The key role of pathology, surgery and radiotherapy in the initial management of soft tissue sarcoma

References

• 1 Ray-Coquard I, Montesco MC, Coindre JM et al. Sarcoma: concordance between initial diagnosis and centralized expert review in a population-based study within three European regions. Ann. Oncol. 23(9), 2442–2449 (2012).
  Medline CASGoogle Scholar
• 2 Casali PG, Blay JY. ESMO/CONTICANET/EUROBONET Consensus Panel of experts. Soft tissue sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 21(Suppl. 5), v198–v203 (2010).
  MedlineGoogle Scholar
• 3 Neuville A, Ranchère-Vince D, Dei Tos AP et al. Impact of molecular analysis on the final sarcoma diagnosis: a study on 763 cases collected during a European epidemiological study. Am. J. Surg. Pathol. 37(8), 1259–1268 (2013).
  MedlineGoogle Scholar
• 4 Ahmed AA, Abedalthagafi M. Cancer diagnostics: the journey from histomorphology to molecular profiling. Oncotarget 7(36), 58696–58708 (2016).
  MedlineGoogle Scholar
• 5 Brohl AS, Solomon DA, Chang W et al. The genomic landscape of the Ewing Sarcoma family of tumors reveals recurrent STAG2 mutation. PLoS Genet. 10(7), e1004475 (2014).
  MedlineGoogle Scholar
• 6 Peters TL, Kumar V, Polikepahad S et al. BCOR-CCNB3 fusions are frequent in undifferentiated sarcomas of male children. Mod. Pathol. 28(4), 575–586 (2015).
  Medline CASGoogle Scholar
• 7 Italiano A, Sung YS, Zhang L et al. High prevalence of CIC fusion with double-homeobox (DUX4) transcription factors in EWSR1-negative undifferentiated small blue round cell sarcomas. Genes Chromosomes Cancer 51(3), 207–218 (2012).
  Medline CASGoogle Scholar
• 8 Gambarotti M, Benini S, Gamberi G et al. CIC-DUX4 fusion-positive round-cell sarcomas of soft tissue and bone: a single-institution morphological and molecular analysis of seven cases. Histopathology 69(4), 624–634 (2016).
  MedlineGoogle Scholar
• 9 Sugita S, Arai Y, Tonooka A et al. A novel CIC-FOXO4 gene fusion in undifferentiated small round cell sarcoma: a genetically distinct variant of Ewing-like sarcoma. Am. J. Surg. Pathol. 38, 1571–1576 (2014).
  MedlineGoogle Scholar
• 10 Solomon DA, Brohl AS, Khan J et al. Clinicopathologic features of a second patient with Ewing-like sarcoma harboring CIC-FOXO4 gene fusion. Am. J. Surg. Pathol. 38, 1724–1725 (2014).
  MedlineGoogle Scholar
• 11 Huang SC, Zhang L, Sung YS et al. Recurrent CIC gene abnormalities in angiosarcomas: a molecular study of 120 Cases with concurrent investigation of PLCG1, KDR, MYC, and FLT4 gene alterations. Am. J. Surg. Pathol. 40(5), 645–655 (2016).
  MedlineGoogle Scholar
• 12 Bonvalot S, Raut CP, Pollock RE et al. Technical considerations in surgery for retroperitoneal sarcomas: position paper from E-Surge, a master class in sarcoma surgery, and EORTC-STBSG. Ann. Surg. Oncol. 19(9), 2981–2991 (2012).
  MedlineGoogle Scholar
• 13 Trans-Atlantic RPS Working Group. Management of primary retroperitoneal sarcoma (RPS) in the adult: a consensus approach from the Trans-Atlantic RPS Working Group. Ann. Surg. Oncol. 22(1), 256–263 (2015).
  MedlineGoogle Scholar
• 14 Gronchi A, Ferrari S, Quagliuolo V et al. Histotype-tailored neoadjuvant chemotherapy versus standard chemotherapy in patients with high-risk soft-tissue sarcomas (ISG-STS 1001): an international, open-label, randomised, controlled, Phase 3, multicentre trial. Lancet Oncol. 18(6), 812–822 (2017).
  Medline CASGoogle Scholar
• 15 Rosenberg SA, Tepper J, Glatstein E et al. The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. Ann. Surg. 196, 305–315 (1982).
  Medline CASGoogle Scholar
• 16 Pisters PW, Harrison LB, Leung DH, Woodruff JM, Casper ES, Brennan MF. Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J. Clin. Oncol 14, 859–868 (1996).
  Medline CASGoogle Scholar
• 17 Yang JC, Chang AE, Baker AR et al. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J. Clin. Oncol. 16, 197–203 (1998).
  Medline CASGoogle Scholar
• 18 O'Sullivan B, Davis AM, Turcotte R et al. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial. Lancet 359, 2235–2241 (2002).
  MedlineGoogle Scholar
• 19 Davis AM, O'Sullivan B, Turcotte R et al. Late radiation morbidity following randomization to preoperative versus postoperative radiotherapy in extremity soft tissue sarcoma. Radiother. Oncol. 75, 48–53 (2005).
  MedlineGoogle Scholar
• 20 O'Sullivan B, Griffin AM, Dickie CI et al. Phase 2 study of preoperative image-guided intensity- modulated radiation therapy to reduce wound and combined modality morbidities in lower extremity soft tissue sarcoma. Cancer 119, 1878–1884 (2013).
  MedlineGoogle Scholar
• 21 Clinical Trials Database: NCT01344018. https://clinicaltrials.gov/ct2/show/NCT01344018.
  Google Scholar
• 22 Haas RL, Delaney TF, O'Sullivan B et al. Radiotherapy for management of extremity soft tissue sarcomas: why, when, and where? Int. J. Radiat. Oncol. Biol. Phys. 84(3), 572–580 (2012).
  MedlineGoogle Scholar
• 23 Haas RL. Present and future of radiotherapy before and after surgery for sarcoma patients. Eur. J. Surg. Oncol. 40(12), 1595–1597 (2014).
  Medline CASGoogle Scholar
• 24 Haas RL, Miah AB, LePechoux C et al. Preoperative radiotherapy for extremity soft tissue sarcoma; past, present and future perspectives on dose fractionation regimens and combined modality strategies. Radiother. Oncol. 119(1), 14–21 (2016).
  MedlineGoogle Scholar
• 25 Memorial Sloan Kettering Cancer Center (MSKCC) prediction tool. Sarcoma nomograms. www.mskcc.org/nomograms/sarcoma.
  Google Scholar
• 26 Cahlon O, Brennan MF, Jia X et al. A postoperative nomogram for local recurrence risk in extremity soft tissue sarcomas after limb-sparing surgery without adjuvant radiation. Ann. Surg. 255(2), 343–347 (2012).
  MedlineGoogle Scholar
• 27 Eilber F, Giuliano A, Huth JH. Neoadjuvant chemotherapy, radiation, and limited surgery for high grade soft tissue sarcoma of the extremity. In: Recent Concepts in Sarcoma Treatment. Ryan JR, Baker LO (Eds). Kluwer Academic Publishers, Dordrecht, The Netherlands, 115–122 (1988).
  Google Scholar
• 28 Eilber F, Eckardt J, Rosen G et al. Preoperative therapy for soft tissue sarcoma. Hematol. Oncol. Clin. North Am. 9, 817–823 (1995).
  Medline CASGoogle Scholar
• 29 Temple WJ, Temple CL, Arthur K et al. Prospective cohort study of neoadjuvant treatment in conservative surgery of soft tissue sarcomas. Ann. Surg. Oncol. 4(7), 586–590 (1997).
  Medline CASGoogle Scholar
• 30 Koseła-Paterczyk H, Szacht M, Morysiński T et al. Preoperative hypofractionated radiotherapy in the treatment of localized soft tissue sarcomas. Eur. J. Surg. Oncol. 40(12), 1641–1647 (2014).
  Medline CASGoogle Scholar
• 31 Canter RJ, Martinez SR, Tamurian RM. Radiographic and histologic response to neoadjuvant radiotherapy in patients with soft tissue sarcoma. Ann. Surg. Oncol. 17, 2578v2584 (2010).
  Google Scholar
• 32 Shah D, Borys D, Martinez SR et al. Complete pathologic response to neoadjuvant radiotherapy is predictive of oncological outcome in patients with soft tissue sarcoma. Anticancer Res. 32, 3911–3915 (2012).
  MedlineGoogle Scholar
• 33 Kraybill WG, Harris J, Spiro IJ et al. Phase II study of neoadjuvant chemotherapy and radiation therapy in the management of high-risk, high-grade, soft tissue sarcomas of the extremities and body wall: Radiation Therapy Oncology Group Trial 9514. J. Clin. Oncol. 24, 619–625 (2006).
  Medline CASGoogle Scholar
• 34 Ryan CW, Montag AG, Hosenpud JR et al. Histologic response of dose-intense chemotherapy with preoperative hypofractionated radiotherapy for patients with high-risk soft tissue sarcomas. Cancer 112, 2432–2439 (2008).
  Medline CASGoogle Scholar
• 35 MacDermed DM, Miller LL, Peabody TD et al. Primary tumor necrosis predicts distant control in local advanced soft-tissue sarcomas after preoperative concurrent chemoradiotherapy. Int. J. Radiat. Oncol. Biol. Phys. 76, 1147v1153 (2010).
  Google Scholar
• 36 Yoon SS, Duda DG, Karl DL et al. Phase II study of neoadjuvant bevacizumab and radiotherapy for resectable soft tissue sarcomas. Int. J. Radiat. Oncol. Biol. Phys. 81, 1081–1090 (2011).
  Medline CASGoogle Scholar
• 37 Canter RJ, Borys D, Olusanya A et al. Phase I trial of neoadjuvant conformal radiotherapy plus sorafenib for patients with locally advanced soft tissue sarcoma of the extremity. Ann. Surg. Oncol. 21, 1616–1623 (2014).
  MedlineGoogle Scholar
• 38 Meyer JM, Perlewitz KS, Hayden JB et al. Phase I trial of preoperative chemoradiation plus sorafenib for high-risk extremity soft tissue sarcomas with dynamic contrast-enhanced MRI correlates. Clin. Cancer Res. 19, 6902–6911 (2013).
  Medline CASGoogle Scholar
• 39 Lewin J, Khamly KK, Young RJ et al. A Phase Ib/II translational study of sunitinib with neoadjuvant radiotherapy in soft-tissue sarcoma. Br. J. Cancer 111, 2254–2261 (2014).
  Medline CASGoogle Scholar
• 40 Haas RL, Gelderblom H, Sleijfer S et al. A Phase I study on the combination of neoadjuvant radiotherapy plus pazopanib in patients with locally advanced soft tissue sarcoma of the extremities. Acta Oncol. 54, 1195–1201 (2015).
  Medline CASGoogle Scholar
• 41 Bonvalot S, Le Pechoux C, De Baere T et al. First-in-human study testing a new radioenhancer using nanoparticles (NBTXR3) activated by radiation therapy in patients with locally advanced soft tissue sarcomas. Clin. Cancer Res. 23(4), 908–917 (2017).
  Medline CASGoogle Scholar
• 42 Clinical Trials Database: NCT02106312. https://clinicaltrials.gov/ct2/show/NCT02106312.
  Google Scholar
• 43 Clinical trials database: NCT02275286. https://clinicaltrials.gov/ct2/show/NCT02275286.
  Google Scholar