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Interdisciplinary Approach to Soft Tissue Sarcoma Care: Bridging Gaps for...
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Interdisciplinary Approach to Soft Tissue Sarcoma Care: Bridging Gaps for Better Outcomes

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (20 September 2024) | Viewed by 4865

Special Issue Editor

Dr. Juan Pretell-Mazzini

E-Mail Website
Guest Editor
1. Clinical Professor of Orthopedics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33176, USA
2. Chief of Division of Orthopedic Oncology, Miami Cancer Institute, Baptist Health System South Florida, Miami, FL 33176, USA
Interests: soft tissue sarcomas; bone sarcomas; surgical treatment of musculoskeletal metastatic disease; limb salvage surgery; complex reconstruction of extremities; hemipelvectomies; benign soft tissue masses

Special Issue Information

Dear Colleagues,

Soft tissue sarcomas are a heterogeneous group of tumors with more than 70 subtypes representing 1% of adult cancers. These tumors have an aggressive behavior with a 5-year overall survival of about 65% and as low as 20% when there is metastatic disease. A multidisciplinary approach in sarcoma centers is the optimal way of managing these patients including a wide range of specialties. There have been recent advancements regarding systemic treatment evolving from traditional chemotherapy to a more targeted therapy based on molecular findings. Also, there are evolving protocols within the radiation field decreasing the time of treatments and modifying radiation doses helping the patient navigate a more tolerable treatment, decreasing complication rates but keeping adequate local control rates. In surgery, limb salvage procedures are the standard of care, and different methods have been developed to preserve as much function as possible within adequate oncologic control. Unfortunately, there are some patients undergoing resections without following oncologic principles with an impact on their overall prognosis. It is our purpose to present a comprehensive review of the state of the art in the treatment of these tumors, emphasizing the importance for these patients to be managed at sarcoma centers so we can avoid poor outcomes.

Dr. Juan Pretell-Mazzini
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • multidisciplinary treatment approach for soft tissue sarcomas
  • epidemiology
  • classification
  • diagnostic modalities
  • treatment options
  • survival

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Published Papers (5 papers)

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Review

10 pages, 212 KiB  
Review
Hypofractionated Radiotherapy for Soft Tissue Sarcomas
by Mehmet Murat Zerey, Amna Gul, Noah S. Kalman and Matthew D. Hall
Cancers 2025, 17(7), 1170; https://doi.org/10.3390/cancers17071170 - 31 Mar 2025
Viewed by 320
Abstract
Hypofractionated radiotherapy may offer similar local control and toxicity outcomes in the management of soft tissue sarcomas (STS) compared to standard fractionation. Shorter-course radiotherapy regimens can reduce overall treatment time and delays in surgical intervention or systemic treatment. It may also improve patient [...] Read more.
Hypofractionated radiotherapy may offer similar local control and toxicity outcomes in the management of soft tissue sarcomas (STS) compared to standard fractionation. Shorter-course radiotherapy regimens can reduce overall treatment time and delays in surgical intervention or systemic treatment. It may also improve patient compliance and reduce healthcare costs. In this comprehensive review, the current evidence on the use of hypofractionated radiotherapy in the treatment of STS is synthesized, and an overview is provided for how hypofractionated radiotherapy may be used in the treatment of STS. Full article
(This article belongs to the Special Issue Interdisciplinary Approach to Soft Tissue Sarcoma Care: Bridging Gaps for Better Outcomes)
19 pages, 331 KiB  
Review
Systemic Treatment in Soft Tissue Sarcomas: Are We Making a Difference?
by Amrit Paudel, Priya Chattopadhyay, Brandon Rose, Aleksandra Watson, Gina D’Amato, Jonathan Trent, Steven Bialick and Emily Jonczak
Cancers 2025, 17(5), 889; https://doi.org/10.3390/cancers17050889 - 5 Mar 2025
Viewed by 626
Abstract
Soft tissue sarcomas [STSs] are rare tumors of mesodermal origin that arise in diverse tissues such as muscles, fat, and nerves. There are over 100 subtypes of STS, each with distinct clinical behaviors and responses to treatment. Recent advances in treatment have moved [...] Read more.
Soft tissue sarcomas [STSs] are rare tumors of mesodermal origin that arise in diverse tissues such as muscles, fat, and nerves. There are over 100 subtypes of STS, each with distinct clinical behaviors and responses to treatment. Recent advances in treatment have moved towards histology-specific approaches, emphasizing the integration of pathological, immunohistochemical, and molecular features to guide treatment. Localized STS is primarily treated with surgery, often supplemented by neoadjuvant or adjuvant radiation and/or chemotherapy. However, about half of patients with localized disease will progress to an advanced stage, which is typically managed with systemic therapies including anthracycline-based chemotherapy such as doxorubicin or epirubicin. Despite these treatments, the survival rates for most subtypes of advanced metastatic STS remain relatively low. While anthracycline-based chemotherapy remains the mainstay of treatment, ongoing research into the biology of STSs is enhancing our understanding and approach to these complex tumors with an expansion beyond chemotherapy to include targeted therapy and immunotherapy to improve response rates and survival outcomes. This review focuses on STS other than gastrointestinal stromal tumors [GISTs], examines the current systemic treatment strategies, highlights recent advances, and explores future directions in the systemic therapy of sarcoma patients. Full article
(This article belongs to the Special Issue Interdisciplinary Approach to Soft Tissue Sarcoma Care: Bridging Gaps for Better Outcomes)
20 pages, 3098 KiB  
Review
Principles of Surgical Treatment of Soft Tissue Sarcomas
by Marcos R. Gonzalez, Carolina Mendez-Guerra, Megan H. Goh and Juan Pretell-Mazzini
Cancers 2025, 17(3), 401; https://doi.org/10.3390/cancers17030401 - 25 Jan 2025
Viewed by 1105
Abstract
Soft tissue sarcoma (STS) is a group of highly heterogeneous tumors of mesenchymal origin that have variable primary site locations and clinical behavior. Despite the broad diversity of STS, the standard of care involves surgical resection with or without radiation therapy (RT) to [...] Read more.
Soft tissue sarcoma (STS) is a group of highly heterogeneous tumors of mesenchymal origin that have variable primary site locations and clinical behavior. Despite the broad diversity of STS, the standard of care involves surgical resection with or without radiation therapy (RT) to control local recurrence and systemic treatment in select cases. The complexities of STS require a critical understanding of the preoperative work-up process, surgical treatment, and postoperative management. Advanced imaging plays a vital role in the characterization of the soft tissue mass, preoperative biopsy planning, and disease staging. Surgical treatment prioritizes wide resection with negative margins, supported by newer margin classification systems for better prognosis. Further, advancements in surgical technique have enabled limb-salvage surgery to largely replace amputation in the management of these tumors. Additional surgical considerations, such as nerve preservation, vascular reconstruction, and complex tissue closure, further highlight the complexity of STS management. Lastly, postoperative follow-up is critical for the early detection of local or distant recurrences. For complex cases, such as unplanned excisions or invasive tumors, strategies like re-resection may be beneficial. Ongoing research into imaging, chemotherapy, and targeted therapies will further refine management strategies, especially in complex and recurrent cases. This review highlights the essential aspects of STS surgical management and underscores the need for coordinated, multidisciplinary care to enhance both survival and quality of life for affected patients. Full article
(This article belongs to the Special Issue Interdisciplinary Approach to Soft Tissue Sarcoma Care: Bridging Gaps for Better Outcomes)
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12 pages, 254 KiB  
Review
A Narrative Review of the Assessment and Treatment of Physical Impairments Commonly Seen in Sarcoma Cancer Survivors Using a Rehabilitative Approach
by Adrian Cristian, Nandita Keole, Romer Orada, Jayhyun Seo, Austin Guerrina and Arun Maharaj
Cancers 2025, 17(1), 6; https://doi.org/10.3390/cancers17010006 - 24 Dec 2024
Viewed by 735
Abstract
Background: Sarcomas are a rare, complex group of malignancies characterized by numerous clinical and pathological features. Sarcomas originate from various tissues such as fat, muscle, bone, nerves, blood vessels and connective tissues. Typically, the treatment of sarcomas consists of surgery, chemotherapy, and radiation [...] Read more.
Background: Sarcomas are a rare, complex group of malignancies characterized by numerous clinical and pathological features. Sarcomas originate from various tissues such as fat, muscle, bone, nerves, blood vessels and connective tissues. Typically, the treatment of sarcomas consists of surgery, chemotherapy, and radiation therapy. The location, type, stage, and treatment of sarcomas contribute to the development of physical impairments affecting joint and limb function, peripheral nerves, strength, and mobility, diminishing physical function and quality of life. Traditionally, rehabilitative therapy has been implemented after cancer treatment to help improve physical impairments imparted from cancer therapy. Recent work in rehabilitative medicine has explored the implementation of rehabilitative therapy prior to beginning cancer treatment (pre-habilitation) to help mitigate the detrimental physical consequences seen in sarcoma patients. Objective: The objective of this narrative review is to examine the physical impairments affecting sarcoma patients after cancer therapy and the impact of rehabilitative medicine on physical function and quality of life when implemented before and after cancer treatment. Full article
(This article belongs to the Special Issue Interdisciplinary Approach to Soft Tissue Sarcoma Care: Bridging Gaps for Better Outcomes)
15 pages, 23685 KiB  
Review
External Hemipelvectomy in Soft Tissue Sarcomas: Are They Still Needed?
by Luis Rafael Ramos Pascua, Paula Casas Ramos, Lidia De la Cruz Gutiérrez, Maximiliano Eugenio Negri, Elena Vilar González, Julio César Córdova Peralta, María Inmaculada Mora Fernández and Jesús Enrique Vilá y Rico
Cancers 2024, 16(22), 3828; https://doi.org/10.3390/cancers16223828 - 14 Nov 2024
Viewed by 1495
Abstract
Background: The development of new technologies, the interpretation of amputations as therapeutic failures by society, and the high morbidity and mortality associated with external hemipelvectomies make these mutilating surgical procedures appear obsolete. Herein, we review the scientific literature on the topic and present [...] Read more.
Background: The development of new technologies, the interpretation of amputations as therapeutic failures by society, and the high morbidity and mortality associated with external hemipelvectomies make these mutilating surgical procedures appear obsolete. Herein, we review the scientific literature on the topic and present two cases of high-grade ulcerated soft tissue sarcomas in the gluteal region which show exceptional behavior and different outcomes. Methods: We performed a literature review of the PubMed databases from 2014 to April 2024. Additionally, we present two cases of soft tissue sarcomas in an 18-year-old female patient and in a 71-year-old female patient, which were treated with extended external hemipelvectomies with anterior flap, in combination with an abdominoperineal amputation and a colostomy in one case. Results: After 4 years of follow-up, case 1 is living a relatively normal life. She had an uncomplicated pregnancy and a cesarean section delivery. Case 2 underwent emergency surgery for intestinal perforation and sepsis. She died 2.5 months following the surgery. Conclusions: External hemipelvectomy for soft tissue sarcoma treatment is a demanding surgical procedure with purpose in selected cases after review by multidisciplinary committees and with informed patient consent. This should be similarly individualized and extended to other pathologies when possible. Full article
(This article belongs to the Special Issue Interdisciplinary Approach to Soft Tissue Sarcoma Care: Bridging Gaps for Better Outcomes)
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