Description
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) Murray F. Brennan, MD International Center & Department of Surgery Memorial Sloan-Kettering Cancer Center New York, NY Cristina R. Antonescu, MD Department of Pathology Memorial Sloan-Kettering Cancer Center New York, NY Kaled M. Alektiar, MD Department of Radiation Oncology Memorial Sloan-Kettering Cancer Center New York, NY Robert G. Maki, MD, PhD 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 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 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
