Liposarcoma surgery: Difference between revisions
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{{CMG}} ; {{AE}} {{Ammu}} | {{CMG}} ; {{AE}} {{Ammu}} | ||
==Overview== | ==Overview== | ||
Surgery is the primary treatment of liposarcoma. It may be integrated with [[chemotherapy]] and [[ | Surgery is the primary treatment of liposarcoma. It may be integrated with [[chemotherapy]] and [[radiation therapy]] depending on the site, stage and recurrence of the tumors. | ||
==Surgery== | ==Surgery== | ||
Revision as of 14:07, 25 August 2015
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Liposarcoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Liposarcoma surgery On the Web |
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American Roentgen Ray Society Images of Liposarcoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
Surgery is the primary treatment of liposarcoma. It may be integrated with chemotherapy and radiation therapy depending on the site, stage and recurrence of the tumors.
Surgery
Surgery is the key treatment for liposarcoma that has not metastasized into other organs. Tumor along with a wide margin of healthy tissue is removed to ensure that only healthy tissue is retained. Stage 1 of lims, trunk, head and neck are treated with surgery. Stage 2 and 3 may require radiation and chemotherapy along with surgery for treatment. Following is a classification for surgical resection. [1]
| Surgical resection | Proceedure |
|---|---|
| Intraleisional | Curettage, Partial tumor removal |
| Marginal | May leave microscopic tumor behind |
| Wide | Remove tumor and surrounding cuff of tissue |
| Radical | Remove entire compartment including amputation |
Treatment by stage
Treatment by stage involves some basic criteria.[2]. Some of them are given below.
Treatment of stage 1 sarcoma
- Primary treatment is surgery. If the margins are cut >1 cm sparing the fascia, Care after surgery adjuvant treatment. Care includes the following.
- Rehabilitation if needed
- Medical history and physical examination every 3-6 months for every 2-3 years.
- Chest Imaging every 6-12 months
- Tumor site imaging right after surgery and then at regular intervals of time.
- If the margins are cut <1 cm with the fascia, for stage 1A consider radiation therapy and Care after treatment and for stage 1B radiation treatment.
Treatment of stage 2 and stage 3 sarcoma
- For stage 2A , radiation is given as neoadjuvant therapy followed by surgery as a primary treatment and then radiation boost as an adjuavant therapy
- For stage 2B or 3, radiation/ chemotherapy/ chemoradiation are given as neoadjuvant therapy followed by surgery as a primary treatment and radiation boost or chemotherapy as an adjuvant therapy
- For tumors which cannot be surgically resected, radiaion therapy/chemoradiation/ chemotherapy/ isolated limb chemotherapy is given as primary treatment.
- It is followed by surgery if possible and radiation boost/ chemotherapy as a follow up treatment option.
- If surgery is still not feasible, observation if no symptoms/ radiation / palliative chemotherapy or surgery/ amputation / supportive care are the treatment options
Treatment of stage 4 sarcoma
Confined cancer spread
| For confined cancer spread |
|---|
| Surgery to remove metastasis with chemotherapy and radiation before and after surgery |
| Ablation |
| Observation |
| Stereotactic Body Radiation Therapy (SBRT) |
| Embolization |
Widespread cancer
| For widespread cancer |
|---|
| Palliative chemotherapy |
| Palliative radiation therapy |
| Palliative surgery |
| Stereotactic Body Radiation Therapy (SBRT) |
| Embolization |
| Observation if no symptoms |
| Ablation |
| Supportive care |
Recurrent sarcoma in distant sites are treated with the following options
| Cancer spread | Treatment options |
|---|---|
| Tumor in one organ | Surgery with chemotherapy/radiation before and after surgery |
| Confined area | Lymph nde surgery with chemotherapy/radiation Surgery to remove metastasis with chemotherapy/radiation Stereotactic Body Radiation Therapy (SBRT) |
| Widespread | Palliative chemotherapy Palliative radiation therapy Palliative surgery Stereotactic Body Radiation Therapy (SBR) Embolization Ablation |
References
- ↑ Enneking WF, Spanier SS, Goodman MA (1980). "A system for the surgical staging of musculoskeletal sarcoma". Clin Orthop Relat Res (153): 106–20. PMID [ 7449206 [ Check
|pmid=value (help). - ↑ "NCCN".