The Importance of the Multidisciplinary Approach to Surgical Treatment of Extremity Soft-Tissue Sarcomas

Soft tissue sarcomas (STS) are rare neoplasm with frequencies around 1% of all neoplasms. Although it consists of a high heterogeneous group of tumors, surgery is the mean treatment. The STS surgery is still challenging and complex procedure is usually required: this is because STS requires different types of resection and reconstruction due to various tissue-commitments (nerve, arteries, skin and muscle). So, a multidisciplinary team must be prepared for STS approach to obtain the maximum local control and a limited extremity functional impairment. We, here, showing our experience, wish to introduce some technical contrivances in STS surgery, with special reference to tissue reconstruction. This may illustrate the necessity of a multidisciplinary team approach in this surgery.

Analysis of PTEN Methylation Pattern by Pyrosequencing in Renal Cell Carcinoma

Objectives: We aimed to determine the frequency of PTEN (phosphatase with tensin homology deleted in chromosome 10) hypermethylation in renal cell carcinoma (RCC) and its impact on overall (OS) and disease-free survival (DFS). The association between PTEN hypermethylation and clinic and pathologic factors was also analyzed. Materials and Methods: The authors analyzed 137 patients who had undergone a radical or partial nephrectomy between 1997 and 2011. The methylation pattern was quantified individually at multiple CpG islands that are located on the exon 1 of PTEN gene by pyrosequencing. Results: Mean follow-up was 32.3 months. PTEN hypermethylation was detected with a low frequency (3.6%). There were no deaths or disease recurrence among patients with PTEN hypermethylation. Determining the association between PTEN hypermethylation and clinical and pathological factors was not possible due to the low frequency observed. Conclusion: The results show that the methylation of promoter CpG sites in PTEN is relatively infrequent in renal carcinogenesis and has no prognostic impact on survival.

Analysis of Sentinel Lymph Node Biopsy on Clear Cell Sarcoma Treatment

Clear Cell Sarcoma (CCS) is a rare soft tissue sarcoma that corresponds to a less than 1% of all sarcomas and is a high degree neoplasm with propensity to disseminate to regional lymph nodes. Regional lymphadenectomies have a controversial impact on sarcomas treatment and survival, even though those patients have higher local recurrence and lower survival. So, sentinel lymph node biopsy must be one option for better regional staging to STS with higher propensity to lymph node commitment. The authors demonstrate two cases of CCS submitted to surgery through compartmental resection associated with the sentinel lymph node biopsy. A literature review about soft tissue sarcoma and lymph node sentinel biopsy is shown as an initial experience of two cases.