Sarcoma

Question 1

Sarcoma higher risk of nodes

Answer 1

higher risk of nodes: SCARE- 
synovial
clear cell
angio
rhabdo
epitheliod (10-30%)

Question 2

Sarcoma Staging TNM

Answer 2

T1 – up to 5cm
T2 – >5-10cm
T3 – >10-15cm
T4 – >15 cm

N1 regional nodes

Question 3

Sarcoma Group Stage

Answer 3

Stage Groups
IA: G1, T1
IB: G1, T2-4

II: G2-3, T1

IIIA: G2-3, T2
IIIB: G2-3, T3-4

IV: N1 or M1

• if G1, always Stage I
• if N1, then Stage IV

T1 – up to 5cm
T2 – >5-10cm
T3 – >10-15cm
T4 – >15 cm

N1 regional nodes

Question 4

Sarcoma Stage I treatment

Answer 4

I: surgery alone (LC 90-100% as long as margin >1 cm) (if close margin, re-excise)
- Consider RT if: +margins, mult LRs, location not amenable to subsequent salvage surgery

Question 5

Sarcoma Stage II-III treatment

Answer 5

II – III: surgery with preop vs postop EBRT

- Consider neoadjuvant or adjuvant chemo for deep, large, high grade tumors

Question 6

Desmoid Treatment

Answer 6

Observation or WLE -> RT for +margins to 50 Gy; Unresectable: observe or RT to 60 Gy
[Note: desmoids can be observed if asx and not in area that could lead to functional impairment w/ tumor growth]
Can be treated with NSAIDS or tamoxifen or methotrexate/vinblastine

Take a long time to regress radiographically
LC 70-80%