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Soft-tissue sarcoma is a rare cancer that accounts for approximately 1% of all malignant tumors. Although they occur in various age groups, soft-tissue sarcomas account for 8% of all malignant tumors developing in adolescents and young adults, suggesting that they are not rare in this age group. This study aimed to evaluate the clinical and pathological characteristics of soft-tissue sarcoma in adolescents and young adults. According to the Bone and Soft-Tissue Tumor Registry in Japan, myxoid liposarcoma is the most common type of soft-tissue sarcoma found in adolescents and young adults; alveolar soft part sarcoma, extraskeletal Ewing sarcoma, epithelioid sarcoma, clear cell sarcoma and synovial sarcoma occur predominantly in this age group among soft-tissue sarcomas. The analysis based on this registry demonstrated that age was not a prognostic factor for poor survival of soft-tissue sarcoma, although the prognosis in adolescents and young adults was better than that in older patients in the US and Scandinavia. Adolescent and young adult patients with soft-tissue sarcoma have age-specific problems, and a multidisciplinary approach to physical, psychological, and social issues is necessary to improve the management of these young patients both during and after treatment. [ABSTRACT FROM AUTHOR]

Background: Primary tumor resection is the mainstay of treatment for undifferentiated pleomorphic sarcoma (UPS); however, the necessity of adjuvant chemotherapy has been debated. We aimed to clarify the effect of adjuvant chemotherapy on survival rates in patients with UPS with localized and resectable primary lesions. Methods: This retrospective analysis included data of 2112 patients with localized UPS arising in the extremities and trunk, extracted from a registry in Japan. We estimated overall survival (OS), identified prognostic factors, and adjusted patient characteristics in the two groups treated with or without chemotherapy using propensity score matching (PSM). Results: The 5-year OS rate was 79.4%. In multivariate OS analysis, adjuvant chemotherapy was a good prognostic factor (hazard ratio 0.65; 95% confidence interval 0.48–0.9, P = 0.009). Large tumor size was the poorest prognostic factor, and OS decreased with the tumor size (P < 0.0001). In all patients, adjuvant chemotherapy prolonged OS (5-year OS: 82.3% vs. 78.6%, P = 0.03). Adjuvant chemotherapy did not affect OS in patients with tumor size < 5 cm; the benefit was strong in patients with tumor size 10 to < 15 cm (5-year OS: 79.5% vs. 66.8%, P = 0.003). Adjuvant chemotherapy efficacy was not pronounced in patients with tumor size 5 to < 10 cm (5-year OS: 87% vs. 80%, P = 0.06) and ≥ 15 cm (5-year OS: 60.7% vs. 49.5%, P = 0.08). After PSM, adjuvant chemotherapy was significantly associated with improved OS (P = 0.02). Conclusions: In patients with localized UPS, adjuvant chemotherapy tended to improve OS when tumors were ≥ 5 cm, especially when they were 10 to < 15 cm. [ABSTRACT FROM AUTHOR]

Background Dissection and division of tissues are widely performed in microscopic neurosurgery, especially in brain tumor resection. Dissection maneuvers can be divided into two types: sharp dissection with microscissors and blunt dissection using a dissector. It is essential to use the appropriate method according to the intraoperative situation and conditions. Therefore, specific tools for each type of dissection maneuver are required. We developed an ultrasonic microdissector, a newly designed tool that functions as both microscissors and dissector to further advance brain tumor surgery. This preliminary experimental study was performed to evaluate the usefulness of this new device. Methods Solfy F (J. Morita Mfg. Corp., Kyoto, Japan), a dental ultrasonic instrument, was used to provide power in this study. Two experiments were performed. The first one involved touching the brain parenchyma of a pig cadaver with the tip of the ultrasonic microdissector under various conditions to investigate its side effects. In the second experiment, the rat femoral artery, vein, and nerve were dissected from surrounding structures using a prototype of the ultrasonic microdissector. The effects of this device were then investigated histologically. Results The amount of tissue damage was greater with the higher ultrasonic power. No irrigation and a long manipulation time also affected tissue degeneration. Dissection using the ultrasonic microdissector was superior to conventional dissection methods in terms of time (p < 0.05) and safety without any additional histologic damages. Conclusions The newly developed ultrasonic microdissector can dissect soft tissue without damage to the surrounding tissue. Further studies are required to determine the optimal intensity for its clinical use. [ABSTRACT FROM AUTHOR]

Five species of bivalves (Japanese littleneck, blue mussel, trough shell, Stimpson's quahog, and Japanese dosinia) were collected from three different sites in Tokyo Bay and their shells and soft tissues were analyzed for rare earth element (REE) concentrations. Their REE compositions were compared with those of sediment and seawater at corresponding sites. To estimate the digestive strength of the bivalves, different acids were used to extract the elements in sediment for comparison of REE compositions. The REE concentrations of soft tissues were higher than those of shells. The REE abundance patterns of both shells and soft tissues resembled those of sediments or suspended particles rather than those dissolved in seawater, except for mussels. REE composites calculated by mixing particulate and dissolved REEs at much greater ratios for particulate REEs can explain the REE composition of both shells and soft-tissues. In the case of mussel shells, the contribution of REEs dissolved in seawater is important, but despite this most of mussel REEs similarly originate from suspended particles in seawater. This implies that a simple projection to seawater REEs from the REE composition of shells would be difficult. The apparent partitioning coefficients of REEs over Ca in shells ranged from 0.1 to 10 against REEs/Ca of seawater. [ABSTRACT FROM AUTHOR]

Soft tissue sarcomas are rare tumors consisting of more than 50 histological subtypes. The rarity and diversity made it difficult to conduct studies for investigational new drugs. Doxorubicin remains the standard of care in metastatic soft tissue sarcoma and several investigational new drugs such as olaratumab failed to demonstrate additional benefit in combination with doxorubicin. Pazopanib, a multitargeted tyrosine kinase inhibitor, is the only drug approved for soft tissue sarcoma. In gastrointestinal stromal tumor (GIST) and dermatofibrosarcoma protuberans, molecular targeted agent and accompanying genetic alterations have been investigated and introduced into daily clinical practice. Recent advances in omics technologies such as next-generation sequence have focused on more precise approaches and enabled to investigate comprehensive mutational analyses for soft tissue sarcomas. New driver genes have been identified across the tumor types and one of the promising genetic alterations is NTRK fusion. NTRK fusion could be detected in less than 1% of sarcomas. TRK tyrosine kinases show high activity against NTRK fusion-positive tumors including soft tissue sarcomas. Multigene assay might have some role to detect such rare genetic alterations. GIST is one of a successful model of precision medicine. Imatinib, sunitinib, and regorafenib are currently available in Japan. Novel molecular targeted agents such as kit inhibitors and a HSP90 inhibitor are currently under development. [ABSTRACT FROM AUTHOR]

Background: The surgical management of soft tissue sarcoma (STS) in elderly patients has only been addressed in a few studies. The objective of the current study was to assess surgical outcomes in patients with STS aged 70 years and older and the association of older age with the survival after complete resection., Methods: A retrospective analysis was conducted in 158 elderly patients with localized STS who visited 11 institutions participating in Japanese Musculoskeletal Oncology Group between 1995 and 2006 and were treated by surgical resection. Univariate and multivariate analyses were performed to identify prognostic factors., Results: Median follow-up period was 38 months. Histologically high-grade tumors were detected in 71% of the patients. Wide resection with adequate margins was performed in 66% of the cases. Systemic chemotherapy was performed in only 5 patients. Univariate analysis identified histological grade and gender as statistically significant prognostic factors for sarcoma-specific survival. Multivariate analysis did not identify significant prognostic factors for sarcoma-specific survival, although high grade sarcoma emerged as a potentially significant prognostic factor (P = 0.050). Local recurrence was detected in 19% of the patients. Multivariate analysis of local recurrence-free survival showed that tumor site and surgical margins were statistically significant prognostic factors., Conclusions: Older age was not identified as a prognostic factor for sarcoma-specific survival, which is not consistent with the findings of previous studies showing that older age was associated with decreased sarcoma-specific survival. Complete resection should be indicated and can lead to optimal treatment outcome for properly selected elderly patients., (Copyright © 2013 Elsevier Ltd. All rights reserved.)