||Nokitaka Setsu, Eisuke Kobayashi, Akira Kawai, Orthopedic management of skeletal metastases, Japanese Journal of Cancer and Chemotherapy, 2015.11, Recent advances in drug therapy for metastatic bone diseases are changing the indications for surgical treatments. Bone-modifying agents, including bisphosphonates and denosumab, have reduced skeletal-related events. Meanwhile, novel anticancer drugs that have been developed, especially molecular-targeted drugs, can improve the prognoses of patients with bone metastases, thereby potentially increasing the number of patients who could receive benefits from surgeries for metastases. A multidisciplinary approach and the early involvement of surgeons are required for the application of adequate orthopedic treatments, including braces, rehabilitation, and surgeries for local tumor control, palliative fixation, and spinal decompression..
||Makoto Endo, Nokitaka Setsu, Toshifumi Fujiwara, Takeaki Ishii, Makoto Nakagawa, Kenichiro Yahiro, Atsushi Kimura, Eijiro Shimada, Yasuharu Nakashima, Yoshihiro Matsumoto, Diagnosis and Management of Subcutaneous Soft Tissue Sarcoma, Current Treatment Options in Oncology, 10.1007/s11864-019-0656-z, 2019.07, The proper diagnosis and treatment planning for subcutaneous soft tissue sarcoma is very important. Soft tissue tumors can occur anywhere in the body, but if they occur subcutaneously, patients can easily notice a subcutaneous soft tissue mass. Therefore, it is possible to determine through recording, the growth speed of the mass, which is often difficult to obtain with deep-situated soft tissue masses. Palpation can also provide information about the firmness and mobility of the mass. Thus, history taking and physical examinations are informative for subcutaneous soft tissue tumors, compared to tumors that occur deeply. Because subcutaneous soft tissue tumors are easily recognized, they are often resected, without sufficient imaging analyses or thorough treatment planning. An operation performed based on such an inadequate preoperative plan is called a “whoops surgery.” In the case of “whoops surgeries,” subsequent radical surgery is required to remove additional areas, including hematomas that result from the initial surgery, that require a wider range of resection and soft tissue reconstruction. Therefore, as with deep-seated soft tissue tumors, it is important to conduct careful imaging examinations and make appropriate preoperative plans for subcutaneous soft tissue tumors. Subcutaneous soft tissue sarcomas often show an invasive pattern, and such tumors require a more careful assessment to prevent local recurrence after surgery. During surgery, it is necessary to remove the entire infiltration area along the fascia. Sometimes, an adequately wide excision is necessary, which is considered the minimum necessary procedure to eradicate the lesion. As noted above, clinicians who see patients with subcutaneous soft tissue tumors are encouraged to have sufficient knowledge and experience regarding the diagnosis and treatment. This article is intended for all doctors who deal with subcutaneous soft tissue tumors and focuses on essential points regarding their diagnosis and management..