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Sarcoma
From Wikipedia, the free encyclopedia

Main page For the journal, see Sarcoma (journal).

Contents Not to be confused with sarcoid.
Current events
A sarcoma is a malignant tumor, a type of cancer
Random article Sarcoma
that arises from transformed cells of mesenchymal
About Wikipedia Other names Sarcomas, sarcomata
Contact us (connective tissue) origin.[1][2] Connective tissue is a
Donate broad term that includes bone , cartilage , fat,
vascular , or hematopoietic tissues, and sarcomas
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can arise in any of these types of tissues.[2][3] As a
Help result, there are many subtypes of sarcoma, which
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are classified based on the specific tissue and type of
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cell from which the tumor originates.[4] Sarcomas
Recent changes
Upload file are primary connective tissue tumors, meaning that
they arise in connective tissues.[2] This is in contrast
Tools to secondary (or "metastatic") connective tissue
What links here tumors, which occur when a cancer from elsewhere
Related changes in the body (such as the lungs, breast tissue or Optical coherence tomography (OCT) image of a
Special pages
prostate) spreads to the connective tissue.[5] The sarcoma
Permanent link
word sarcoma is derived from the Greek σάρκωμα Specialty Oncology
Page information
Cite this page sarkōma "fleshy excrescence or substance", itself
from σάρξ sarx meaning "flesh". [6][7][8]
Wikidata item

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Printable version 1.1 Subtypes of bone sarcoma
1.2 Subtypes of soft tissue sarcoma
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2 Signs and symptoms
Wikimedia Commons 3 Cause
3.1 Causes and risk factors
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4 Mechanisms
Dansk 5 Diagnosis
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5.1 Bone sarcomas
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5.2 Soft tissue sarcomas
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5.3 Staging
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5.4 Grade
Nederlands 6 Screening
Русский 7 Treatment
Türkçe 8 Prognosis

34 more 8.1 Factors that affect prognosis

8.2 Outcome data
Edit links
9 Epidemiology
 10 In fossils
11 Research
12 Awareness
13 References
14 External links

Classification ​[ edit ]

Sarcomas are typically divided into two major groups: bone sarcomas and soft-tissue sarcomas ,[2] each of
which has multiple subtypes. In the United States, the American Joint Committee on Cancer (AJCC) publishes
guidelines that classify the subtypes of sarcoma.[4] These subtypes are as follows:

Subtypes of bone sarcoma ​[ edit ]

Osteosarcoma
Chondrosarcoma
Poorly differentiated round/spindle cell tumors (includes Ewing sarcoma)
Hemangioendothelioma
Angiosarcoma
Fibrosarcoma /myofibrosarcoma
Chordoma
Adamantinoma
Other:
Liposarcoma
Leiomyosarcoma
Malignant peripheral nerve sheath tumor
Rhabdomyosarcoma
Synovial sarcoma
Malignant solitary fibrous tumor. [4]

Subtypes of soft tissue sarcoma ​[ edit ]

Liposarcoma (includes the following varieties: well-differentiated, not otherwise specified, de-
differentiated, myxoid/round cell, and pleomorphic)
Atypical lipomatous tumor
Dermatofibrosarcoma protuberans (includes fibrosarcomatous and pigmented varieties)
Malignant solitary fibrous tumor
Inflammatory myofibroblastic tumor
Low-grade myofibroblastic sarcoma
Fibrosarcoma (includes adult and sclerosing epithelioid varieties)
Myxofibrosarcoma (formerly myxoid malignant fibrous histiocytoma)
Low-grade fibromyxoid sarcoma
Giant cell tumor of soft tissues
Leiomyosarcoma
Malignant glomus tumor
Rhabdomyosarcoma (includes the following varieties: embryonal, alveolar, pleomorphic, and spindle
cell/sclerosing)
 Hemangioendothelioma (includes the following varieties: retiform, pseudomyogenic, and epithelioid)
Angiosarcoma of soft tissue
Extraskeletal osteosarcoma
Gastrointestinal stromal tumor , malignant (GIST)
Malignant peripheral nerve sheath tumor (includes epithelioid variety)
Malignant Triton tumor
Malignant granular cell tumor
Malignant ossifying fibromyxoid tumor
Stromal sarcoma not otherwise specified
Myoepithelial carcinoma
Malignant phosphaturic mesenchymal tumor
Synovial sarcoma (includes the following varieties: spindle cell, biphasic, and not otherwise specified)
Epithelioid sarcoma
Alveolar soft part sarcoma
Clear cell sarcoma of soft tissue
Extraskeletal myxoid chondrosarcoma
Extraskeletal Ewing sarcoma
Desmoplastic small round cell tumor
Extrarenal rhabdoid tumor
Perivascular epithelioid cell tumor , not otherwise specified
Intimal sarcoma
Undifferentiated spindle cell sarcoma
Undifferentiated pleomorphic sarcoma
Undifferentiated round cell sarcoma
Undifferentiated epithelioid sarcoma
Undifferentiated sarcoma, not otherwise specified. [4]

Signs and symptoms ​[ edit ]

Symptoms of bone sarcomas typically include bone pain, especially at night, and swelling around the site of
the tumor.[2]

Symptoms of soft-tissue sarcomas vary, but they often present as firm, painless lumps or nodules.[2]
Gastrointestinal stromal tumors (a subtype of soft tissue sarcoma) often are asymptomatic, but can be
associated with vague complaints of abdominal pain, a feeling of fullness, or other signs of intestinal
obstruction.[2]

Cause ​[ edit ]

Causes and risk factors ​[ edit ]

The cause of most bone sarcomas is not known, [3] but several factors are associated with an increased risk
of developing bone sarcoma. Previous exposure to ionizing radiation (such as prior radiation therapy) is one
such risk factor.[2] Exposure to alkylating agents, such as those found in certain cancer chemotherapeutic
medicines, also increases the risk of bone sarcoma. [3] Certain inherited genetic syndromes, including Li-
Fraumeni syndrome, heritable RB1 gene mutations, and Paget's disease of bone , are associated with an
increased risk of developing bone sarcomas.[2]
Most soft tissue sarcomas arise from what doctors call "sporadic" (or random) genetic mutations within
an affected person's cells.[3] Nevertheless, there are certain risk factors associated with an increased risk of
developing soft tissue sarcoma. Previous exposure to ionizing radiation is one such risk factor. [2] Exposure to
vinyl chloride (e.g., such as the fumes encountered in the production of Polyvinyl chloride (PVC)), Arsenic
and Thorotrast all are associated with an increased risk of angiosarcoma.[2][3] Lymphedema, such as that
resulting from certain types of breast cancer treatment, also is a risk factor for development of
angiosarcoma.[3] As with bone sarcomas, certain inherited genetic syndromes also are associated with an
increased risk of developing soft tissue sarcoma, including Li-Fraumeni syndrome , familial adenomatous
polyposis, neurofibromatosis type 1 , and heritable RB1 gene mutations.[3] Kaposi's sarcoma is caused by
Kaposi's sarcoma-associated herpesvirus (HHV-8).

Mechanisms ​[ edit ]

The mechanisms by which healthy cells transform into cancer cells are described in detail elsewhere (see
Cancer main page; Carcinogenesis main page). The precise molecular changes that result in sarcoma are
not always known, but certain types of sarcomas are associated with particular genetic mutations.[2][3]
Examples include:

Most cases of Ewing sarcoma are associated with a chromosomal translocation in which part of
chromosome 11 fuses with part of chromosome 22 .[2] This results in the EWS gene becoming fused to
other genes, including the FLI1 gene in 90% of Ewing cases and ERG gene in 5-10% of cases. [2] These
fusions result in the production of abnormal proteins, although how these abnormal proteins result in
cancer is not fully known.[2]
Dermatofibrosarcoma protuberans often is associated with a chromosomal translocation in which the
COL1A1 gene becomes fused to the PDGFRB gene .[3] This results in over-active PDGF signaling, which
is thought to promote cell division and ultimately lead to tumor development.[3]
Inflammatory myofibroblastic tumor often is associated with rearrangements of the ALK gene , and
occasionally with rearrangements of the HMGA2 gene .[3]
Giant cell tumor of soft tissue frequently is associated with a chromosomal translocation between
chromosome 1 and chromosome 2 , in which the CSF1 gene becomes fused with the COL6A3 gene .[3] This
results in increased CSF1 protein production, which is thought to play a role in cancer development.[3]
Many liposarcomas are associated with duplication of part of chromosome 12, which results in extra
copies of known cancer-promoting genes ("oncogenes ") such as the CDK4 gene , the MDM2 gene and
the HMGA2 gene .[3]

Diagnosis ​[ edit ]

Bone sarcomas ​[ edit ]

Diagnosis of bone sarcomas begins with a thorough history and physical examination which may reveal
characteristic signs and symptoms (see Signs and Symptoms above).[3] Laboratory studies are not particularly
useful in diagnosis, although some bone sarcomas (such as osteosarcoma) may be associated with elevated
alkaline phosphatase levels, while others (such as Ewing Sarcoma) can be associated with elevated erythrocyte
sedimentation rate.[9] Importantly, however, none of these laboratory findings are specific to bone sarcomas,
meaning that elevations in these lab values are associated with many other conditions as well as sarcoma, and
thus cannot be relied upon to conclusively diagnose sarcoma.[3] Imaging studies are critically important in
diagnosis, and most clinicians will order a plain radiograph (X-ray) initially. [3] Other imaging studies
commonly used in diagnosis include magnetic resonance imaging (MRI) studies and radioisotope bone
[9][3]
scans. Computed tomography (CT) imaging typically is not used in diagnosis of most types of bone
sarcoma, although it is an important tool for staging (see below).[3] Definitive diagnosis requires biopsy of the
tumor and careful review of the biopsy specimen by an experienced pathologist.[3]

Soft tissue sarcomas ​[ edit ]

Main article: Soft-tissue sarcoma

Diagnosis of soft-tissue sarcomas also begins with a thorough history and physical examination.[3] Imaging
studies can include either CT or MRI, although CT tends to be preferred for soft tissue sarcomas located in the
thorax , abdomen , or retroperitoneum .[3] Positron emission tomography (PET) also may be useful in
diagnosis, although its most common use is for staging (see below).[3] As with bone sarcomas, definitive
diagnosis requires biopsy of the tumor with evaluation of histology by a trained pathologist.[3][10]

Staging ​[ edit ]

In general, cancer staging refers to how advanced a cancer is, and usually it is based upon factors such as
tumor size and whether it has spread to other parts of the body.[3][11] Staging is important because the stage
affects the prognosis (likely outcome), as well as the types of treatments that are likely to be effective against
the cancer.[2][4] With sarcomas, staging requires a determination of whether the tumor has grown into
surrounding tissues ("local invasion"), as well as imaging to determine whether it has spread (a process known
as "metastasis ") to lymph nodes (forming "nodal metastases") or to other tissues or organs in the body
(forming "distant metastases").[4]

The most common imaging tools used for staging bone sarcomas are MRI or CT to evaluate the primary
tumor, contrast-enhanced CT of the chest to evaluate whether the cancer has spread (i.e., metastasized) to the
lungs, and radioisotope bone scan to evaluate whether the cancer has spread to other bones.[4] Staging for soft
tissue sarcomas typically includes imaging of the primary tumor by MRI or CT to determine tumor size, as
well as contrast-enhanced CT of the chest to evaluate for metastatic tumors in the lungs.[4]

Grade ​[ edit ]

Like some other cancers, sarcomas are assigned a grade (low, intermediate, or high) based on the appearance
of the tumor cells under a microscope.[12] In general, grade refers to how aggressive the cancer is and how
likely it is to spread to other parts of the body ("metastasize").[12] Low-grade sarcomas have a better prognosis
than higher-grade sarcomas, and are usually treated surgically, although sometimes radiation therapy or
chemotherapy are used.[3][4] Intermediate- and high-grade sarcomas are more frequently treated with a
combination of surgery, chemotherapy, or radiation therapy.[13] Since high-grade tumors are more likely to
undergo metastasis (invasion and spread to locoregional and distant sites), they are treated more aggressively.
The recognition that many sarcomas are sensitive to chemotherapy has dramatically improved the survival of
patients. For example, in the era before chemotherapy, long-term survival for pediatric patients with localized
osteosarcoma was only about 20%, but now has risen to 60–70%.[14]

Screening ​[ edit ]

In the US, the US Preventive Services Task Force (USPSTF) publishes guidelines recommending preventive
screening for certain types of common cancers and other diseases.[15] As of March 2019, the USPSTF does
not recommend screening for sarcoma,[15] possibly because it is a very rare type of cancer (see Epidemiology
below).

The American Cancer Society (ACS) also publishes guidelines recommending preventive screening for certain
types of common cancers.[16] Like the USPSTF, as of March 2019 ACS does not recommend preventive
screening for sarcoma.[16]

Treatment ​[ edit ]

Surgery is the most common form of the treatment for most sarcomas that have not spread to other parts of
the body.[3][17] Limb-sparing surgery , as opposed to amputation, can now be used to save the limbs of patients
in at least 90% of extremity (arm or leg) sarcoma cases.[17] Additional treatments, including chemotherapy ,
radiation therapy (also called "radiotherapy") and proton therapy , may be administered before surgery (called
"neoadjuvant " chemotherapy or radiotherapy) or after surgery (called "adjuvant " chemotherapy or
radiotherapy).[3][13] The use of neoadjuvant or adjuvant chemotherapy and radiotherapy significantly improves
the prognosis for many sarcoma patients.[3][18] Treatment can be a long and arduous process, lasting about a
year for many patients.[13]

Liposarcoma treatment consists of surgical resection, with chemotherapy not being used outside of the
investigative setting. Adjuvant radiotherapy may also be used after surgical excision for liposarcoma.[19]
Rhabdomyosarcoma is treated with surgery, radiotherapy, or chemotherapy.[20] The majority of
rhabdomyosarcoma patients have a 50–85% survival rate.[21]
Osteosarcoma is a tumor of the bone that is treated with surgical resection of as much of the cancer as
possible, often along with neoadjuvant chemotherapy .[22] Radiotherapy is a second alternative although
not as successful.

Expression of receptor B7-H3 provides a promising target for new immunotherapeutic strategies.

In childhood sarcomas, the cytotoxic agent cyclophosphamide is widely used and has shown good anti-
tumour efficacy.[23]

It is believed that higher doses of chemotherapy might improve survival. However, high doses of
chemotherapy stop the production of blood cells in the bone marrow and can be harmful. Stem cells collected
from people before high‐dose chemotherapy can be transplanted back to the person if the blood cell count gets
too low; this is called autologous hematopoietic stem cell transplantation. Research to investigate if using
high‐dose chemotherapy followed by autologous hematopoietic stem cell transplantation was more favourable
then standard‐dose chemotherapy [24]found only one RCT and this did not favour either of the two treatment
arms with respect to overall survival. Further evidence is needed through well‐designed clinical trials.

Prognosis ​[ edit ]

Factors that affect prognosis ​[ edit ]

The AJCC has identified several factors that affect prognosis of bone sarcomas:[4]

Size of the tumor: larger tumors tend to have a worse prognosis compared to smaller tumors.
Spread of tumor to surrounding tissues: tumors that have spread locally to surrounding tissues
tend to have a worse prognosis compared to tumors that have not spread beyond their place of origin.
Stage and presence of metastases: tumors that have spread ("metastasized") to the lymph nodes
(which is rare for bone sarcomas) or other organs or tissues (for example, to the lungs) have a worse
prognosis compared to tumors that have not metastasized.
Tumor grade: higher grade tumors (grades 2 and 3) tend to have a worse prognosis compared to low
grade (grade 1) tumors.
Skeletal location: tumors originating in the spine or pelvic bones tend to have a worse prognosis
compared to tumors originating in arm or leg bones.

For soft tissue sarcomas other than GISTs, factors that affect prognosis include:[4]
 Stage: as with bone sarcomas, tumors that have metastasized have a worse prognosis compared to tumors
that have not metastasized.
Grade: the AJCC recommends using a grading system called the French Federation of Cancer Centers
Sarcoma Group (FNCLCC) Grade for soft tissue sarcomas, with high-grade tumors having a worse
prognosis compared to low-grade tumors.

For GISTs, the key factor that affects prognosis is: [4]

Mitotic rate: mitotic rate refers to the fraction of cells that are actively dividing within the tumor; GISTs
that have a high mitotic rate have a worse prognosis compared to GISTs that have a low mitotic rate.

Outcome data ​[ edit ]

According to data published by the US National Cancer Institute (NCI), the overall 5-year survival for bone
sarcomas is 66.9%. [25] The American Cancer Society (ACS) estimates that 1,660 people in the US will die
in 2019 from bone sarcomas, accounting for 0.3% of all cancer deaths.[26] The median age at death is 61
years old, although death can occur in any age group.[25] Thus, 12.3% of bone sarcoma deaths occur in people
under 20 years old, 13.8% occur in people 20–34 years old, 5.5% occur in people 35–44 years old, 9.3% occur
in people 45–54 years old, 13.5% occur in people 55–64 years old, 16.2% occur in people 65–74 years old,
16.4% occur in people 75–84 years old, and 13.1% occur in people 85 years or older.[25]

For soft tissue sarcomas, the overall 5-year survival (irrespective of stage) is 64.5%, but survival is
affected by many factors, including stage.[27] Thus, the 5-year survival is 80.8% for soft tissue sarcomas that
have not spread beyond the primary tumor ("localized" tumors), 58.0% for soft tissue sarcomas that have
spread only to nearby lymph nodes, and 16.4% for soft tissue sarcomas that have spread to distant organs.[27]
The ACS estimates that 5,270 people will die from soft tissue sarcoma in 2019, accounting for 0.9% of all
cancer deaths.[26]

Epidemiology ​[ edit ]

Sarcomas are quite rare. [2] The risk of a previously healthy person receiving a new diagnosis of bone cancer is
less than 0.001%, while the risk of receiving a new diagnosis of soft tissue sarcoma is between 0.0014-
0.005%.[3] The American Cancer Society estimates that in the United States there will be 3,500 new cases of
bone sarcoma in 2019, and 12,750 new cases of soft tissue sarcoma.[26] Considering that the total estimated
number of new cancer diagnoses (all types of cancer) is 1,762,450, this means bone sarcomas represent only
0.2% of all new cancer diagnoses (making them the 30th most common type of cancer[25]) and soft tissue
sarcomas represent only 0.7% (making them the 22nd most common type of cancer[27]) of all new cancer
diagnoses in the US in 2019.[26] These estimates are similar to previously reported data.[3]

Sarcomas affect people of all ages. Around 50% of bone sarcomas and 20% of soft-tissue sarcomas are
diagnosed in people under the age of 35.[28] Some sarcomas, such as leiomyosarcoma , chondrosarcoma ,
and gastrointestinal stromal tumor (GIST), are more common in adults than in children.[2] Most high-grade
bone sarcomas, including Ewing's sarcoma and osteosarcoma , are much more common in children and
young adults.[2]

In fossils ​[ edit ]

In 2016, scientists reported the discovery of an osteosarcoma tumor in a 1.6-1.8 million-year-old fossil from
the skeleton of now-extinct hominin species, making it the earliest-known case of human cancer.[29]

Research ​[ edit ]
Treatment of sarcoma, especially when the sarcoma has spread, or "metastasized", often requires
chemotherapy but existing chemotherapeutic medicines are associated with significant toxicities and are not
highly effective in killing cancer cells.[3] Therefore, research to identify new medications to treat sarcoma is
being conducted as of 2019.[3] One possibility is the use of cancer immunotherapy (e.g., immune checkpoint
inhibitors like anti-PD1, anti-PDL1, and anti-CTLA4 agents) to treat sarcomas.[30] This is not yet an
established treatment tool.[30] Other strategies, such as small-molecule targeted therapy , biologic agents (e.g.,
small interfering RNA molecules), and nanoparticle-directed therapy, also are being investigated.[3]

Research to understand the specific genetic and molecular factors that cause sarcoma to develop is
underway.[3] This could allow for the design of new targeted therapies and allow physicians to more
accurately predict a patient's prognosis.[3]

Presence of the H3-B3 immunoregulatory checkpoint receptor in the tumor cells provides the opportunity for
clinical trial testing of new drugs and targeted agents and immunotherapies in development.

Awareness ​[ edit ]

In the US, July is widely recognized as Sarcoma Awareness Month.[31] The UK has a Sarcoma Awareness
Week in July led by Sarcoma UK , the bone and soft-tissue cancer charity. [32]

References ​[ edit ]

1. ^ Yang J, Ren Z, Du X, Hao M, Zhou W (27 October 2014). "The role of mesenchymal
stem/progenitor cells in sarcoma: update and dispute" . Stem Cell Investigation. 1: 18.
doi:10.3978/j.issn.2306-9759.2014.10.01 . PMC 4923508 . PMID 27358864 .
2. ^ a b c d e f g h i j k l m n o p q r s Tobias J (2015). Cancer and its Management, Seventh Edition.
Chichester, West Sussex, PO198SQ, UK: John Wiley & Sons, Ltd. p. 446. ISBN 9781118468753.
3. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai aj DeVita Jr V (2015). DeVita,
Hellman and Rosenberg's Cancer: Principles & Practice of Oncology (10th ed.). Philadelphia, PA
19103, USA: Wolters Kluwer Health. pp. 1241–1313. ISBN 978-1-4511-9294-0.
4. ^ a b c d e f g h i j k l Amin MB (2017). AJCC Cancer Staging Manual, Eight Edition. Chicago, IL
60611, USA: Springer International Publishing AG Switzerland. pp. 471–548. ISBN 978-3-319-
40617-6.
5. ^ "Metastatic Cancer" . National Cancer Institute. 12 May 2015. Retrieved 22 March 2019.
6. ^ σάρκωμα , σάρξ . Liddell, Henry George; Scott, Robert; A Greek–English Lexicon at the
Perseus Project.
7. ^ "Definition of SARCOMA" . www.merriam-webster.com. Retrieved 22 March 2019.
8. ^ Harper, Douglas. "sarcoma" . Online Etymology Dictionary.
9. ^ a b Unni KK (2010). Dahlin's Bone Tumors. Philadelphia, PA 19106: Lippincott Williams & Wilkins.
pp. 1–8. ISBN 978-0-7817-6242-7.
10. ^ Rastogi S, Aggarwal A, Shishak S, Barwad A, Dhamija E, Pandey R, et al. (9 August 2019).
"Discordance of Histo-pathological Diagnosis of Patients with Soft Tissue Sarcoma Referred to
Tertiary Care Center" . Asian Pacific Journal of Cancer Care. 4 (4): 119–123.
doi:10.31557/apjcc.2019.4.4.119-123 .
11. ^ "Staging" . National Cancer Institute. 9 March 2015. Retrieved 21 March 2019.
12. ^ a b "Tumor Grade" . National Cancer Institute. 9 May 2013. Retrieved 21 March 2019.
13. ^ abc Buecker P (2005). "Sarcoma: A Diagnosis of Patience" . ESUN. 2 (5). Retrieved 15 April
2009.
14. ^ Longhi A, Errani C, De Paolis M, Mercuri M, Bacci G (October 2006). "Primary bone osteosarcoma
in the pediatric age: state of the art". Cancer Treatment Reviews. 32 (6): 423–36.
doi:10.1016/j.ctrv.2006.05.005 . PMID 16860938 .
 15. ^ a b "Published Recommendations - US Preventive Services Task Force" .
www.uspreventiveservicestaskforce.org. Retrieved 20 March 2019.
16. ^ a b "Cancer Screening Guidelines | Detecting Cancer Early" . www.cancer.org. Retrieved
20 March 2019.
17. ^ a b Morris C (2005). "Malignant Fibrous Histiocytoma (MFH)" . ESUN. 2 (2). Retrieved 19 October
2011.
18. ^ Baker L (2006). "A Rose is a Rose or a Thorn is a Thorn" . ESUN. 3 (5). Retrieved 19 October
2011.
19. ^ Liposarcoma Treatment & Management~treatment at eMedicine
20. ^ "Rhabdomyosarcoma" . Boston Children's Hospital.
21. ^ Wexler L (2004). "Rhabdomyosarcoma" . ESUN. 1 (4). Retrieved 19 October 2011.
22. ^ Osteosarcoma Treatment & Management~treatment at eMedicine
23. ^ Mulder RL, Paulides M, Langer T, Kremer LC, van Dalen EC (September 2015).
"Cyclophosphamide versus ifosfamide for paediatric and young adult bone and soft tissue sarcoma
patients" . The Cochrane Database of Systematic Reviews (9): CD006300.
doi:10.1002/14651858.cd006300.pub4 . PMC 7389335 . PMID 26421585 .
24. ^ Peinemann F, Enk H, Smith LA (April 2017). "Autologous hematopoietic stem cell transplantation
following high-dose chemotherapy for nonrhabdomyosarcoma soft tissue sarcomas" . The
Cochrane Database of Systematic Reviews. 4: CD008216. doi:10.1002/14651858.cd008216.pub5 .
PMC 6478255 . PMID 28407197 .
25. ^ a b c d "Bone and Joint Cancer - Cancer Stat Facts" . SEER. Retrieved 27 March 2019.
abcd
26. ^ Siegel RL, Miller KD, Jemal A (January 2019). "Cancer statistics, 2019" . Ca. 69 (1): 7–34.
doi:10.3322/caac.21551 . PMID 30620402 .
27. ^ a b c "Soft Tissue Cancer - Cancer Stat Facts" . SEER. Retrieved 27 March 2019.
28. ^ Darling J (2007). "A Different View of Sarcoma Statistics" . ESUN. 4 (6). Retrieved 6 October
2012.
29. ^ AJ Willingham. "Scientists find cancer in million-year-old fossil" . CNN. Retrieved 27 March 2019.
30. ^ a b Thanindratarn P, Dean DC, Nelson SD, Hornicek FJ, Duan Z (April 2019). "Advances in immune
checkpoint inhibitors for bone sarcoma therapy" . Journal of Bone Oncology. 15: 100221.
doi:10.1016/j.jbo.2019.100221 . PMC 6365405 . PMID 30775238 .
31. ^ "Cancer Awareness Dates" . American Society of Clinical Oncology. 19 December 2013.
32. ^ "Sarcoma Awareness Week 2018" . Sarcoma UK. 25 January 2016. Retrieved 13 April 2018.

External links ​[ edit ]

Bone sarcoma at the National Cancer Institute

What is Sarcoma?
Sarcoma Help from the Liddy Shriver Sarcoma Initiative

Classification ICD-O: M8800/3 · MeSH: D012509 · SNOMED CT: 424413001 D

v·t·e Connective/soft tissue tumors and sarcomas [show]

v·t·e Tumours of bone and cartilage [show]

v·t·e Tumours of blood vessels [show]

BNE: XX526877 · BNF: cb11982790q (data) · GND: 4179127-7 ·

Authority control
LCCN: sh85117504

Categories : Sarcoma Anatomical pathology Soft tissue disorders

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