Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Aug 25;16(17):2965.
doi: 10.3390/cancers16172965.

Mesenchymal Tumor Management: Integrating Surgical and Non-Surgical Strategies in Different Clinical Scenarios

Laura Samà  1 , Giorgia Amy Rodda  1   2 , Laura Ruspi  1 , Federico Sicoli  1 , Vittoria D'Amato  1 , Salvatore Lorenzo Renne  2   3 , Alice Laffi  4 , Davide Baldaccini  5 , Elena Clerici  5 , Pierina Navarria  5 , Marta Scorsetti  2   5 , Alexia Francesca Bertuzzi  4 , Vittorio Lorenzo Quagliuolo  1 , Ferdinando Carlo Maria Cananzi  1   2
Affiliations
Review

Mesenchymal Tumor Management: Integrating Surgical and Non-Surgical Strategies in Different Clinical Scenarios

Laura Samà et al. Cancers (Basel). .

Abstract

Mesenchymal tumors originate from mesenchymal cells and can be either benign or malignant, such as bone, soft tissue, and visceral sarcomas. Surgery is a cornerstone treatment in the management of mesenchymal tumors, often requiring complex procedures performed in high-volume referral centers. However, the COVID-19 pandemic has highlighted this need for alternative non-surgical approaches due to limited access to surgical resources. This review explores the role of non-surgical treatments in different clinical scenarios: for improving surgical outcomes, as a bridge to surgery, as better alternatives to surgery, and for non-curative treatment when surgery is not feasible. We discuss the effectiveness of active surveillance, cryoablation, high-intensity focused ultrasound, and other ablative techniques in managing these tumors. Additionally, we examine the use of tyrosine kinase inhibitors in gastrointestinal stromal tumors and hypofractionated radiotherapy in soft tissue sarcomas. The Sarculator tool is highlighted for its role in stratifying high-risk sarcoma patients and personalizing treatment plans. While surgery remains the mainstay of treatment, integrating advanced non-surgical strategies can enhance therapeutic possibilities and patient care, especially in specific clinical settings with limitations. A multidisciplinary approach in referral centers is vital to determine the optimal treatment course for each patient.

Keywords: GIST; desmoid-type fibromatosis; extremity sarcoma; mesenchymal tumor; multidisciplinary approach; non-surgical treatment; personalized medicine; retroperitoneal sarcoma; soft tissue sarcoma.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Different clinical scenarios of non-surgical management of soft tissue sarcomas.
Figure 2
Figure 2
Different clinical scenarios and related treatment options for improving surgical results.
Figure 3
Figure 3
Different clinical scenarios and related treatment options as a bridge to surgery.
Figure 4
Figure 4
Different clinical scenarios and related treatment options as alternatives to surgery.
Figure 5
Figure 5
Non-curative treatment approaches.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Sbaraglia M., Bellan E., Dei Tos A.P. The 2020 WHO Classification of Soft Tissue Tumours: News and Perspectives. Pathologica. 2020;113:70–84. doi: 10.32074/1591-951X-213. - DOI - PMC - PubMed
    1. Mazzaferro V., Danelli P., Torzilli G., Droz Dit Busset M., Virdis M., Sposito C. A Combined Approach to Priorities of Surgical Oncology during the COVID-19 Epidemic. Ann. Surg. 2020;272:e84–e86. doi: 10.1097/SLA.0000000000004005. - DOI - PMC - PubMed
    1. Torzilli G., Viganò L., Galvanin J., Castoro C., Quagliuolo V., Spinelli A., Zerbi A., Donadon M., Montorsi M. A Snapshot of Elective Oncological Surgery in Italy during COVID-19 Emergency: Pearls, Pitfalls, and Perspectives. Ann. Surg. 2020;272:e112–e117. doi: 10.1097/SLA.0000000000004081. - DOI - PMC - PubMed
    1. Bunzli S., O’Brien P., Aston W., Ayerza M.A., Chan L., Cherix S., De Las Heras J., Donati D., Eyesan U., Fabbri N., et al. Life or Limb: An International Qualitative Study on Decision Making in Sarcoma Surgery during the COVID-19 Pandemic. BMJ Open. 2021;11:e047175. doi: 10.1136/bmjopen-2020-047175. - DOI - PMC - PubMed
    1. Casali P.G., Blay J.Y., Abecassis N., Bajpai J., Bauer S., Biagini R., Bielack S., Bonvalot S., Boukovinas I., Bovee J.V.M.G., et al. Gastrointestinal Stromal Tumours: ESMO–EURACAN–GENTURIS Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up. Ann. Oncol. 2022;33:20–33. doi: 10.1016/j.annonc.2021.09.005. - DOI - PubMed

LinkOut - more resources