Liposarcoma surgery: Difference between revisions
Jump to navigation
Jump to search
| Line 44: | Line 44: | ||
====Treatment of stage 4 sarcoma==== | ====Treatment of stage 4 sarcoma==== | ||
=====Confined cancer spread===== | |||
{| style="border: 2px solid #DCDCDC; font-size: 90%; width: 25%;" | {| style="border: 2px solid #DCDCDC; font-size: 90%; width: 25%;" | ||
! style="width: 500px;background: #4479BA"|{{fontcolor|#FFF| '''''For confined cancer spread'''''}} | ! style="width: 500px;background: #4479BA"|{{fontcolor|#FFF| '''''For confined cancer spread'''''}} | ||
| Line 52: | Line 52: | ||
| style="width: 120px;background: #DCDCDC"|Ablation | | style="width: 120px;background: #DCDCDC"|Ablation | ||
|- | |- | ||
| style="width: 120px;background: #F5F5F5"| | | style="width: 120px;background: #F5F5F5"|Observation | ||
|- | |- | ||
| style="width: 120px;background: #DCDCDC"|Stereotactic Body Radiation Therapy (SBRT) | | style="width: 120px;background: #DCDCDC"|Stereotactic Body Radiation Therapy (SBRT) | ||
|- | |- | ||
| style="width: 120px;background: #F5F5F5"|Embolization | | style="width: 120px;background: #F5F5F5"|Embolization | ||
|} | |||
=====Widespread cancer===== | |||
{| style="border: 2px solid #DCDCDC; font-size: 90%; width: 25%;" | |||
! style="width: 500px;background: #4479BA"|{{fontcolor|#FFF| '''''For widespread cancer'''''}} | |||
|- | |||
| style="width: 120px; background: #F5F5F5"|Palliative chemotherapy | |||
|- | |||
| style="width: 120px;background: #DCDCDC"|Palliative radiation therapy | |||
|- | |||
| style="width: 120px;background: #F5F5F5"|Palliative surgery | |||
|- | |||
| style="width: 120px;background: #DCDCDC"|Stereotactic Body Radiation Therapy (SBRT) | |||
|- | |||
| style="width: 120px;background: #F5F5F5"|Embolization | |||
|- | |||
| style="width: 120px;background: #DCDCDC"|Observation if no symptoms | |||
|- | |||
| style="width: 120px;background: #F5F5F5"|Ablation | |||
|- | |||
| style="width: 120px;background: #DCDCDC"|Supportive care | |||
|} | |} | ||
Revision as of 05:01, 22 September 2014
|
Liposarcoma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Liposarcoma surgery On the Web |
|
American Roentgen Ray Society Images of Liposarcoma surgery |
Overview
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 |
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".