
  • Sarcomas are rare and heterogeneous mesenchymal neoplasms originating from the bone or soft tissues, which pose significant treatment challenges. The current standard treatment for sarcomas consists of surgical resection, often combined with chemo- and radiotherapy; however, local recurrence and metastasis remain significant concerns. Although immunotherapy has demonstrated promise in improving long-term survival rates for certain cancers, sarcomas are generally considered to be relatively less immunogenic than other tumors, presenting substantial challenges for effective immunotherapy. In this review, we examine the possible opportunities for sarcoma immunotherapy, noting cancer testis antigens expressed in sarcomas. We then cover the current status of immunotherapies in sarcomas, including progress in cancer vaccines, immune checkpoint inhibitors, and adoptive cellular therapy and their potential in combating these tumors. Furthermore, we discuss the limitations of immunotherapies in sarcomas, including a low tumor mutation burden and immunosuppressive tumor microenvironment, and explore potential strategies to tackle the immunosuppressive barriers in therapeutic interventions, shedding light on the development of effective and personalized treatments for sarcomas. Overall, this review provides a comprehensive overview of the current status and potential of immunotherapies in sarcoma treatment, highlighting the challenges and opportunities for developing effective therapies to improve the outcomes of patients with these rare malignancies.