Soft tissue sarcomas for trauma and orthopaedic exam candidates

Q4 Medicine
Farhan Eitezaz, Kathryn H Steele, Nicholas Eastley
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引用次数: 0

Abstract

Soft tissue sarcomas (STS) represent a diverse group of malignant tumours for which surgery is the cornerstone of curative treatment. All STS patients should be managed by a specialized sarcoma multidisciplinary team (MDT). For non-metastatic STS, the surgical aim of treatment is the wide excision of the tumour. Amputations are infrequently employed as a first-line treatment, although may be required in complex or recurrent cases. Wound complications following STS surgery are not uncommon, and reconstructive surgery is key to promote healing. Radiotherapy may be utilized for large, high-grade STS, or those close to essential anatomical structures that necessitate a marginal resection. This radiotherapy may be delivered pre- (neoadjuvant) or post- (adjuvant) operatively, with the aim of reducing local recurrence rates. Systemic treatments such as chemotherapy are generally not utilized for localized STS, other than for a few, specific subtypes. In metastatic patients, systemic treatment may be employed with palliative intent. The management of localized STS recurrence follows the same principles as those of primary disease, with emphasis placed on re-staging all patients to rule out metastatic disease. Long-term patient follow-up is crucial to detect disease recurrence (local or systemic) and any significant treatment-related complications.
创伤和骨科考试考生的软组织肉瘤
软组织肉瘤(STS)代表了一组不同的恶性肿瘤,手术是治疗的基石。所有STS患者应由一个专门的肉瘤多学科小组(MDT)进行治疗。对于非转移性STS,手术治疗的目的是广泛切除肿瘤。虽然在复杂或复发病例中可能需要截肢,但截肢很少被用作一线治疗。STS手术后的伤口并发症并不少见,重建手术是促进愈合的关键。放疗可用于大的、高级别的STS,或那些靠近必要解剖结构需要边缘切除的STS。这种放疗可以在手术前(新辅助)或手术后(辅助)进行,目的是减少局部复发率。除了少数特定亚型外,局部STS一般不采用全身治疗,如化疗。对于转移性患者,可以采用全身治疗来缓解病情。局部STS复发的处理遵循与原发疾病相同的原则,重点是对所有患者进行重新分期,以排除转移性疾病。长期患者随访对于发现疾病复发(局部或全身)和任何显著的治疗相关并发症至关重要。
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来源期刊
Orthopaedics and Trauma
Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine
CiteScore
1.00
自引率
0.00%
发文量
57
期刊介绍: Orthopaedics and Trauma presents a unique collection of International review articles summarizing the current state of knowledge and research in orthopaedics. Each issue focuses on a specific topic, discussed in depth in a mini-symposium; other articles cover the areas of basic science, medicine, children/adults, trauma, imaging and historical review. There is also an annotation, self-assessment questions and a second opinion section. In this way the entire postgraduate syllabus will be covered in a 4-year cycle.
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