Comorbidity, body mass index, and performance status as prognostic factors in older patients with soft-tissue sarcoma

Soft Tissue Sarcoma with Lower Limb Impairment: Development of a Specific Rehabilitation Protocol Based on Demolitive and Reconstructive Surgery Types

Background/Objectives: Soft tissue sarcomas (STSs) are extremely uncommon tumors with a high rate of local recurrence that often require very demolitive surgery. The aim of our study is to propose a specific rehabilitation protocol for patients with STSs, based on the kind of demolition and reconstructive surgery performed, and evaluate its effects. Methods: The protocol was developed on the basis of the clinical experiences of physiatrists and surgeons, as well as data from the literature, recommending timelines for postural steps, verticalization, walking, and therapeutic exercises, in accordance with wound healing times and in order to prevent complications from disuse and immobility. The modified Barthel Index Scale (mBI), the Numeric Rating Scale (NRS), the Adapted Patient Evaluation Conference System (APECS), and the 10 Meter Walk Test (10 MWT) were used to clinically evaluate patients before and after the rehabilitation treatment. Results: Thirty-one patients with primary STSs were enrolled. Following the rehabilitation program, we found a statistically significant improvement in mBI (p < 0.001), APECS (p ≤ 0.001), and NRS (p = 0.001). In a subgroup of patients (n = 18) assessed with the 10 MWT, a statistically significant increase in walking speed was observed (p = 0.012). Conclusions: Patients who completed rehabilitation following the proposed protocol, customized according to the surgical intervention type, demonstrated marked improvements in motor performance, ability in daily activities, walking, and pain. The proposed protocol can assist the multidisciplinary team of surgeons, oncologists, and rehabilitators in maintaining alignment on patient management, thereby ensuring clear indications regarding the activities that patients can and cannot undertake during the recovery period.

Tolerability and Outcomes for Treatment of Older Myxoid Liposarcoma Population

BACKGROUND

Myxoid liposarcoma predominantly affects young and middle-aged individuals, and little is known regarding treatment tolerability and outcomes in older patients. This study aims to better understand this older patient population.

METHODS

This single institution retrospective study included patients aged 70 years and older with localized (non-metastatic) myxoid liposarcoma.

RESULTS

Sixteen patients were included. The median age was 75 years, and 9 (56%) were female. Fourteen (88%) were extremity tumors and two (12%) were trunk. The median tumor size was 10.4 cm (range, 3.6 to 28 cm). Five (31%) tumors had a round cell component. All patients had surgery. Fourteen (88%) had perioperative radiation, and three (19%) had perioperative chemotherapy. One patient had postoperative infection, and one patient had neutropenic fever from preoperative chemotherapy. The median follow up from surgery was 6.3 years. Eight (50%) patients died from MLPS. The median relapse-free survival and overall survival were 34 months and 75 months, respectively.

CONCLUSIONS

Most older patients with localized MLPS received perioperative radiation therapy with surgery, and few serious toxicities were reported. Even with treatment, half of the patients relapsed.

Low NT5DC2 expression predicts favorable prognosis and suppresses soft tissue sarcoma progression via ECM-receptor interaction pathway

BACKGROUND

Soft tissue sarcoma, a malignant tumor arising from mesenchymal tissues with poor prognosis. 5'-Nucleotidase Domain Containing 2 (NT5DC2) is a novel oncogene, and the precise involvement of NT5DC2 in soft tissue sarcoma were still undefined. Hence, our study aims to investigate NT5DC2 functions in soft tissue sarcoma progression.

METHODS

The tumor immune single-cell hub 2 (TISCH2) website, The Cancer Genome Atlas (TCGA) pan-cancer or sarcoma and Gene Expression Omnibus (GEO, GSE21122) databases were applied to visualize the NT5DC2 status in the sarcoma databases. The NT5DC2 protein expression in sarcoma tissues in our hospital was detected by using immunohistochemistry (IHC) and analyzed the associations between NT5DC2 expression and clinicopathological parameters. Real-time quantitative polymerase chain reaction (RT-qPCR), colony formation, 5-ethynyl-2'-deoxyuridine (EdU) assay, wound healing, transwell, flow cytometry and xenograft model were used to elucidate the effects of NT5DC2 downregulated by lentivirus in sarcoma cell.

RESULTS

The TISCH2 website detection found that NT5DC2 expression is enriched in malignant cells in sarcoma single-cell database. Furthermore, the TCGA-sarcoma database indicated that NT5DC2 expression correlates with metastasis, positive margin status, prognosis, and diagnostic value. Additionally, IHC staining showed that 40 % of soft tissue sarcoma patients present high expression of NT5DC2, and NT5DC2 upregulation is closely associated with poor prognosis. Functional verification analysis further revealed that downregulating NT5DC2 expression can suppress sarcoma progression through the ECM-receptor interaction pathway.

CONCLUSION

Low expression of NT5DC2 predicts a favorable prognosis in soft tissue sarcoma, and downregulated NT5DC2 expression can suppress sarcoma cell progression through the ECM-receptor interaction pathway.