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The Medical Management of Sarcomas

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Bone Pathology

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Abstract

Sarcomas can be classified into those usually found in children and adolescents (osteosarcoma, Ewing sarcoma, and rhabdomyosarcoma), and the non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) found primarily in adults. Chemotherapy and multidisciplinary care are essential for cure in the first group, while management of the second group is controversial. Evaluation involves imaging of primary and possible metastatic sites, biopsy and diagnosis (often using molecular tools), and marrow evaluation (in Ewing sarcoma and rhabdomyosarcoma). Most children with sarcomas are entered on clinical trials, with chemotherapy to prevent the emergence of metastases. Neo-adjuvant chemotherapy has become the standard approach to osteosarcoma, Ewing sarcoma, and most rhabdomyosarcomas. Primary tumor treatment is surgical in osteosarcomas, but may include surgery, radiation, or both in rhabdomyosarcoma and Ewing sarcoma. About two-thirds of patients with localized tumors are cured with current approaches, but the outlook for patients with metastases is much poorer. The role of chemotherapy in the treatment of patients with NRSTS is uncertain, and practice varies widely. Treatment of sarcomas has many acute toxic effects, as well as many late effects including second malignant neoplasms, growth disturbances, reduced fertility, and organ dysfunction.

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Authors and Affiliations

  1. Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, USA

    Richard B. Womer

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  1. Richard B. Womer
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Correspondence to Richard B. Womer .

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Editors and Affiliations

  1. Dept. Pathology, Temple University Hospital, N. Broad St. 3401, Philadelphia, 19140, U.S.A.

    Jasvir S. Khurana

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© 2009 Humana Press, a part of Springer Science+Business Media, LLC

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Womer, R.B. (2009). The Medical Management of Sarcomas. In: Khurana, J. (eds) Bone Pathology. Humana Press. https://doi.org/10.1007/978-1-59745-347-9_17

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  • DOI: https://doi.org/10.1007/978-1-59745-347-9_17

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  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-766-2

  • Online ISBN: 978-1-59745-347-9

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