Malignant tumors of bone, muscle, fat, neuroectodermal tissues and fibrous tissues are known are sarcomas. These are diverse tumors with differing causes, histologies (types), patterns of spread, and treatments. They are uncommon in adults, but represent 15% of pediatric tumors. A history of radiation and chemical exposure has been noted in some patients.

OSTEOSARCOMAS are cancers of the bone. Surgery combined with chemotherapy is the mainstay of treatment. Wide excision may achieve control of the disease in 90% of patients with localized disease at diagnosis. Patients with neurovascular invasion usually require amputation. However surgery alone is usually not curative, since many patients with osteosarcoma develop spread of their disease to more distant sites. The most common site of spread is to the lungs. With surgery alone 5 year survival rates are in the range of 20%. However, early use of chemotherapy before spread of disease results in better longterm survival rates, in some reports improving outcomes to 50-60% (Reference: Eilber FR et al. Adjuvant chemotherapy for osteosarcoma. J Clin Oncol 1987; 5:21). The most active drugs include doxorubicin, methotrexate, cisplatin, and ifosfamide.

Transplantation therapy has been used at Hackensack University Medical Center to treat this disease. Given the typical younger age group, many of these are treated by the Pediatric Transplant Program. Please review additional information about sarcomas on their site. Additionally, the physicians at the Northern New Jersey Cancer Center are experienced in the diagnosis and treatment of this disease in the non-transplant setting.

EWING’S SARCOMA is the second most common bone cancer in children. At the time of diagnosis, patients frequently note fever, weight loss, fatigue and bone pain. Up to a third of patients will have spread of disease to the lungs, bone and bone marrow at presentation.

Treatment of Ewing’s sarcoma frequently consists of surgery, radiation and chemotherapy. Aggressive treatment can cure 60% of patients with localized disease and provides hope for 30% with more advanced disease.

Transplantation therapy has been used at Hackensack University Medical Center to treat this disease. Given the typical younger age group, many of these are treated by the Pediatric Transplant Program. Please review additional information about sarcomas on their site. Additionally, the physicians at the Northern New Jersey Cancer Center are experienced in the diagnosis and treatment of this disease in the non-transplant setting.

SOFT-TISSUE SARCOMAS are a group of tumors including rhabdomyosarcoma, leiomyosarcoma, fibrosarcoma, and angiosarcoma. These tumors frequently cause a mass, swelling or pain in the leg (40%) trunk (30%), arm (15%), or head and neck (15%).

Treatment may consist of wide surgical resection with radiation, or amputation. Variations in treatment recommendations are necessary due to the wide variety of tumors and extent of disease at the time of diagnosis. The use of chemotherapy to prevent spread of the tumor following surgery may be controversial in some tumor types (not rhabdomyosarcoma). Overall cure rates, depending on the type of disease and extent of spread of tumor, are in the range of 40-60%. Chemotherapy and surgical resection have been used to treat more advanced disease. Rhabdomyosarcoma is frequently treated with combination chemotherapy and radiation in an attempt to reduce disfiguring surgery at the time of diagnosis.

Transplantation therapy has been used at Hackensack University Medical Center to treat this disease. Given the typical younger age group, many of these are treated by the Pediatric Transplant Program. Please review additional information about sarcomas on their site. Adult patients may call (201) 996-5849 to learn more about transplant options. Additionally, the physicians at the Northern New Jersey Cancer Center are experienced in the diagnosis and treatment of this disease in the non-transplant setting. The Cancer Center is participating in an Eastern Cooperative Oncology Group trial of Ifosfamide and Doxorubicin in patients with advanced synovial sarcomas. Call (201) 996-5800 for more information on this study.