Bone and soft tissue sarcomas, tumors of the skin

Introduction. In retroperitoneal sarcomas with invasion of the large или major vessels, large-scale multivisceral resections with vascular reconstruction is a technical necessity. Despite the successes of oncovascular surgery, aspects of planning and performance of such surgical interventions remain insufficiently studied.

Aim. Retrospective analysis and summary of our own experience of vascular reconstructions in retroperitoneal sarcomas.

Materials and methods. The study included 80 patients (median age 52.5 years, 65 % men, 35 % women) who underwent 88 surgical procedures due to primary (35 (39.8 %) cases) and recurrent (53 (30.2 %) cases) tumors. Preoperative planning was based on clinical examination, imaging and morphological verification data with subsequent multidisciplinary discussion. In 44.3 % of cases liposarcomas were diagnosed, in 22.7 % – leiomyosarcomas. Vascular invasion was classified in accordance with the M.H. Schwarzbach et al. (2006) classification. Type I invasion was observed in 15.9 % patients, type II – in 45.5 %, type III – in 39.6 %. Efficacy of preoperative planning, immediate and long-term oncological and vascular surgical results were evaluated.

Results. Preoperative diagnostic methods were characterized by high sensitivity but moderate specificity: 94.7 and 68.6 %, respectively (area under the curve (AUC) = 0.712 (95 % confidence interval 0.698–0.811). In 96.6 % of cases, vascular reconstructions were performed as a prosthetic replacement (57 cases), vascular patch plastic (16 cases) or vascular suture (12 cases), and in the arterial invasion group graft interposition was the most common (83.7 % cases). In surgeries on the target vessels, R0 resection was achieved. Radical resection (R0) on the margins of tumor lesion was confirmed in 79 (89.8 %) cases. During long-term observation period, specific vascular complications (thrombosis, occlusion) were reported in 10 (12.05 %) patients. Long-term results of treatment were followed-up in 69 (86.25 %) patients. Follow-up duration varied between 3 and 92 months (median 23 months). Local recurrence developed in 18.8 % of patients after R0 resection and in 85.7% after R1/R2 resection. Tumor progression was verified in 24 (39.3 %) patients.

Conclusion. Multivisceral resection with reconstruction of the major vessels in retroperitoneal sarcomas improve survival and decrease the rate of local recurrences. Planning and performance of such procedures require multidisciplinary approach. Despite encouraging results, some fundamental aspects of the problem remain unsolved and necessitate further investigation.

Synovial sarcoma is among the most aggressive soft-tissue sarcomas and carries a high risk of early metastasis. This review summarizes data from 2015–2025 on the role of the tumor microenvironment and microRNAs in shaping the metastatic potential in both children and adults with this pathology. Predominance of M2 macrophages, low CD8⁺ T-cell infiltration, and activation of the programmed cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1) and CD47–SIRPα axes create an immunosuppressive niche that promotes tumor dissemination. Deregulated microRNAs – including tissue, circulating, and exosomal species – enhance angiogenesis, drive epithelial-mesenchymal transition, and modulate immune responses. These factors underpin emerging prognostic models and therapeutic strategies, including immunotherapy and anti-miRNA interventions.

A surgical method is often used to treat a tumor lesion of the chest wall. Such procedures inevitably result in a defect that disrupts the skeletal framework and biomechanics of the thorax, leading to subsequent impairment of its organ function. Despite advancements in surgical techniques, including modern implants, the reconstruction of extensive chest wall defects, particularly in the aperture regions, remains a challenging task, regardless of etiology.

This article discusses the principal challenges associated with the reconstruction of defects in the superior and inferior thoracic apertures in the context of oncological pathology. We present clinical cases involving extensive resection of the thoracic framework in the region of the superior and inferior apertures, with simultaneous reconstruction using super-elastic mesh implants made of nickel-titanium alloy (nitinol).

Introduction. Synovial sarcoma (SS) is a rare and aggressive tumor of the soft tissues comprising about 4 % of all soft tissue sarcomas. While SS can develop at any age, mostly it occurs in teenagers and young adults. In children, SS develops relatively rarely but it is characterized by aggressive course and high metastasis rate which makes it a serious problem of pediatric oncology.

Aim. To compare results of 3 protocols of treatment of pediatric patients with SS (protocol of the L.A. Durnov Research Institute of Pediatric Oncology and Hematology of the N.N. Blokhin National Medical Research Center of Oncology, Children’s Oncology Group (COG) protocol, and CWS-2009 protocol).

Materials and methods. Results of treatment of children with SS of the soft tissues (n = 103) performed at the L.A. Durnov Research Institute of Pediatric Oncology and Hematology of the N.N. Blokhin National Medical Research Center of Oncology between 1999 and 2024 in accordance to the 3 protocols – of this Institute, COG and CWS-2009 – were analyzed.

Results. The best overall survival was achieved using the COG and CWS-2009 protocols with minimal differences for short polychemotherapy courses. For localized disease stage in patients receiving treatment per these protocols, 100 % overall survival was achieved. After radical surgical treatment, radiotherapy was unnecessary.

Conclusion. According to the obtained data, treatment of localized SS per the COG and CWS-2009 protocols leads to overall survival of 100 %. Improvement of 2-year overall survival in patients with disseminated SS when using the CWS-2009 protocol is likely associated with addition of metronomic therapy. To decrease hematological toxicity and to optimize polychemotherapy courses without increasing intervals between the courses, hemopoietic support at the consolidation stage can be used.

Osteosarcoma is the most common primary bone tumor in dogs. In 15–25 % of cases, it is localized in the axial skeleton. Vertebral damage is less common and accounts for less than 5 % of cases. This article describes the multimodal treatment of osteosarcoma of the fifth lumbar vertebra in a 7-year-old dog. Diagnostic workup included computed tomography, magnetic resonance imaging, and open biopsy. Treatment consisted of preoperative chemotherapy with carboplatin, cytoreductive surgery using a custom-made porous titanium plate, followed by radiotherapy, chemotherapy (carboplatin, doxorubicin, docetaxel), and targeted therapy (dasatinib, toceranib, bevacizumab). The dog maintained a satisfactory quality of life for 311 days, with an overall survival of 400 days. This case demonstrates the high effectiveness of a multidisciplinary approach in managing vertebral osteosarcoma in dogs.

Solitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin comprising less than 2 % of all soft tissue tumors. SFT was first described in 1931 by J.H. Kerry who found it in the pleura. Then this tumor was found in various anatomical areas including soft tissues. Considering the absence of standardized methods of treatment for this pathology and radiation and chemotherapy ineffectiveness, surgical treatment is the method of choice. Despite its benign nature, SFT can be aggressive and lead to metastases requiring comprehensive approach to treatment.

The article presents clinical features of SFT, the importance of surgical treatment and justification for using multidisciplinary approach, as well as a clinical case of treatment of recurrence involving tumor removal with resection of the femoral vessels and defect reconstruction with vascular implants.