Management of Soft Tissue Sarcoma

Murray F. Brennan, MDInternational Center & Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew York, NYCristina R. Antonescu, MDDepartment of PathologyMemorial Sloan-Kettering Cancer CenterNew York, NYKaled M. Alektiar, MDDepartment of Radiation OncologyMemorial Sloan-Kettering Cancer CenterNew York, NYRobert G. Maki, MD, PhDGreat Neck, NYCold Spring Harbor Laboratory Cold Spring Harbor, NY

Management of Soft Tissue Sarcoma, 2nd Edition provides the most comprehensive analysis of demographics and natural history currently available for  these lesions, based on the authors' experience with over 10,000 patients. Sections regarding radiation therapy not found in the previous text have been expanded, as have updates on molecular characteristics of sarcomas and chemotherapy studies published since the prior edition. Clinical and molecular diagnoses are addressed, and tumor histopathology is employed as the basis of treatment recommendations including surgery, radiation and systemic therapy. This is the first book to provide specific chemotherapy opinions for every sarcoma subtype. Written by four world-renowned experts, this book gives a practical, up-to-date approach to managing the many subtypes of adult soft tissue sarcoma.
Reviews from the first edition:
"This is an impressive book. Written by a surgeon, a pathologist and an oncologist, the book draws heavily on the Memorial Sloan-Kettering Cancer Center soft tissue sarcoma (STS) database. ... it is a book that should be in the library of any sarcoma unit and will appeal to the sub-specialist in Orthopaedic Oncology." (Robert U. Ashford, European Journal of Orthopaedic Surgery & Traumatology, Vol. 24, 2014)
"The book is laid out in 27 chapters, with an impressive inclusion of a wide array of sarcoma histology. One of the real strengths of the book is the quality and number of images, figures, tables, and graphs. ... The overall outline of the text is well done. ... This book is a unique and important addition to the sarcoma literature. ... this edtion should find itself on every medical oncologist's bookshelf ... ." (Larry C. Daugherty and Sanjay P. Bagaria, Journal of Radiation Oncology, Vol. 3, 2014)

Written by world renowned experts

                                    

Management of Soft Tissue Sarcoma

 

 

Table of Contents

 

Preface

 

 

Part I Introduction

 

1.         General Description

·         Introduction

·         Incidence and Prevalence

·         Predisposing and Genetic Factors

·         References

 

2.         Natural History - Importance of Size, Site, Histopathology

·         Natural History

·         Influence of Site

·         Staging

·         Staging of Retroperitoneal Visceral Sarcoma

·         Prognostic Factors for Extremity and Superficial Soft Tissue Sarcoma

·         Disease-Specific Survival

·         Prognostic Factors for Survival Following Local Recurrence of Extremity Sarcoma

·         Prognostic Factors: Nomograms

·         References

 

3.         General Statement as to Efficacy Surgery / Chemotherapy / Radiation Therapy

·         Extent of primary surgery

·         Surgical Treatment of Local Recurrence

·         Diagnostic Imaging

·         Surgery for Metastatic Disease

o   Pulmonary Metastasis

o   Surgery and the Management of Sarcoma Liver Metastasis

·         Radiation Therapy

o   Adjuvant Radiation Therapy

o   Dose of Radiation Therapy

o   Adjuvant Brachytherapy

o   Radiation Therapy in the Presence of Positive Microscopic Margins

o   Definitive Radiation Therapy

o   Radiation to Patients with Neurovascular Involvement

o   Wound Complications of Radiation Therapy

o   Adjuvant and Neoadjuvant Chemotherapy for Soft Tissue Sarcomas

o   Sarcomas More Common in Adults

o   Larger Randomized Studies

o   Selected Meta-analyses of Randomized Trials of Adjuvant Chemotherapy

o   Adjuvant Therapy for GIST

o   Sarcomas More Common in Pediatric Setting

o   Brief comments regarding chemotherapy for metastatic soft tissue sarcoma

o   Newer Systemic Agents

·         Special Techniques for Primary & Locally Recurrent Disease

o   Intra-arterial Chemotherapy

o   Limb Perfusion and Hyperthermia

o   Immunotherapy for Sarcomas

<·         References

 

 

Part II   Management by Histopathology

 

4.                  Gastrointestinal stromal tumor

·         Imaging

·         Familial GIST

·         Natural History

·         Diagnosis / Molecular Pathology

·         Treatment

o Adjuvant Imatinib for Primary GIST

o Neoadjuvant Therapy for Primary Disease not amenable to Surgery<

o Treatment of Recurrence

o Imatinib: The First Small Molecule Oral Kinase Inhibitor for Metastatic GIST Failing Imatinib & Sunitinib

o Systemic Targeted Therapy for Metastatic GIST

o Dose Intensity over Time

o Imatinib Pharmacokinetics

·         Second-Line Sunitinib for Imatinib-Resistant Metastatic GIST

o Other Tyrosine Kinase Inhibitors for Metastatic GIST

o Failing Imatinib and Sunitinib

o GRID Trial

·         Newer Agents for GIST

·         References

 

5.                  Liposarcoma

·         Imaging

·         Diagnosis

·         Treatment

·         Radiation Therapy for Liposarcoma

·         Systemic Therapy: General Considerations

·         Adjuvant Therapy

·         Treatment of Metastatic Disease

·         Outcome

·         Outcome Following Metastasis

·         References

 

6.                  Leiomyosarcoma

·         Imaging

·         Diagnosis, Molecular Pathology

·         Primary Treatment

·         Radiation Therapy

·         Systemic Therapy

o   Adjuvant Chemotherapy for Leiomyosarcoma

·         Outcomes after Primary Therapy

·         Patterns of Recurrence

·         Treatment of Recurrence

·         Metastatic Disease

·         References

 

7.                  Undifferentiated Pleomorphic Sarcoma (UPS) (Malignant Fibrous Histiocytoma:  MFH) Myxofibrosarcoma

·         Imaging

·         Diagnosis, Molecular Pathology

·         Natural History

·         Treatment

·         Radiation Therapy

·         Metastatic Disease

·         Adjuvant Chemotherapy

·         Outcome

·         References

 

8.                  Synovial Sarcoma

·         Imaging

·         Diagnosis, Molecular Pathology

·         Treatment

·         Radiation Therapy

·         Chemotherapy

·         Treatment of Recurrence

o   Local Recurrence

o   Systemic Treatment

·         Outcome

·         References

                  

9.                  Malignant Peripheral Nerve Sheath Tumor (MPNST) / Triton Tumor

·         Presentation

·         Imaging

·         Diagnosis, Pathology

·         Neurofibromatosis Type 1 and Outcome

·         Treatment

·         Radiation Therapy

·         Chemotherapy for MPNST

·         Outcome

·         References

 

 

10.              Desmoid Tumor / Deep-Seated Fibromatosis (Desmoid-Type Fibromatosis)

·         Clinical Presentation

·         Imaging

·         Diagnosis, Molecular Pathology

·         Natural History

·         Treatment

·         Treatment of Recurrence

<·         Systemic Therapy

·         Treatment by Observation

·         Radiation Therapy

·         Patterns of Failure

·         Outcome

·         References

 

11.              Solitary Fibrous Tumor / Hemangiopericytoma

·         Doege-Potter Syndrome

·         Primary Therapy

·         Systemic Therapy for Metastatic Disease

·         Outcome

·         References

 

12.              Fibrosarcoma and its Variants

·         Outcome

·         Dermatofibrosarcoma Protuberans

·         Outcome

·         Low-Grade Fibromyxoid Sarcoma (of Evans Tumor)

·         Outcome

·         Sclerosing Epithelioid Fibrosarcoma

·         Inflammatory Myofibroblastic Tumor

·         Infantile Fibrosarcoma

·         Myxoinflammatory Fibroblastic Sarcoma / Inflammatory Myxohyaline Tumor of Distal Extremities

·         Adult-Type Fibrosarcoma

·         References

 

13.              Vascular Sarcomas

·         Epithelioid Hemangioendothelioma

·         Angiosarcoma / Lymphangiosarcoma

·         Outcome

·         Kaposi Sarcoma

·         References

 

14.              Epithelioid Sarcoma

·         Outcome

·         References

 

15.              Sarcomas More Common in Children

Soft Tissue Sarcomas More Commonly Observed in Pediatric Patients
• Ewing Sarcoma Family of Tumors (EFT)
• Demographics
• Primary Therapy
• Adjuvant Chemotherapy
• High-Dose Systemic Therapy for Metastatic Disease
• Standard Cytotoxic Chemotherapy After Disease Relapse
• Investigational Approaches
• Ewing Sarcoma-Like Tumors
• Rhabdomyosarcoma
• Demographics
• Molecular Biology
• Risk Stratification
• Staging
• Imaging
Primary Therapy
• Chemotherapy for Metastatic Disease
• Embryonal Sarcoma
• References

 

16.              Radiation-Induced Sarcoma

·         References

 

17.              Alveolar Soft Part Sarcoma

·         Imaging

·         Diagnosis, Molecular Pathology

·         Primary Treatment

·         Treatment of Metastatic Disease

·         Outcome

·         References

 

18.              Clear Cell Sarcoma / Melanoma of Soft Parts

·         Imaging

·         Diagnosis, Molecular Pathology

·         Treatment

·         Outcome

·        

 

19.              Desmoplastic Small Round Cell Tumor

·         Imaging

·         Diagnosis

·         Treatment

·         Outcome

·         References

 

20.              Extraskeletal Myxoid Chondrosarcoma

·         Imaging

·         Diagnosis

·         Treatment

·         Outcome

·         Mesenchymal Chondrosarcoma

·         References

 

21.              Other Uterine Sarcomas

·         Low Grade Endometrial Stromal Sarcoma

o   Diagnosis

o   Treatment 

o   Outcome

·         High Grade Endometrial Stromal Sarcoma

o   Outcome

·         Undifferentiated Uterine Sarcoma (UUS)

·         Uterine Carcinosarcomas and Other Malignant Mixed Müllerian Tumors

·         PEComas

o   Outcome

·         References

 

22.              Extraskeletal Osteogenic Sarcoma

·         Imaging

·         Diagnosis

·         Treatment

·         Outcome

·         References

 

23.              Sustentacular Tumors of Lymph Tissue

·         Follicular Dendritic Cell Tumor (Dendritic Reticulum Cell Tumor [FDCT]) and Interdigitating Reticulum Cell Tumor (IDRCT)

·         True Histiocytic Sarcoma

·         Langerhans Cell Tumors

·         Outcome

·         References

 

24.              Uncommon / Unique Sites

·         Heart and Great Vessels

·         Primary Sarcomas of the Breast

o   Phylloides Tumor

o   Diagnosis

o   Outcome

·         Head and Neck

o   Treatment

·         Primary Sarcomas of the Mediastinum

·         Liver

·        

 

 

Part III           Benign and Less Aggressive Lesions

 

25.              Mostly Benign / Rarely Metastasizing

·         Ossifying Fibromyxoid Tumor

·         Perivascular Epithelial Cell Tumor (PEComa) & Related Entities,  Lymphangioleiomyomatosis, Angiomyolipoma, and Sugar Cell Tumor

·         Therapy

·         Giant Cell Tumor of Tendon Sheath / Pigmented Villonodular Synovitis

·         Myoepithelioma of Soft Tissue

·         Glomus tumor <·         References

                         

26.              Benign Tumors

·         Lipoma         

·         Lipomatosis  

·         Lipoblastoma / Lipoblastomatosis

·         Angiolipoma

·         Angiomyolipoma

·         Angiomyelolipoma

·         Hibernoma

·         Elastofibroma

·         Granular Cell Tumor

·         Hemangioma

·         Leiomyoma

·         Schwannoma

·         Neurofibroma

·         Myxoma

·         Angiomyxoma

·         Angiofibroma

·         References

 

27.              Reactive Lesions

·         Myositis Ossificans

·         Nodular Fasciitis                  

·         Sarcoma Masquerade

·         References

 

 

 

Suggested Keywords

 

Index