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Siberian journal of oncology

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No 3 (2015)
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EPIDEMIOGICAL STUDIES

5-12 1379
Abstract
Introduction. Malignant tumors of connective and soft tissue are met relatively rare, although in general in Russia each year more than 1.500 new cases are registered. On five administrative territories of Russia during a year there are recorded less than 5 new cases of malignant tumors of connective and soft tissue (Yamal-Nenets A.R. – 4; Tuva Republic – 0, Magadan Region – 3; Chukotka A.R. – 0; Jewish A.R. – 4. More seldom data on these patients’ survival are published. Purpose of study. To estimate dynamics of incidence of malignant tumors of connective and soft tissue on the basis of public reporting, to calculate the index accuracy and observed and relative survival rates by histological forms, including sarcomas. Material and methods. To perform a detailed study there were selected, for two periods of observation, respectively 1054 patients (1995–2001) and 919 patients (2002–2008). Estimation of survival was carried out using software, which had been developed together with Ltd. «Novel» (Director – T.L.Tsvetkova, Ph.D.). results of study. The most typical incidence rate for of malignant tumors of connective and soft tissue (S47, 49) that are presented by  cancer registries of different countries is from 1.5 to 2.5 0/   in men and 1.5–2.0 0/   in women. Dynamics  of morbidity of the Russian population, Moscow and St. Petersburg indicates that the level of standardized  incidence rates is in the range of 2.0 0/   in men and within 1.5 0/   in women. The mortality rate in 2013  was respectively for men and women in Russia in total 1.7 0/   and 1.13 0/   , in Moscow – 1.42 0/   and  1.24 0/   , in St. Petersburg – 1.88 0/   and 1.26 0/   . The index accuracy for both sexes in Russia is 0.88,  in Moscow – 1.2; in St. Petersburg – 1.4. This index should be used for the site of these diseases with high fatality. According to official data a one-year lethality of patients with tumors of connective and soft tissue in 2013 was 20.1 %, and for all malignant tumors – 25.3 %, however the index accuracy for all malignant tumors was equal to 0.72, and for malignant tumors of connective and soft tissue – 0.88. That is in 5 of 8 federal districts the index accuracy is 1 or more, testifies significant undercount of patients with malignant tumors of connective and soft tissue. conclusion. The study allowed determining, despite relatively low rates of morbidity and mortality from malignant tumors of connective and soft tissue, there was revealed a significant undercount of primary cases. In a number of federal districts morbidity exceeds morbidity. Kaposi’s sarcoma is a tiny fraction of this group of tumors. The main part of patients with malignant tumors of connective and soft tissue is for C49 column «Malignant tumors of other types of connective and soft tissue». In basic part of patients with malignant tumors of connective and soft tissue there has been established positive dynamics of a 5-year observed and relative survival but this level is lower than the European average. Among sarcomas all malignant tumors of connective and soft tissue the best indicator of survival is for liposarcoma (>70 %), then for leiomyosarcoma (>40 %), and the least for sarcoma with undefined diagnosis.
13-19 1070
Abstract
Introduction. Standardized (world standard) incidence of malignant tumors of bones (S40,41) does not have has significant fluctuations. According to IARC among male population the most common incidence rates range from 1 to 2 cases per 100.000 and among female population – from 0.5 to 1.0 among women.  Purpose of study. To study dynamics of morbidity and mortality from malignant tumors of bones, the quality of estimation, observed and relative survival of patients according to histological forms. The work of this level is held in Russia for the first time. Material and methods of study. There were used an open world and domestic sources to estimate the prevalence of malignant tumors of bones, databases of population-based cancer registers, classical methods of population-based estimation of the prevalence of malignant tumors of bones. results of study. The basis of this work is data from the Population-based Cancer Registry of St. Petersburg and special studies being held before its establishing in 1993. Annually in St. Petersburg there are registered 40–60 primary cases of malignant tumors of bones (S40, 41). The level of morphological verification of these malignancies in Russia is 82.1 %, in St. Petersburg – 84.9 %. There is a high rate of undefined stage: in Russia – 19.7 %, in St. Petersburg – 24.5 %, in Moscow – 23.5 %. During the first year of observation 27.3 % of patients die in Russia, 21.7 % in St. Petersburg, and 11.1 % in Moscow. In comparison with the average data (Eurocare program) the relative survival of patients in St. Petersburg is significantly lower: in men (St. Petersburg – 42.2–48.2 %, (Eurocare-3,4 – 55–58 %), in women (St. Petersburg – 32.2–54.6 % (Eurocare – 59–63 %). conclusion. Thus, in this work for the first time in Russia it is showed dynamics of absolute and relative incidence rates of malignant tumors of bones since 1980 by sex and age-specific indicators. It is presented a set of analytical indicators, the level of morphological verification, one-year mortality as well as observed and relative survival. For the first time it is provided dynamics of a 5-year survival of patients with malignant tumors of bone in accordance with the histological forms. There is marked a growth of a 5-year survival rates of patients with chondrosarcoma and osteosarcoma.

CLINICAL STUDIES

20-25 656
Abstract
Capabilities of 199Tl-chloride and 99mTc-MIBI scintigraphy in the non-nonspecific indications of bone and soft tissue sarcomas in overall 31 patients (34 lesions) were studied. Sensitivity of these methods in the detections of neoplasms reached 96.0 % and 100.0 %, respectively. It described positive, negative and mixed types of sarcomas visualizations on the both 199Tl-chloride and 99mTc-MIBI scintigraphy. There are preconditions for the 199Tl-chloride scintigraphy in the successful differentiations between bone and soft tissue sarcomas and benign tumors or non-tumor diseases, primarily inflammations.
26-30 579
Abstract
Diagnostic imaging of bone sarcomas of the pelvic girdle using computed tomograpgy, sonography and scintigraphy was performed on 59 patients with the aim to determine the precise tumor localization and to assess tumor spread. Features of tumor spread into the pelvic bones involving all layers of the bone were found. The main trends in spread of soft tissue component in bones of the pelvic girdle were studied.
31-37 718
Abstract
The efficacy of the chest wall reconstruction with TiNi implants was assessed. Between 2007 and 2014, 21 patients with malignant tumors of the skin, soft tissues, ribs and sternum (sarcomas and metastases) underwent replacement of post-resection chest wall defects using the original Ti-Ni constructions. A total of 28 surgeries were performed including 19 single-stage reconstructions or 2 delayed reconstructions. The average square of the defect was 127 cm2 (40 to 323 cm2).  results. Spontaneous breathing was restored on the day of surgery in 27 (96.4 %) cases. Chest carcass recovery was achieved in all cases. The amplitude reduction was observed in 10 (36 %) cases and complete elimination of pathological chest wall flotation was achieved in 18 (64 %) cases. Complications requiring surgery were observed in 3 (11 %) patients. At a long-term follow-up, 10 patients are alive. conclusion. The technique combining the use of TiNi alloy structures and complex autotissue grafts with axial type of blood supply allows chest wall cancer with extensive local spread to be successfully treated.
38-44 671
Abstract
The paper presents the experience in surgical treatment of 10 patients with tumors of the sacroiliac joint. All patients underwent reconstruction of the pelvic ring with polyaxial screws and titanium rods. The mean age of the patients was 39 years (23 to 59). There were 6 (60%) patients with chondrosarcoma, 1 (10%) with fibrosarcoma, 1 (10%) with Ewing’s sarcoma, 1 (10%) with metastasis from kidney cancer and 1 (10%) with metastasis from osteosarcoma. The mean length of surgery was 4.2 hours (3 to 6). The average volume of intraoperative blood loss was 2 800 ml (1500 to 5000 ml). Microscopically positive resection margin (R1) was revealed in 2 (20 %) patients. The median follow-up was 8.5 months (2 to 40). All patients are alive with no evidence of disease progression. Postoperative complications were observed in 4 (40 %) patients. The mean Musculoskeletal Tumor Society score at last available follow-up was 70 % (62 to 92 %).
45-50 1530
Abstract
Introduction. The aim of this study was to analyze the surgical treatment for multiple intrapulmonary metastases sarcomas of bone and soft tissue. Methods. This analysis includes retrospective survival data from 24 patients with soft tissue sarcomas and bone sarcomas who were treated from January 2004 to December 2014 in MRRC and meet the following criteria: the presence of more than four lesions in the lungs, no progression of the primary tumor, no distant metastases and overall satisfactory status (ECOG 0–1). Survival of patients assessed by Kaplan-Meier method. results. In total 49 pulmonary metastasectomy were performed. There were no postoperative deaths. In 4 patients underwent repeated operations. From this cohort 1-year survival has survived 10 patients (41.6 %), 5-year – 3 (12.5 %). 3 patients are alive 28, 62 and 139 months after surgery with no evidence of progression of tumors. conclusion. The detection of lesion in the pulmonary parenchyma is most often regarded as the poor prognosis of the disease. Individually tailored treatment strategy allows you to increase the overall life expectancy and improve quality of life. The surgical method can be considered as a stage of complex treatment, as in the progression of the disease in the lungs, and in synchronous lesions. Surgical repeated resection may be an appropriate treatment for patients with progression and the justified possibility of an operation.
51-54 943
Abstract
Short-and long-term surgical treatment outcomes of 15 patients with non-organic retroperitoneal tumors were presented. Surgical removal of the tumor was performed in 10 (66.7%) patients and combined resection of adjacent organs in 5 (33.3%) patients. The curative resection rate was 100%. Postoperative complications were observed in 2 (13.3±8.7%) patients. No postoperative lethality was registered. Local recurrence was diagnosed in  4 (26.7±11.4%) patients, of them 2 (13.3±8.7%) died of disease progression. Thus, in spite of certain difficulties associated with the need to perform traumatic surgeries, surgery remains the most effective treatment for non-organic retroperitoneal cancer.
55-60 948
Abstract
183 patients with locally advanced STS treated in MRRC were analyzed. In group 1 were included 107 patients who received preoperative thermo-chemo-radiotherapy (ТCRТ) and surgery (S). The group 2 consisted of 76 patients treated with preoperative chemo-radiotherapy (CRТ) followed by S too. The locoregional-recurrencefree-survival (LRFS), metastasis-free survival and overall survival rates (93 %, 69 %, 84 %) at 5 years were higher in groups with ТCRТ compared to the CRT (78 %, 56 %, 68 %). Local hyperthermia didn’t increase an incidence of postoperative complications.

REVIEWS

61-67 1902
Abstract
The review presents the recent data on factors affecting life expectancy and cancer prognosis in patients with disseminated breast cancer with spinal metastases
68-75 872
Abstract
The review presents the most recent data on the incidence and pathogenesis of lymph node metastasis from soft tissue sarcoma, a very rare clinical event.
76-81 782
Abstract
The review aimed to assess the role of local hyperthermia in combined modality treatment of soft tissue sarcoma. The recent randomized trials have shown significant benefits from local hyperthermia in patients with soft tissue sarcoma. When combined with radiotherapy, hyperthermia has a complementary and additive effect. Extensive researches have also shown that hyperthermia improves the efficacy of many chemotherapeutic agents. Besides the increased effectiveness of radiotherapy and chemotherapy, hyperthermia has many anti-cancer effects and improves treatment results in patients with soft tissue sarcomas.
82-89 1518
Abstract
Literature data on the potential value of ultrasound imaging in diagnosis of soft tissue sarcoma were analyzed. Ultrasound in B-regime was used to assess the extent of soft tissue sarcoma, Doppler ultrasonography was used to study tumor vascularization and sonoelastography was useful to differentiate benign from malignant tumors of soft tissues. The analysis of diagnostic value of ultrasound in detection of soft tissue lesions was carried out.  Criteria characterizing various histological types of tumors were identified.


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ISSN 1814-4861 (Print)
ISSN 2312-3168 (Online)