H.M. Pinedo – författare

Where do you begin to look for a recent, authoritative article on the diagnosis or management of a particular malignancy? The few general oncology textbooks are generally out of date. Single papers in specialized journals are informative, but seldom comprehensive; these are more often preliminary reports on a very limited number of patients. Certain general journals frequently publish good in-depth reviews of cancer topics, and published symposium lectures are often the best overviews available. Unfor­ tunately, these reviews and supplements appear sporadically, and the reader can never be sure when a topic of special interest will be covered. Cancer Treatment and Research is a series of authoritative volumes that aim to meet this need. It is an attempt to establish a critical mass of oncology literature covering virtually all oncology topics, which is revised frequently to keep the coverage up to date, and which is easily available on a single library shelf or by a single personal subscription. We have approached the problem in the following fashion: first, by dividing the oncology literature into specific subdivisions, such as lung can­ cer, genitourinary cancer, pediatric oncology, etc.; and second, by asking eminent authorities in each of these areas to edit a volume on the specific topic on an annual or biannual basis. Each topic and tumor type is covered in a volume appearing frequently and predictably, discussing current diag­ nosis, staging, markers, all forms of treatment modalities, basic biology, and more.

The purpose of this book is to contribute to the further development of the multidisciplinary approach to the treatment of soft tissue sarcomas. A proper diagnosis and staging remains the cornerstone of the treatment strategy. Sophisticated histopathology techniques and growing consensus on grading systems have further increased the importance of the histopathologist in providing estimates of the prognosis of the patient as well as providing data for the planning of treatment strategy. The use of cytogenetics is relatively new in this field. This might enable distinction of subgroups in specific histological tumor types. Further to this, molecular biological studies not only help to reveal inherited predispositions and details in oncogenesis in tumour development, but they may also provide additional predictive factors for tumour behaviour. Further data for the treatment strategy will be provided by diagnostic imaging, in which field the role of magnetic resonance imaging is rapidly developing.

This updated volume on soft-tissue sarcomas highlights the importance of the multidisciplinary approach to treatment. Chapters relating to diagnosis include information on proper diagnosis and treatment strategy, histopathology, cytogenetics and PET imaging. Chapters focusing on treatment include planning radiotherapy, brachytherapy, and treatment of benign soft tissue lesions with radio-therapy. The book also covers secondary soft tissue sarcomas and how the functional outcome of the treatment is dependent on the skills of the surgeon, the vicinity of joints and the expertise of the centre This volume also includes information on metastatic disease, chemotherapy, clinical behaviour, treatment strategy and the outcome of treatment in childhood soft tissue sarcomas.

One of the major advances of the last decade concerning the treatment of patients with soft tissue sarcomas is that an increased number of patients are being discussed in multidisciplinary teams prior to the initial treatment. The present volume on soft tissue sarcomas in the series Cancer Treatment and Research reflects the multidisciplinary approach with a focus on recent developments. The availability of new histopathologic techniques has reduced the number of unclassified sarcomas and has furhter increased the importance of the histo­ pathologist in providing estimates of the prognosis of the patient as well as data for the planning of treatment strategy. Further data for this strategy will be provided by diagnostic imaging. In this field, the role of magnetic reson­ ance imaging has been further defined. Of utmost importance is the recent trend toward consensus in staging. The modification of the staging system of the American Joint Commission for Cancer Staging and End Results Report­ ing brings the possibility of a single staging system within reach in the next decade. As surgery still provides the only chance for cure, the importance of being the most sparing as possible is obvious. For this reason, radiotherapy has been applied with success. The introduction of relatively new radiation tech­ niques is therefore being observed with interest.

Although soft tissue sarcomas are rare tumors, representing only ± 1 % of all malignant tumors in adults, they remain a challenge to all disciplines in medical treatment and research. Apart from research in all fields of treatment, soft tissue sarcomas are also encountered in several forms of combined modality treatment. Since the appearance of the first volume on soft tissue sarcomas in this series (Soft Tissue Sarcomas, Laurence H. Baker, ed., Martinus Nijhoff Publishers, 1983), a large amount of data has emerged from preclinical as well as clinical in­ vestigations. The present volume provides an up-to-date review of the state of the art without duplicating the contents of the earlier volume. In the chapter on pathology it is again indicated that malignant fibrocytic hys­ tiocytoma is at present the most frequently diagnosed type of soft tissue sarcoma. Nevertheless, sub-typing is less important for the prognosis than grade. Recently, grading has been defined better, permitting a more common use of this prognostic factor. However, the experience of the pathologist is most important for adequate grading. The pathologist will need an adequate biopsy to perform his investiga­ tions. Cytology is not sufficient for diagnosis. However, for confirmation of metastatic lesions, cytology may provide enough information. Some new tools have been added to the equipment of the pathologist.

Recent achievements in the development of new techniques and agents for the treatment of cancer in general as well as for soft tissue sarcomas are tremendous. Molecular biology research has changed the landscape considerably and an increasing number of subtypes of soft tissue sarcomas are related to changes in cellular growth factors in the cell signaling pathways. This enables the development of targeted agents with specific activity against these factors. The presence of the KIT receptor at the surface of the gastrointestinal stroma tumor cell, and the activation constituted by mutations has led to the discovery of an extremely active specific KIT tyrosine kinase inhibitor. In accordance with the more targeted approach in drug use, the changes in the field of radiation therapy and surgery basically focus on a better targeting of the disease, albeit not yet based on the molecular characteristics. All of these stress the importance of the multidisciplinary approach to the treatment of soft tissue sarcoma that was the focus of previous editions of this book.Targeting Treatment of Soft Tissue Sarcomas summarizes the recent events in this field, putting the achievements in perspective. Physicians and researchers working in the field of soft tissue sarcomas must be aware of the changes in treatment, the underlying concepts, and of the changes we face in the future.

One of the major advances of the last decade concerning the treatment of patients with soft tissue sarcomas is that an increased number of patients are being discussed in multidisciplinary teams prior to the initial treatment. The present volume on soft tissue sarcomas in the series Cancer Treatment and Research reflects the multidisciplinary approach with a focus on recent developments. The availability of new histopathologic techniques has reduced the number of unclassified sarcomas and has furhter increased the importance of the histo­ pathologist in providing estimates of the prognosis of the patient as well as data for the planning of treatment strategy. Further data for this strategy will be provided by diagnostic imaging. In this field, the role of magnetic reson­ ance imaging has been further defined. Of utmost importance is the recent trend toward consensus in staging. The modification of the staging system of the American Joint Commission for Cancer Staging and End Results Report­ ing brings the possibility of a single staging system within reach in the next decade. As surgery still provides the only chance for cure, the importance of being the most sparing as possible is obvious. For this reason, radiotherapy has been applied with success. The introduction of relatively new radiation tech­ niques is therefore being observed with interest.

Although soft tissue sarcomas are rare tumors, representing only ± 1 % of all malignant tumors in adults, they remain a challenge to all disciplines in medical treatment and research. Apart from research in all fields of treatment, soft tissue sarcomas are also encountered in several forms of combined modality treatment. Since the appearance of the first volume on soft tissue sarcomas in this series (Soft Tissue Sarcomas, Laurence H. Baker, ed., Martinus Nijhoff Publishers, 1983), a large amount of data has emerged from preclinical as well as clinical in­ vestigations. The present volume provides an up-to-date review of the state of the art without duplicating the contents of the earlier volume. In the chapter on pathology it is again indicated that malignant fibrocytic hys­ tiocytoma is at present the most frequently diagnosed type of soft tissue sarcoma. Nevertheless, sub-typing is less important for the prognosis than grade. Recently, grading has been defined better, permitting a more common use of this prognostic factor. However, the experience of the pathologist is most important for adequate grading. The pathologist will need an adequate biopsy to perform his investiga­ tions. Cytology is not sufficient for diagnosis. However, for confirmation of metastatic lesions, cytology may provide enough information. Some new tools have been added to the equipment of the pathologist.

The previous volume of this series on soft tissue sarcomas highlighted the importance of the multidisciplinary approach to treatment, the focus of which is continued in the present edition. Proper diagnosis and staging remain the cornerstone of the treatment strategy. Sophisticated histopathology techniques and growing consensus on grading systems have further increased the importance of the histopathologist in providing estimates of the prognosis of the patient as well as providing data for the planning of treatment strategy. The use of cytogenetics is relatively new in this field. This might enable the distinction of subgroups in specific histological tumor types. Furthermore, molecular biological studies not only help to reveal inherited predispositions and details in oncogenesis in tumor development, but they may also provide additional predictive factors for tumor behavior. Further data on treatment strategy will be provided by diagnostic imaging, a field in which the role of magnetic resonance imaging is rapidly developing. As far as actual treatment is concerned, surgery still provides the major chance for cure. In view of the endeavor to be as sparing as possible, the addition of radiotherapy to surgery is of utmost importance. Usually radiotherapy is given after surgery, but the optimal sequence of the two modalities still needs to be defined. The combined use of surgery with radiotherapy and/or chemotherapy does have an impact on wound healing.

Where do you begin to look for a recent, authoritative article on the diagnosis or management of a particular malignancy? The few general oncology textbooks are generally out of date. Single papers in specialized journals are informative, but seldom comprehensive; these are more often preliminary reports on a very limited number of patients. Certain general journals frequently publish good in-depth reviews of cancer topics, and published symposium lectures are often the best overviews available. Unfor­ tunately, these reviews and supplements appear sporadically, and the reader can never be sure when a topic of special interest will be covered. Cancer Treatment and Research is a series of authoritative volumes that aim to meet this need. It is an attempt to establish a critical mass of oncology literature covering virtually all oncology topics, which is revised frequently to keep the coverage up to date, and which is easily available on a single library shelf or by a single personal subscription. We have approached the problem in the following fashion: first, by dividing the oncology literature into specific subdivisions, such as lung can­ cer, genitourinary cancer, pediatric oncology, etc.; and second, by asking eminent authorities in each of these areas to edit a volume on the specific topic on an annual or biannual basis. Each topic and tumor type is covered in a volume appearing frequently and predictably, discussing current diag­ nosis, staging, markers, all forms of treatment modalities, basic biology, and more.

The previous volumes in this series on soft tissue sarcomas highlighted the importance of the multidisciplinary approach to treatment, and this focus is continued in the present volume. Proper diagnosis and staging remain the cornerstone of the treatment strategy. Sophisticated histopathology tech­ niques and growing consensus on grading systems have further increased the importance of the histopathologist in providing estimates of patient prognosis as well as in providing data for planning the treatment strategy. The use of cytogenetics in this field is rapidly increasing and might enable the distinction of subgroups in specific histological tumor types. Furthermore, molecular biological studies not only help reveal inherited predispositions and details in tumor oncogenesis, but they may also provide additional predictive factors for tumor behavior. Further data on treatment strategy will be provided by diag­ nostic imaging, and in this volume the value of PET imaging, a relatively new achievement, is highlighted. As far as the actual treatment is concerned, surgery still provides the major opportunity for cure. The addition of radiotherapy to surgery is of utmost importance in efforts to spare as much tissue as possible. The chapters on the planning of radiotherapy, brachytherapy, and the treatment of benign soft tissue lesions using radiotherapy are new contributions to this book. One of the potential late problems of radiotherapy is the occurrence of secondary soft tissue sarcomas, which is discussed in Chapter 10.

Recent achievements in the development of new techniques and agents for the treatment of cancer in general as well as for soft tissue sarcomas are tremendous. Molecular biology research has changed the landscape considerably and an increasing number of subtypes of soft tissue sarcomas are related to changes in cellular growth factors in the cell signaling pathways. This enables the development of targeted agents with specific activity against these factors. The presence of the KIT receptor at the surface of the gastrointestinal stroma tumor cell, and the activation constituted by mutations has led to the discovery of an extremely active specific KIT tyrosine kinase inhibitor.In accordance with the more targeted approach in drug use, the changes in the field of radiation therapy and surgery basically focus on a better targeting of the disease, albeit not yet based on the molecular characteristics. All of these stress the importance of the multidisciplinary approach to the treatment of soft tissue sarcoma that was the focus of previous editions of this book.Targeting Treatment of Soft Tissue Sarcomas summarizes the recent events in this field, putting the achievements in perspective. Physicians and researchers working in the field of soft tissue sarcomas must be aware of the changes in treatment, the underlying concepts, and of the changes we face in the future.