Soft tissue sarcoma
Soft tissue sarcoma. Depending on the source of origin to distinguish soft tissue fibrosarcoma, mesenchyme, liposarcoma, histiocytoma, leiomyosarcoma, rhabdomyosarcoma, synovial sarcoma, angiosarcoma, Lim-fangiosarkomu, hemangiopericytoma, malignant schwannoma and neurilemma. The tumor may be located in the soft tissues of the limbs, trunk, retroperitoneum and in other areas of the body. soft tissue sarcomas of 1% of all malignant tumors. Early diagnosis is important for the prognosis. Upon detection of soft tissue tumors should not use the method of follow-up. Errors in diagnosis are frequent, period of diagnosis is often set aside for 6-12 months. Needed a biopsy or removal of the tumor.
soft tissue sarcomas have a tendency to recur after surgery, particularly in excess of 5 cm, and low tumor differentiation. Distant metastases occur in the lungs, sometimes in other organs. Metastases in regional lymph nodes are diagnosed only in 5-20% of patients. The differential diagnosis spend with benign tumors, which occur much more frequently than malignant, but their malignancy is rare.
Diagnosis is based on the data of morphological studies (fibroma, lipoma, leiomyoma, rhabdomyoma et al.).
Treatment. The main method of treatment - surgery. It is important to remove a broad tissue adjacent to the tumor. To reduce the risk of tumor reditsiva postoperative radiation therapy is used; more sensitive embryonal rhabdomyosarcoma. Chemotherapy or radiotherapy without use with unresectable tumors and metastases. regimens: 1) Cyclophosphamide - 500 mg / m2 / w in combination with adriamycin - 50 mg / m2 / s in one day, vincristin - 1 mg / m2 / 1 st and 5th days and imidazolkarboksamidom -250 mg / m 2 / 1-5-ydni 2) carminomycin 6 mg / m2 / in the 1st, 8th and 15th days, in combination with vincristine - 1 mg / m2 (or methotrexate - 20 mg / m2) in / on the same days and fan-tsiklofos - 250 mg / m 2/3 times a week for 6 doses; 3) CRC lofosfan - 500 mg / m2 in combination with adriamycin - 50 mg / m2 day 1, vincristine - 1 mg / m2 / 1 st and 5th days and dactinomycin - 0.3 mg / m2 in / on days 3-5; 4) adriamycin - 60 mg / m2 day 1 in combination with cyclophosphamide - 600 mg / m2 day 2 and cisplatin - 100 mg / m2 Day 3 / in.
When single metastases in the lungs can be done to remove them promptly, expediency is more justified for a large range from the removal of the primary tumor to the detection of metastases in the lungs and their slow growth. Five-year survival in soft tissue sarcomas ranges from 20 to 80% depending on the structure and morphological differentiation of the tumor, its size and location.
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