The UCLA Sarcoma Program provides innovative multidisciplinary treatment for adults and children with sarcoma at any stage of the disease. UCLA is one of the three busiest sarcoma centers in the nation. On an annual basis we evaluate over 800 patients with sarcoma, 500 of which undergo surgery at UCLA. At our weekly sarcoma conference physicians specializing in sarcoma from surgical oncology, orthopedic oncology, medical oncology, radiation oncology, pediatric oncology, pathology and radiology formulate and coordinate optimal treatment strategies for individual patients.
Sarcomas are a type of malignancy that arise from the supporting elements and connective tissues of the body. Sarcomas may arise from bone, blood vessels, nerves, fat, muscles, or tendons. Since connective tissues are widespread, sarcomas can affect any part of the body. They most commonly arise in the extremities, particularly the thigh. A patient with a sarcoma typically notices a painless swelling that slowly enlarges. Since there are so many types of connective tissue, there are an equally large number of specific types, or histologies, of sarcomas. Some of the more common sarcomas of bone and soft tissue are: liposarcoma (fat), leiomyosarcoma (smooth muscle), malignant peripheral nerve sheath tumor (nerve covering) and synovial cell sarcoma (joint space lining).
Sarcomas can affect all age groups. Muscle sarcomas, such as RMS, and osteosarcomas of bone predominantly affect children. Other sarcomas arise in adults, particularly between the third and fifth decade of life.
Under microscopic examination, sarcomas may appear very much like normal, non-malignant, connective tissue (low-grade sarcomas) or demonstrate worrisome features (intermediate and high-grade sarcomas). The latter sarcomas are capable of spreading through the bloodstream to organs such as the lungs or liver (metastases). Low-grade sarcomas rarely metastasize.
At UCLA, patients with sarcoma are managed by a multidisciplinary team of specialized physicians. The team consists of physicians from surgical oncology, orthopedic surgery, medical oncology, radiation oncology, pathology, and radiology. The expertise of this team spans nearly 30 years and has resulted in significant contributions to the science of managing patients with sarcomas. All patients with sarcomas are discussed by the multidisciplinary team at a weekly conference designed to achieve a coordinated plan of treatment. The goal of management is to cure the patient and preserve the maximum amount of normal tissue and function.
Low-grade ST sarcomas are generally managed by a combination of surgical tumor removal and a course of postoperative radiation therapy lasting 5 weeks. Intermediate and high-grade sarcomas typically are treated with a multimodal combination of chemotherapy, radiation therapy, and surgery. For patients with extremity soft tissue sarcomas, preservation of a functional limb can be expected in greater than 90% of cases.
Radiation therapy for patients with soft tissue sarcoma at UCLA involves the most sophisticated techniques available, including conformal radiotherapy (CRT) and intensity-modulated radiotherapy (IMRT). Treatment is administered with state-of-the-art linear accelerators. Computerized treatment planning by a staff of specialized physicists ensures accurate irradiation of tumor and maximum protection of normal tissue. Patients undergoing preoperative irradiation for intermediate and high-grade tumors typically receive 8 treatments. Patients undergoing postoperative irradiation typically receive 28-35 treatments depending upon the grade and type of sarcoma.
Simulation X-ray for a patient with a sarcoma of the thigh.
Computerized radiation dose planning for soft tissue sarcoma near the knee.
