Management Of Soft Tissue Sarcomas Research Articles

Early outcomes of ultra-hypofractionated preoperative radiation therapy for soft tissue sarcoma followed by immediate surgical resection

BackgroundThere is increasing interest in shorter courses of radiation therapy (RT) in the management of soft tissue sarcoma (STS). We report our institutional experience for patients undergoing ultra-hypofractionated preoperative RT followed by immediate resection. MethodsAn IRB approved review of patients treated with preoperative 5 fraction, once daily RT followed by immediate resection (within 7 days) for STS of the extremity or trunk was conducted. The primary endpoints are major wound complications and local control (LC). Secondary endpoints include grade ≥ 2 toxicity, metastasis free survival (MFS), and overall survival (OS). ResultsTwenty-two patients with a median age of 67 years (range 30–87) and median follow-up of 24.5 months (IQR 17.0–35.7) met eligibility criteria; 18/22 patients (81.8 %) had ≥ 1 year follow-up. Primary tumor location was lower extremity in 15 patients (68.2 %), upper extremity in 5 (22.7 %), and trunk in 2 (9.1 %). All patients received 30 Gy in 5 fractions. The median time to resection following RT was 1 day (range 0–5). The median time from biopsy to resection was 34 days (range 20–69). Local control was 100 %; in patients with localized disease, 2-year MFS and OS were 71.3 % and 76.9 %, respectively. Major wound complications occurred in 9 patients (40.9 %), with wound complications requiring reoperation occurring in 8 patients (36.4 %). Other acute and late grade ≥ 2 toxicities were seen in 0 and 4 patients (18.2 %), respectively. ConclusionUltra-hypofractionated preoperative RT followed by immediate resection permits expedited completion of oncologic therapy with early results demonstrating excellent local control and acceptable toxicity. Prospective data with long-term follow-up is needed.

Surgical Margins in Soft Tissue Sarcoma Management and Corresponding Local and Systemic Recurrence Rates: A Retrospective Study Covering 11 Years and 169 Patients in a Single Institution.

Soft tissue sarcomas (STSs) are a diverse group of rare malignant soft tissue tumors with a high disease burden. Treatment protocols are complex and, to this day, a precise recommendation for the surgical margin width is lacking. The present study aims to analyze the width of the surgical margins in STS resection specimens and analyze them for local and systemic disease-free survival as well as for most frequent histologic STS subtypes. A total of 169 consecutive patients diagnosed and treated in curative intent in our institution following a primary and localized STS of the extremities or trunk from January 2010 to December 2020 were included in this study regardless of age. Our data reveal that low-grade STSs are best controlled locally by a surgical margin ≥2 mm and in this way also preventing distant metastases effectively. Local recurrence-free survival and metastasis-free survival in high-grade STS were improved by intact muscle fascia or periosteum at the margin when compared only to soft tissue. However, the outcome was independent of the surgical margin width, suggesting a close but negative margin may be safe in high-grade STS subtypes with less invasive growth patterns when combined with adjunct radiochemotherapy.

Practical Strategies in Reconstruction of Soft-Tissue Sarcoma.

After studying this article, the participant should be able to: 1. Discuss the natural history and pathophysiology of sarcoma. 2. Summarize the most up-to-date multidisciplinary management of soft-tissue sarcoma. 3. Provide a synopsis of reconstructive modalities based on anatomical location. 4. Highlight some novel strategies for treatment of lymphedema and phantom limb pain that are common sequelae following treatment and resection of soft-tissue sarcomas. The management of soft-tissue sarcoma presents unique challenges to the reconstructive surgeon. The optimal management mandates a multidisciplinary approach; however, reconstruction must take into account the extent of the resection and exposed vital structures, but often occurs in the setting of adjuvant treatments including chemotherapy and radiation therapy. Reconstruction is based on the extent of the defect and the location of the primary tumor. As such, an evidence-based, algorithmic approach following the reconstructive ladder is warranted to minimize the risks of complications and maximize success, which varies from head and neck to torso to breast to extremity sarcomas. Aside from reconstruction of the defect, advances in the surgical treatment of lymphedema and neuropathic pain resulting from treatment and extirpation of soft-tissue sarcoma are critical to maintain function and patients' quality of life.

Five decades of sarcoma care at Memorial Sloan Kettering Cancer Center.

Early studies of the management of soft tissue sarcoma at Memorial Sloan Kettering Cancer Center were influenced by development of robust prospective long-term databases. Increasing capacity for molecular diagnostics has identified a myriad of subtypes with definable natural history. Accurate identification of tissue-specific risk of recurrence and disease-specific survival have increasingly allowed selective use of surgery, radiation therapy, and target-specific cytotoxic and immune therapies.

1515P Nationwide management of soft tissue sarcoma (STS) in France, before (2019) versus during COVID-19 pandemic (2020)

COVID-19 pandemic has disorganized cancer care management, with a significant decrease in diagnosed common cancer cases such as colon or breast. In France, the management of STS is organized by a network of multidisciplinary tumor boards (MTD) covering the French territory. We describe the number of incident STS cases, delay between diagnosis and 1st surgical procedure, and rate of neoadjuvant treatments in 2019 versus 2020. Eligible cases were confirmed cases of STS (diagnosed within or outside the accredited network) in adult patients; arising in limbs, girdles, superficial and internal trunk. Osseous, and visceral (e.g., GIST) were excluded. The data collected in the national database (NETSARC+) describe the activity of the 25 labelled MTD dedicated to sarcoma management. We present the data using percentages, mean and standard deviation (DS). Incident cases slightly decreased: 1,463 in 2019 versus 1,415 in 2020. Mean age, rate of male patients, tumor size, rate of Grade 1 tumors and M1 at diagnosis were similar: 62.2 (DS: 17.3) versus 63.3 (DS: 16.7); 54.8% versus 52.4%; 104 mm (DS: 79.2) versus 105.3 (DS: 77.5); 14.2% versus 14.1%; and 10.0% versus 10.5%, respectively. In 2019, 68.8% of STS were operated compared to 73.8% in 2020. The mean delay between diagnosis and surgery was 70.4 days (DS: 86.7) versus 72.2 (DS: 76.8). Surgery was performed in accredited centers in 53.5% in 2019 compared to 61.2% in 2020. Outside the network, the rate of R0 resection was 19.9% versus 27.8%. Inside accredited centers, the rate of R0 resection was 60.9 versus 69.8%. In parallel, the use of neoadjuvant treatment was 21.0% in 2019 and 26.4% in 2020. During COVID-19, we observed a slight decrease in STS incidence, while patients’ characteristics did not differ between 2019 and 2020. Both the rate of patients operated in accredited centers and R0 resections increased. There was no neoadjuvant treatment increase nor surgery delay. The accredited network therefore appears particularly robust in the event of major Health crisis.

Prediction tools for the personalized management of soft-tissue sarcomas of the extremity.

Prediction tools are instruments which are commonly used to estimate the prognosis in oncology and facilitate clinical decision-making in a more personalized manner. Their popularity is shown by the increasing numbers of prediction tools, which have been described in the medical literature. Many of these tools have been shown to be useful in the field of soft-tissue sarcoma of the extremities (eSTS). In this annotation, we aim to provide an overview of the available prediction tools for eSTS, provide an approach for clinicians to evaluate the performance and usefulness of the available tools for their own patients, and discuss their possible applications in the management of patients with an eSTS.Cite this article: Bone Joint J 2022;104-B(9):1011-1016.

The Role of Immunotherapy in the Management of Soft Tissue Sarcomas: Current Landscape and Future Outlook.

Soft tissue sarcomas (STS) are a subset of sarcoma, a rare group of heterogeneous malignancies of mesenchymal origin. Current standard of care involves surgical resection with systemic chemotherapy used to treat high-risk localized and metastatic disease. Though classically thought to be immunologically quiet tumors, STS interact with the immune system, undergoing immunoediting that alters tumor immunogenicity and the tumor microenvironment. Recent advances with immune checkpoint inhibition have led to clinical trials exploring the efficacy of immunotherapy in treating STS. Results from these trials point to histologic subtype-specific clinical activity of immune checkpoint blockade. In addition, combinatorial strategies adding immune checkpoint inhibition to local or systemic therapies for STS have further increased their efficacy. Targeted immunotherapies using engineered T-cell receptor-based approaches also show increasing promise as treatment options for some patients with STS. Adoptive transfer of autologous T cells targeting NY-ESO-1 and MAGE-A4 have high response rates in sarcomas expressing these antigens, although recurrence is often seen in responding patients. Future work must focus on identifying primary and acquired mechanisms of resistance to these therapies, and extend T-cell receptor discovery to other tumor-associated antigens.

Multiparametric Evaluation of Soft Tissue Sarcoma: Current Perspectives and Future Directions

Imaging plays an essential role in diagnosing and managing musculoskeletal soft tissue masses. It provides anatomic details and aids in the characterization and prognostication of tumors. Advanced imaging is also essential for assessing treatment response and post-treatment surveillance. Several novel imaging techniques are now available that provide additional functional and metabolic information about these tumors. This additional information may be used to predict the biological behavior of the tumors and effectively assess the treatment response for optimizing their management. This article focuses on multiparametric imaging evaluation of soft tissue masses with a discussion of advancements in the domains of ultrasound, MRI, and CT imaging and how these may be helpful in pre- and post-treatment assessment of soft tissue tumors. Current perspectives on the role of diffusion imaging, perfusion imaging, and MR spectroscopy have been highlighted, and future directions of metabolic imaging are briefly outlined. As these advances hold a promising role in the multidisciplinary management of soft tissue sarcomas, it is important for the radiologist to be familiar with the latest advances and developments in imaging soft tissue tumors.

Recurrent Dermatofibrosarcoma Protuberant of the Hand: A Case Report

Dermatofibrosarcoma is a rare, slow growing tumor with a tendency to local recurrence. The treatment is mainly surgical. In Madagascar there is no specialized center for the management of soft tissue sarcomas. It is in this context that we report a case of a 45-year-old man, driver, presenting with recurrent dermatofibrosarcoma of the left hand. The diagnosis was confirmed by the positivity of the CD34 marker. Extensive local excision surgery was performed with the patient’s consent. After free years of treatment, there is no tumor recurrence.

Predicting distant metastases in soft-tissue sarcomas from PET-CT scans using constrained hierarchical multi-modality feature learning

Objective. Positron emission tomography-computed tomography (PET-CT) is regarded as the imaging modality of choice for the management of soft-tissue sarcomas (STSs). Distant metastases (DM) are the leading cause of death in STS patients and early detection is important to effectively manage tumors with surgery, radiotherapy and chemotherapy. In this study, we aim to early detect DM in patients with STS using their PET-CT data. Approach. We derive a new convolutional neural network method for early DM detection. The novelty of our method is the introduction of a constrained hierarchical multi-modality feature learning approach to integrate functional imaging (PET) features with anatomical imaging (CT) features. In addition, we removed the reliance on manual input, e.g. tumor delineation, for extracting imaging features. Main results. Our experimental results on a well-established benchmark PET-CT dataset show that our method achieved the highest accuracy (0.896) and AUC (0.903) scores when compared to the state-of-the-art methods (unpaired student’s t-test p-value < 0.05). Significance. Our method could be an effective and supportive tool to aid physicians in tumor quantification and in identifying image biomarkers for cancer treatment.

SARCOMES DES TISSUS MOUS : CARACTERISTIQUES ET PRISE EN CHARGE DANS UN SERVICE DE CHIRURGIE GENERALE DU CHU DU POINT G DE BAMAKO.

Abstract: Introduction: Soft tissue sarcomas constitute a heterogeneous group of rare tumors, originating from mesenchymal tissue, developing at the expense of extra skeletal connective tissues, the management of which is complex and the prognosis severe. The aim of this study was to describe the characteristics and management of soft tissue sarcomas in a general surgery department in Bamako in 2019. Methods: This was a retrospective file review of 9 years of activity from 2008 to 2016 targeting soft tissue sarcomas which resulted in 37 cases. The eligibility criteria were age greater than 12 years, histological evidence of soft tissue sarcoma. The parameters describing the epidemiological, clinical, histological and therapeutic characteristics were analyzed. Results: There were 25 men and 12 women aged 46 years on average whose lesion presented in the form of a swelling in 97.3% of cases, mainly located on the limbs in 86.4%, metastatic in the time of diagnosis in 32.4%. Fibrosarcoma and rhabdomyosarcoma were the most common histologic subtypes in 40.5% and 37.8%, respectively. Surgical treatment was initiated in 78.4% with a resection rate of 27%. The consequences were marked by 9 cases of recurrence and 7 deaths. Conclusion: Any soft tissue tumor should be considered a sarcoma until proven otherwise and treated as such. When complete resection is not possible, it is better to abstain and resort to nonsurgical means as a palliative. Keywords: Soft tissue sarcoma, epidemiology, histological types, prognosis.

Preoperative Radiation Performed at a Nonsarcoma Center May Lead to Increased Wound Complications Following Resection in Patients With Soft Tissue Sarcomas.

Preoperative radiation therapy (RT) followed by wide-local excision with or without chemotherapy is widely accepted as management for soft tissue sarcomas (STS). Although studies have demonstrated excellent local control with this technique, there can be significant morbidity with the development of wound complications. It has been shown that sarcoma resections performed at a high-volume center lead to improved survival and functional outcomes. It is unclear, however, if radiation performed in a high-volume center leads to improved outcomes especially related to morbidity. The goal of this study was to determine whether preoperative RT performed at an academic cancer center have lower rates of wound complication compared with RT performed in community cancer centers. A total of 204 patients with STS were treated with preoperative RT±chemotherapy followed by limb-sparing resection. Of these, 150 patients had preoperative RT performed at an academic sarcoma center. wound complication were defined as those requiring secondary operations or prolonged wound care for 4 months following surgery. Predictors for wound complication were evaluated using a Fisher exact test for univariate analysis and logistic regression for multivariate analysis. The overall incidence of wound complication was 28.3%. Significant predictors for wound complication include tumor location and radiation delivered at a community hospital. The postoperative incidence of wound complication was 21% when the preoperative RT was performed at an academic cancer center versus 39% when performed at a community cancer center (P=0.009). On multivariate analysis, both tumor location (P=0.0012, 95% confidence interval: 0.03-0.45, odds ratio: 0.13) and RT performed at a community cancer center (P=0.02, 95% confidence interval: 1.13-4.48, odds ratio: 2.25) remained significant in correlation with postoperative wound complication. Preoperative RT performed at an academic cancer center led to lower rates of postoperative wound complication. This may support the recommendation that preoperative RT and resection of STS be performed at an experienced sarcoma center.

Wound Complications Following Wide Resection and Intraoperative Radiation Therapy for Management of Soft Tissue Sarcoma of the Extremities

In cases where wide margins are not readily achievable during limb-sparing surgery (LSS) for soft tissue sarcoma (STS) of the extremity, intraoperative radiation therapy (IORT) may be used either alone or in conjunction with post-operative radiation (PORT) to improve local control with potentially decreased toxicities. The aim of this study is to describe wound healing issues following IORT for extremity STS.Retrospective analysis was performed for 92 patients treated with LSS and IORT for definitive management of extremity STS between 2012 and 2020 at a single institution. No patients received pre-operative RT. Major wound complications were classified as follows: secondary operation for wound repair requiring general/regional anesthesia, other invasive procedure for wound management, readmission for wound care, or persistent deep packing over 120 days. Univariate and multivariate binary logistic regression analyses were performed to identify factors associated with development of major wound complications.Median age at IORT was 58 years (IQR 35-71). Tumor distribution was 25% upper extremity and 75% lower extremity. The most common histologies were undifferentiated pleomorphic sarcoma (27%), synovial sarcoma (24%), and liposarcoma (18%). Tumors were grade 1 (14%), grade 2 (34%), and grade 3 (52%). 37% had received pre-operative chemotherapy. Median tumor size at resection was 7 cm (IQR 5-11), and 28% of patients had tumors over 10 cm in maximum dimension. The majority of patients received a prescribed IORT dose of 12 Gy (27%) or 15 Gy (66%). 30% of patients underwent complex surgical closure, as defined by use of a muscle flap (11%, n = 10), fasciocutaneous flap (5%, n = 5), and/or skin graft (16%, n = 15). 90% of patients were discharged in less than 1 week from LSS with IORT. 72% subsequently received PORT at a median time of 7 weeks from LSS (IQR 5-11). Overall, the rate of major wound complications was 18% (n = 17), of which 4 events occurred prior to PORT and 9 events occurred within 4 months from IORT. In total, 10% (n = 9) required a secondary operation for wound repair, 5% (n = 5) required an invasive procedure (commonly drainage of a seroma/hematoma), and 3% (n = 3) required readmission for wound care. None required persistent deep packing. On univariate analysis, factors predicting for development of a major wound complication included current smoking status (HR 15.86, P = 0.02) and complex wound closure (HR 3.32, P = 0.03), both of which remained significant on multivariate analysis. Factors that were not associated with wound complications included age, tumor size, IORT dose, pre-operative chemotherapy, and PORT.Despite the bias of selective use of IORT for more challenging surgical cases, IORT was not associated with increased rates of wound complications as compared to historical reports, and patients were able to transition to the next phase of therapy in a timely manner as part of optimal interdisciplinary management of STS.

Deep learning for diagnosis and survival prediction in soft tissue sarcoma

Clinical management of soft tissue sarcoma (STS) is particularly challenging. Here, we used digital pathology and deep learning (DL) for diagnosis and prognosis prediction of STS. Our retrospective, multicenter study included a total of 506 histopathological slides from 291 patients with STS. The Cancer Genome Atlas cohort (240 patients) served as training and validation set. A second, multicenter cohort (51 patients) served as an additional test set. The use of the DL model (DLM) as a clinical decision support system was evaluated by nine pathologists with different levels of expertise. For prognosis prediction, 139 slides from 85 patients with leiomyosarcoma (LMS) were used. Area under the receiver operating characteristic (AUROC) and accuracy served as main outcome measures. The DLM achieved a mean AUROC of 0.97 (±0.01) and an accuracy of 79.9% (±6.1%) in diagnosing the five most common STS subtypes. The DLM significantly improved the accuracy of the pathologists from 46.3% (±15.5%) to 87.1% (±11.1%). Furthermore, they were significantly faster and more certain in their diagnosis. In LMS, the mean AUROC in predicting the disease-specific survival status was 0.91 (±0.1) and the accuracy was 88.9% (±9.9%). Cox regression showed the DLM's prediction to be a significant independent prognostic factor (P= 0.008, hazard ratio 5.5, 95% confidence interval 1.56-19.7) in these patients, outperforming other risk factors. DL can be used to accurately diagnose frequent subtypes of STS from conventional histopathological slides. It might be used for prognosis prediction in LMS, the most prevalent STS subtype in our cohort. It can also help pathologists to make faster and more accurate diagnoses. This could substantially improve the clinical management of STS patients.

Management of Soft Tissue Sarcomas in Extremities: Variation in Treatment Recommendations and Surveillance According to Specialty and Continent

BackgroundThis study aimed to provide an insight into clinical decision-making and surveillance strategy of sarcoma specialists for patients with primary soft tissue sarcoma of the extremities (eSTS). The secondary aim was to quantify the role of patient- and tumor-specific factors in the perioperative management.MethodsMembers of sarcoma societies were sent a Web-based 21-item survey about eSTS management. The survey concerned only primary resectable high-grade eSTS in adults.ResultsThe study enrolled 396 respondents. The majority of the surgical specialists thought the evidence for perioperative chemotherapy (CTX) for high-grade eSTS was insufficient. Radiotherapy (RTX) was less frequently offered in Asia than in North America and Europe. The specialties and continents also differed regarding the importance of patient and tumor characteristics influencing RTX and CTX recommendation. For surveillance after initial treatment outpatient visits, chest computed tomography (CT) scans, and magnetic resonance images of the extremity were the methods primarily used. The specialists in North America preferred chest CT scan over chest x-ray, whereas those in Asia and Europe had no clear preference.DiscussionSpecialty and continent are important factors contributing to the variation in clinical practice, treatment recommendations, and surveillance of patients with primary resectable high-grade eSTS.

A Prolonged Response and Characteristics of Trabectedin Treatment of Metastatic Soft Tissue Sarcoma

Unique features and treatment effects of trabectedin are presented in consideration of soft tissue sarcoma management. A prolonged time on trabectedin through 59 cycles is shown. This is one of the longer reported uses of trabectedin successfully to control disease. Adjunctive cytoreduction options with surgery, radiation or ablation are presented. Future studies would be helpful to investigate treatment holidays, the impact of multi-modality care and assessment of genetics of clonal metastases. This may assist in guiding and selecting patients for priority treatment with trabectedin. J Med Cases. 2021;12(4):160-163 doi: https://doi.org/10.14740/jmc3655

SEOM Clinical Guideline of management of soft-tissue sarcoma (2020)

Soft-tissue sarcomas constitute an uncommon and heterogeneous group of tumors of mesenchymal origin. Diagnosis, treatment, and management should be performed by an expert multidisciplinary team. MRI/CT of the primary tumor and biopsy is mandatory before any treatment. Wide surgical resection with tumor-free tissue margin is the mainstay for localized disease. Radiotherapy is indicated in large, deep, high-grade tumors, or after marginal resection not suitable for re-excision. Perioperative chemotherapy should be discussed for high-risk sarcomas of the extremities and trunk-wall. In the case of oligometastatic disease, patients should be considered for local therapies. First-line treatment with anthracyclines (or in combination with ifosfamide) is the treatment of choice. Other drugs have shown activity in second-line therapy and in specific histological subtypes but options are limited and thus, a clinical trial should always be discussed.

Diagnostic concordance between ultrasound-guided core needle biopsy and surgical resection specimens for histological grading of extremity and trunk soft tissue sarcoma.

Determination of accurate histological grade impacts on management for soft tissue sarcomas (STSs). Although ultrasound-guided core needle biopsy (US-CNB) accurately establishes tumour subtype compared with surgical specimens, the concordance for tumour grade is uncertain. The aim of this study was to assess the concordance between US-CNB and surgical resection specimens for tumour grade in trunk and extremity STS. Retrospective review of consecutive patients presenting with extremity/trunk STS. Data collected included patient age, gender, lesion location, US-CNB diagnosis and grade, and surgical histology and grade. The histological diagnosis and tumour grade from US-CNB was compared with surgical resection histology. A total of 118 patients were included, 76 males and 42 females with a mean age of 54years (range 10months-90years old). STS size ranged from 26 to 350mm (mean 89.5mm). All US-CNB procedures were performed with a 14G biopsy needle with a mean number of 5 passes. First US-CNB was diagnostic for STS in all patients, and provided adequate tissue for tumour grading in all but one patient. Histological tumour subtype on US-CNB matched surgical specimens in all cases, with 25 (21.2%) STS being low grade and 93 (78.8%) high grade. The concordance for tumour grade was 96.6%, with no difference between low- and high-grade STSs (p > 0.05). The 4 cases of mismatch were considered low grade on US-CNB, but subsequently high grade on surgical resection. US-CNB of STS can reliably predict histological tumour grade compared with surgical resection specimens, thus allowing confident treatment decisions to be made.

Double Antero-lateral Thigh Flow-Through Free Flaps in Series Connection to Reconstruct a Huge Defect in Back

Soft tissue sarcomas can occur anywhere in the body. In the back, they pose a significant problem due to their large size. Surgery is the main stay of treatment for soft tissue sarcoma management. However, removal of such tumors results in large soft tissue defects. Skin grafts can resurface large defects, but skin grafts have their own limitations and can delay initiation of radiotherapy. Providing a stable soft tissue cover which can withstand post-op radiotherapy is desirable. Single flap cannot cover large defects. We report one such technique where two antero-lateral thigh free flaps were connected in series for the first time as “chain flaps” for large defect coverage. Six months follow-up showed no complications following radiotherapy. We recommend this technique to cover large size defects which are not amenable to cover via single flap, for optimal outcome.

Hyperthermia combined with nanoparticles to enhance cytotoxic effects of fresh human soft tissue sarcoma.

e23570 Background: Sarcomas represent 1% of all adult cancers and 20% of all pediatric cancers worldwide.Sarcomas are heterogeneous with more than 50 histologic subtypes involving the mesenchyme including bones, muscle, fat, blood vessels, and nerves. Patients with high-risk localized or advanced disease are treated with the combination of neoadjuvant or adjuvant chemotherapy, radiation, and surgical resection have all failed to substantially improve overall survival (OS).4 Novel treatments are desperately needed in the management of soft tissue sarcoma. Thermal ablation of sarcoma may offer a novel method for eradicating the disease. Polymer based nanoparticles that can be stimulated with light to generate heat (photothermal nanoparticles) have been developed previously and used to induce. The goal of the current work is to utilize these nanoparticles for selected ablation of sarcoma. Methods: Polymer nanoparticles were first prepared in the in our lab through the synthesis of 2‐ethylhexyl cyclopentadithiophene 2,1,3‐benzoselenadiazole (PCPDTBSe). Nanoparticles of this polymer were prepared using an oil-water emulsion technique, with FITC labeled polyethylene glycol as the stabilizing agent, to create an aqueous suspension. The nanoparticles were characterized for their size and ability to generate heat when stimulated with 800 nm laser light (180J/cm2). Fresh Soft tissue sarcoma samples are obtained through informed consent and approval of the institutional IRB. Nanoparticles were injected into sarcoma in a volume of 100ul, at a concentration of 250ug/ml. The tissues were then exposed to the laser source to generate heat. Controls included the injection of the sarcoma with the nanoparticles and no laser exposure, as well as the injection of water, plus laser exposure. Results: Sarcomas vary in their ability to take up and response to nanoparticles. We have found that liposarcoma samples are extremely leaky and do not hold the injection of nanoparticles, which leach out of the tumor. Conclusions: Future directions include studies that would involve targeted, immunotherapy and chemotherapy given with nanoparticles that facilitate combinatory and unique individual cytotoxic effects of the soft tissue sarcoma subtypes.