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Soft-tissue sarcoma

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 16 Jul 2025
Última atualização: 06 Dec 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • mass
  • upper/lower gastrointestinal bleed
  • neuropathic pain
  • increased abdominal girth
  • features of acute abdomen
Detalhes completos

Outros fatores diagnósticos

  • unilateral extremity swelling
  • weight loss
  • fatigue
  • anorexia
  • abdominal bloating, discomfort, pain
Detalhes completos

Fatores de risco

  • genetically inherited syndromes
  • radiation
  • human herpesvirus-8 (HHV-8) infection
  • congenital disorders
  • male sex
  • lymphedema
  • history of exposure to chemical carcinogens
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • CT scan of primary tumor
  • MRI of primary tumor
  • CT scan chest
  • biopsy for histology
Detalhes completos

Investigações a serem consideradas

  • abdominal/pelvic computed tomography
  • magnetic Resonance Imaging (MRI) of total spine
  • fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT)
  • endoscopy
  • complete blood count (CBC)
  • coagulation studies
  • blood urea nitrogen (BUN)
  • creatinine
  • liver function tests (LFTs)
  • echocardiogram or multigated acquisition (MUGA) scan
  • ancillary techniques
Detalhes completos

Algoritmo de tratamento

AGUDA

extremity: stage I

extremity: stage II resectable

extremity: stage III or select stage IV (any T, N1, M0), resectable

extremity: stage III or select stage IV (any T, N1, M0), unresectable

extremity: stage IV, oligometastases with limited tumor bulk or regional nodes

extremity: stage IV, disseminated metastases

extremity: recurrent

retroperitoneal/intra-abdominal: resectable (primary or recurrent)

retroperitoneal/intra-abdominal: unresectable

retroperitoneal/intra-abdominal: metastatic disease, single organ and limited tumor bulk amenable to local therapy

retroperitoneal/intra-abdominal: disseminated metastases

gastrointestinal stromal tumors: resectable with minimal morbidity

gastrointestinal stromal tumors: resectable with significant morbidity

gastrointestinal stromal tumors: unresectable

gastrointestinal stromal tumors: progressive

gastrointestinal stromal tumors: recurrent or metastatic

Colaboradores

Autores

James S. Hu, MD, FACP

Associate Professor of Clinical Medicine

USC Norris Comprehensive Cancer Center

Los Angeles

CA

Declarações

JSH declares that he has no competing interests.

Sant P. Chawla, MD, FRACP

Director

Sarcoma Oncology Center

Santa Monica

CA

Declarações

SPC owns stock in AADi, Cellestia Biotech, CounterPoint, and Immix BioPharma, and has received grants, consulting fees, payments of honoraria, and payment from speakers bureau for Amgen, Roche, GSK, Threshold Pharmaceuticals, CytRx Corporation, Ignyta, Immune Design, TRACON Pharma, Karyopharm Therapeutics, Sarcoma Alliance for Research through Collaboration (SARC), Janssen, Advenchen Laboratories, Bayer, Inhibrx, NKMax, and Thyme.

Agradecimentos

Dr James S. Hu and Dr Sant P. Chawla would like to gratefully acknowledge Dr Swati Sikaria, Dr Jonathan C. Trent, Dr Saira Hassan, and Dr David Thomas, previous contributors to this topic.

Declarações

SS, JCT and SH each declare that they have no competing interests. DT has received research support from Pfizer, Amgen, and Novartis.

Revisores

Richard F. Riedel, MD

Professor of Medicine

Duke University

Durham

NC

Declarações

RFR owns shares in Limbguard, has received institutional clinical research support from AADi, Adaptimmune, AROG, Ayala, BioAtla, Blueprint, Cogent, Daiichi-Sankyo, Deciphera, GlaxoSmithKline, InhibRx, NanoCarrier, Oncternal, PTC Therapeutics, SARC, SpringWorks, Tracon, and Trillium. He has been a consultant/advisor for AADi, Adaptimmune, Bayer, Blueprint, Boehringer Ingelheim, Daiichi-Sankyo, Deciphera, GlaxoSmithKline, NanoCarrier, SpringWorks and has received funding for travel from Deciphera.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

World Health Organization. WHO classification of tumours: soft tissue and bone tumours. 5th ed (Vol 3). Lyon, France: IARC Press; 2020.

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: soft tissue sarcoma [internet publication].Texto completo

Gronchi A, Miah AB, Dei Tos AP, et al. Soft tissue and visceral sarcomas: ESMO-EURACAN-GENTURIS Clinical practice guidelines for diagnosis, treatment and follow-up*. Ann Oncol. 2021 Nov;32(11):1348-65.Texto completo  Resumo

Casali PG, Blay JY, Abecassis N, et al. Gastrointestinal stromal tumours: ESMO-EURACAN-GENTURIS Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2022 Jan;33(1):20-33. Resumo

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: gastrointestinal stromal tumors (GIST) [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

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