2023CSCO大会指南更新——小圆细胞肉瘤部分更新亮点

On April 21-22, 2023, the CSCO Guidelines Conference was held in Guangzhou. At this conference, the "Chinese Society of Clinical Oncology (CSCO) Diagnosis and Treatment Guidelines for Bone and Soft Tissue Tumors 2023 Edition" was released. This article summarizes the key content updated at the conference. Please follow the editor to learn about it~

1. Bone and soft tissue tumors

Bone and soft tissue tumors are diseases that seriously endanger human health and life, and their incidence has gradually increased in recent years. Primary malignant bone tumors are more common in adolescents and middle-aged people, and the common ones are osteosarcoma, Ewing sarcoma, chondrosarcoma, malignant fibrous histiocytoma, chordoma, etc.; common soft tissue malignant tumors are synovial sarcoma, fibrosarcoma, liposarcoma, rhabdomyosarcoma, etc. Bone metastasis cancer is more common in middle-aged and elderly people. Common primary tumors are lung cancer, breast cancer, kidney cancer, prostate cancer, and thyroid cancer.

(Soft tissue sarcoma, picture from Baidu Encyclopedia, infringement will be deleted)

2. 2023 CSCO Special Session on Bone and Soft Tissue Tumors - Partial Update on Small Round Cell Sarcoma

The 2023 new edition of CSCO Guidelines on Bone and Soft Tissue Tumors has added a lot of new content, including the "Undifferentiated Small Round Cell Sarcoma" chapter. However, due to space reasons, the editor only excerpted the small round cell sarcoma part here. So before learning the details of the updated content, let us first understand what small round cell tumor is!

Small round cell sarcoma is a malignant tumor that usually refers to small cell malignant tumors, that is, small cell carcinoma. The higher degree of malignant transformation makes it have many types, such as medulloblastoma, Ewing sarcoma, neuroblastoma, small round cell liposarcoma, etc.

The updated key points of CSCO’s bone and soft tissue tumors in 2022 include:

Based on this, which parts of the bone and soft tissue tumors special session at the 2023 CSCO Conference have been updated? Let’s take a look at it together with the conference courseware!

Due to space reasons, this article only introduces the updated content of diagnosis, staging, and pathological examination.

Key highlights of diagnosis, staging, and pathological examination updates:

1. Added "Diagnosis - Imaging Diagnosis (Soft Tissue)"

In the staging examination of local tumors, newly recommended detection methods for level I include MRI or CT (plain scan + enhanced), and for level II recommendations, B-ultrasound and plain X-ray are listed. As shown in the figure:

Note: Local tumors include primary tumors before surgical treatment and recurrent tumors after surgical treatment.

2. Added "Pathological Examination-Biopsy"

"Biopsy" methods are added to the pathological examination, including biopsy methods of lesions, which are puncture biopsy recommended by Level I and incisional biopsy and excisional biopsy recommended by Level III.

3. Added “Pathological Staging”

Pathological staging has been added, and what is different from the past is that it is divided into stage IA, stage IB, stage IIA, stage IIB and stage III.

4. Added "TNM installment"

The TNM stages are divided into stages IA, IB, II, IIIA, IIIB and IV.

And some people want to ask, what is TNM staging? The TNM staging system is the most common tumor staging system in the world. In the TNM staging system: T ("T" is the first letter of the English word "Tumor" for tumor) refers to the primary tumor; N ("N" is the first letter of the English word "Node" for lymph node) refers to the regional lymph node (regional lymph node) node) involvement; M ("M" is the first letter of the English word "metastasis" for metastasis) refers to distant metastasis (usually blood vessel metastasis). On this basis, the combination of the three TNM indicators (grouping) is used to delineate a specific stage.

3. Conclusion

Among all solid tumors, bone and soft tissue cancer is a relatively rare and special type of malignant tumor, with an incidence rate of only 1% of solid tumors, and the pathological types are very complex, so diagnosis and treatment are very difficult. What is even more distressing is that most of the patients suffering from bone and soft tissue tumors around the world are young people in their prime. Therefore, the editor hopes that in the future there will be more effective drugs or treatment models that can cure bone and soft tissue cancer and help more patients suffering from the disease to get out of the sea of ​​suffering!