follow The risk of residual disease is harder to assess microscopically, especially where the proliferation area is poorly contoured or where satellite nodules are present. These findings suggest that tumor proliferation type represents not only a technical problem for surgeons, increasing the risk of intralesional resection and microscopic residue, but also a marker of systemic aggressiveness.
In conclusion, the present proposed modifications in margin classification RM could enable more reproductible description of less than 1 mm margins and also, along with other known factors histological grading, size, sub-aponeurotic nature , help identify not only patients at risk of local recurrence but also those with poorer survival chances. The authors declare that they have no conflicts of interest concerning this article. Previous Article Arthroscopic repair of large and massive rotator cuff tears using the side-to-side suture technique.
Mid-term clinical and anatomic evaluation T. Rousseau, X. Roussignol, S. Bertiaux, F. Duparc, F. Dujardin, O. Journal page Archives Sommaire. Article Article Outline. Access to the text HTML. Access to the PDF text If you experience reading problems with Firefox, please follow this procedure. Recommend this article. Save as favorites. Free Article! Critical study of resection margins in adult soft-tissue sarcoma surgery. Lintz a , A. Moreau b , G.
Waast a , O. Maillard d , F. Corresponding author. Outline Masquer le plan. Patients and methods. Disclosure of interest. Top of the page - Article Outline. Figure 1. Figure 2. Figure 3. Figure 4. We think combination immunotherapy will benefit more people with sarcoma. Much of our efforts are focused on identifying the best drugs to combine for patients. I led a national phase II clinical trial testing the combination of these drugs in people with metastatic sarcoma.
We found that nivolumab and ipilimumab are effective in certain sarcoma subtypes. The tumor responses appeared to be similar to those seen with standard chemotherapy. In addition, the combination of these two drugs was found to be very safe and tolerable. The findings were published in January in the journal Lancet Oncology. They support future studies of this drug combination for people with specific metastatic subtypes.
We are continuing to focus on identifying sarcoma biomarkers that allow us to predict who will respond well to this type of immunotherapy. For example, there is an ongoing effort combining nivolumab with NKTR This drug is a modified form of a protein called interleukin-2, which is made by the immune system. NKTR is designed to trigger other cells in the immune system to attack cancer cells. The goal is to see if this combination will increase the likelihood of an immune response for metastatic or locally advanced sarcoma. Tumors often can produce an enzyme called IDO1 to avoid the immune system.
Epacadostat blocks this enzyme to help the immune system hit the tumor with its full force.
Most recently, in collaboration with Dr. This trial just completed patient accrual, and we are currently analyzing the results. We have been collaborating with a company to engineer T cells to fight synovial sarcoma. Because of that we are able to target the cancer cells selectively. The treatment is being tested in a pilot study at MSK. The trial involves removing T cells from a person with synovial sarcoma , engineering the cells to recognize the NY-ESO-1 protein, and then giving them back to the person in large numbers.
As of November , 37 patients have received these modified T cells in multiple groups with variations to the treatment approach. Overall, the response rate has been promising. There are ongoing efforts to optimize this treatment approach and determine the best strategy moving forward. We are now in the process of leading a similar effort for people with myxoid liposarcoma. This trial is actively enrolling patients. CAR T has demonstrated remarkable results in people with chemotherapy-resistant leukemia.
We hope to launch a clinical trial testing this approach in the near future. The major hurdle is identifying the right strategies for specific subtypes.
The cells all look different under a microscope and have different mutations. There are ongoing efforts to identify sarcoma biomarkers that can help us predict whether a therapy will be effective. The important point is that there is great potential and hope for immunotherapy to have some effectiveness against sarcoma.
Both checkpoint inhibitors and CAR T cell therapy have demonstrated success in other cancer types. We hope to continue to figure out ways to extend this benefit to people with sarcoma.
Eduardo, thank you for reaching out. Memorial Sloan Kettering does not currently have any clinical trials testing immunotherapy for leiomyosarcoma. However, you can read a recent story about the latest research on this form of sarcoma here:. I joined a nivolumab clinical trial in the fall of and was on it for 1 full year. I was off treatment for 8 months then when the cancer began to grow again slowly I was put back on treatment and am responding once again.
I owe my life to MSK and their immunotherapy clinical trials. So grateful. Dear Luis, we are glad to know that you have felt well-cared for by your MSK team and that your cancer is responding to treatment with immunotherapy. Thank you for sharing your kind words on our blog. We wish you all our best! I am so encouraged that this double checkpoint inhibitor trial for sarcoma patients is finally starting! Even though I had 2 recurrences and metastatic disease, I went through great lengths to harness my immune system against cancer NY-ESO-1 peptide vaccine, dendritic vaccine, NK cell vaccine, Coley's Toxins, cryoablation.
I am a biology researcher, and the science convinced me that the immune system is capable of curing cancer. I have been cancer-free for the past 3 years. I am so thankful that immunotherapy treatments, such as this trial, are readily available to sarcoma patients now.
I hope sarcoma patients will take advantage of this incredible treatment opportunity and emerge cancer-free. Metastatic chordoma of the spine The CAR T cell therapy sounds exciting. Hi Jay, we sent your question to one of our sarcoma experts, and he said there are some emerging treatments at MSK. Thank you for your comment.
Firstly thank you for your research into such a terrible illness, it fills us with confidence that you are exploring alternative therapies which is not typical chemotherapy. My partner who is just 25 was diagnosed with Renal Dedifferentied Liposarcoma 9 months ago and under went a full nephrectomy.
She was not offered any other treatment after this. Yesterday she was suddenly in severe abdominal pain and was taken into hospital. After a range of CT scans the doctors confirmed two more growths near where the kidney was removed, nearer the colon.
They have also confirmed the presence of 7 lumps in the lungs. We are planning on having the abdominal masses removed straight away but for obvious reasons we want to try all we can to fight the lung growths. Immunotherapy is something which we have hope in and was wondering if there is any suitable trials or treatments you can offer there to give us a chance of beating this.
We currently live in Singapore but are more than happy to travel there if you have any suggestions or input. The email address is international mskcc. Have you treated anyone with fibromyxoid sarcoma or know of any trials for that specific sarcoma? Dear Robyn, yes we have treated children with that type of cancer. If you have questions about any of these studies or would like to make an appointment, please call our Pediatric Department at Thank you for reaching out to us.
It is hopeful and promising to see that there are a variety of treatment options offered at MSK. My father just learned that he has sarcoma, but it is has still not been determined which specific kind. Also more recently known as pleomorphic undifferentiated sarcoma. Neurofibrosarcoma, also known as a malignant peripheral nerve sheath tumor, is a type of soft tissue sarcoma develops in peripheral nerves.
Rhabdomyosarcoma may occur at any age. It most often affects children and young adults, but its faster-growing types are more common in adults, who are also more likely to have the disease in hard-to-reach areas of the body, making it more difficult to treat. Tumors may occur throughout the body, including:. Synovial sarcoma, also called synovial cell sarcomas, is a type of tumor that most commonly forms in the areas around large joints. Next topic: What are the stages of soft tissue sarcoma? Call us anytime. How we treat cancer Cancers We Treat.
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Sarcomas represent a group of rare tumors which arise from the largest tissue compartment of the body, but account only for about 1 % of all malignancies. Soft Tissue Sarcomas in Adults (Recent Results in Cancer Research): Medicine & Health Science Books @ dynipalo.tk
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