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The current management of clear cell sarcoma

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OXFORD UNIV PRESS
DOI: 10.1093/jjco/hyad083

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clear cell sarcoma; systemic therapy; lymph nodes dissection; targeted therapy; immunotherapy

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Clear cell sarcoma (CCS) is a rare melanocytic soft tissue sarcoma with high lymphatic metastasis and poor prognosis. The management of CCS remains challenging due to its rarity, unique biology, and limited understanding of its molecular pathogenesis. Surgical excision is the standard treatment, but the role of adjuvant therapy is uncertain. Targeted therapies and immunotherapy show promise but further research is needed.
Clear cell sarcoma (CCS) is a rare melanocytic soft tissue sarcoma with a high propensity for lymphatic metastasis and poor prognosis. It is characterized by the translocation of t (12;22), resulting in the rearrangement of the EWSR1 gene and overexpression of MET. Despite improvements in the diagnosis and treatment of soft tissue sarcomas, the management of CCSs remains challenging owing to their rarity, unique biological behaviour and limited understanding of their molecular pathogenesis. The standard treatment for localized CCSs is surgical excision with negative margins. However, there is an ongoing debate regarding the role of adjuvant chemotherapy, radiotherapy and lymphadenectomy in the management of this disease. CCSs are usually resistant to conventional chemotherapy. Targeted therapies, such as sunitinib and MET inhibitors, may provide promising results. Immunotherapy, particularly immune checkpoint inhibitors, is currently under investigation as a potential treatment option for CCSs. Further research is needed to better understand the biology of CCSs and develop effective therapeutic strategies. The purpose of this review is to provide a comprehensive overview of current knowledge and advances in the diagnosis and treatment of CCSs. Surgical excision is the standard treatment for clear cell sarcoma; however, the role of adjuvant therapy remains uncertain. Targeted therapies and immunotherapy are promising, but further research is required.

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