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Multidisciplinary Management of Oligometastatic Soft Tissue Sarcoma.

Publication ,  Journal Article
Grilley-Olson, JE; Webber, NP; Demos, DS; Christensen, JD; Kirsch, DG
Published in: Am Soc Clin Oncol Educ Book
May 23, 2018

Soft tissue sarcomas (STS) encompass a group of rare but heterogeneous diseases. Nevertheless, many patients, particularly those with oligometastatic disease can benefit from thoughtful multimodality evaluation and treatment regardless of the STS subtype. Here, we review surgical, interventional radiology, radiation, and chemotherapy approaches to maximize disease palliation and improve survival, including occasionally long-term disease-free survival. Surgical resection can include lung or other visceral, soft tissue and bone metastases with a goal of rendering the patient disease free. Staged resections can be appropriate, and serial resection of oligometastatic recurrent disease can be appropriate. Retrospective series suggest survival benefit from this approach, although selection bias may contribute. Interventional radiology techniques such as percutaneous thermal ablation (PTA) and arterial embolization can present nonoperative local approaches in patients who are not medically fit for surgery, surgery is too morbid, or patients who decline surgery. Similarly, radiation therapy can be delivered safely to areas that are inaccessible surgically or would result in excessive morbidity. Currently no randomized trials exist comparing interventional radiologic approaches or radiation therapy to surgery but retrospective reviews show relatively similar magnitude of benefit in terms of disease palliation and survival, although it is felt unlikely that these procedures will render a patient to long-term disease-free status. Chemotherapy has evolved recently with the addition of several new treatment options, briefly reviewed here. Importantly, if a patient sustains a good response to chemotherapy resulting in true oligometastatic disease, consideration of multimodality local therapy approaches can be considered in the appropriate patient.

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Published In

Am Soc Clin Oncol Educ Book

DOI

EISSN

1548-8756

Publication Date

May 23, 2018

Volume

38

Start / End Page

939 / 948

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Sarcoma
  • Neoplasm Staging
  • Neoplasm Metastasis
  • Humans
  • Disease Management
  • Combined Modality Therapy
  • 3211 Oncology and carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
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Grilley-Olson, J. E., Webber, N. P., Demos, D. S., Christensen, J. D., & Kirsch, D. G. (2018). Multidisciplinary Management of Oligometastatic Soft Tissue Sarcoma. Am Soc Clin Oncol Educ Book, 38, 939–948. https://doi.org/10.1200/EDBK_200573
Grilley-Olson, Juneko E., Nicholas P. Webber, David S. Demos, Jared D. Christensen, and David G. Kirsch. “Multidisciplinary Management of Oligometastatic Soft Tissue Sarcoma.Am Soc Clin Oncol Educ Book 38 (May 23, 2018): 939–48. https://doi.org/10.1200/EDBK_200573.
Grilley-Olson JE, Webber NP, Demos DS, Christensen JD, Kirsch DG. Multidisciplinary Management of Oligometastatic Soft Tissue Sarcoma. Am Soc Clin Oncol Educ Book. 2018 May 23;38:939–48.
Grilley-Olson, Juneko E., et al. “Multidisciplinary Management of Oligometastatic Soft Tissue Sarcoma.Am Soc Clin Oncol Educ Book, vol. 38, May 2018, pp. 939–48. Pubmed, doi:10.1200/EDBK_200573.
Grilley-Olson JE, Webber NP, Demos DS, Christensen JD, Kirsch DG. Multidisciplinary Management of Oligometastatic Soft Tissue Sarcoma. Am Soc Clin Oncol Educ Book. 2018 May 23;38:939–948.

Published In

Am Soc Clin Oncol Educ Book

DOI

EISSN

1548-8756

Publication Date

May 23, 2018

Volume

38

Start / End Page

939 / 948

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Sarcoma
  • Neoplasm Staging
  • Neoplasm Metastasis
  • Humans
  • Disease Management
  • Combined Modality Therapy
  • 3211 Oncology and carcinogenesis