Publications by authors named "Toru Hiruma"

Article Synopsis
  • Researchers studied 50 patients with solitary fibrous tumours (SFT) to see how things found before and during surgery were connected and how they affected recovery.
  • They looked at details like MRI scans and how long surgeries took, finding that more complicated tumours often took longer to remove and caused more bleeding.
  • The study concluded that some signs seen before surgery, like the type of tumour and blood vessels around it, can help predict how tricky the surgery will be and the chance of problems afterward.
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Myxofibrosarcoma (MFS) and undifferentiated sarcoma (US) have been considered as tumors of the same lineage based on genetic/epigenetic profiling. Although MFS shows a notably better prognosis than US, there are no clear criteria for distinguishing between them. Here, we examined 85 patients with MFS/US and found that tumors with infiltrative growth patterns tended to have more myxoid areas and higher local recurrence rates but fewer distant metastases and better overall survival.

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Bone metastasis occurs frequently in cancer patients. Conventional therapies have limited therapeutic outcomes, and thus, exploring the mechanisms of cancer progression in bone metastasis is important to develop new effective therapies. In the bone microenvironment, adipocytes are the major stromal cells that interact with cancer cells during bone metastasis.

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Response evaluation of carbon-ion radiotherapy poses a diagnostic challenge. Due to its functional aspects, fluorodeoxyglucose positron emission tomography (FDG/PET) has a role in the diagnosis of photon radiation therapy. In addition, several studies suggested that FDG/PET may be useful to select the optimal site for performing a diagnostic biopsy.

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Article Synopsis
  • * A case study highlights a woman in her 60s whose tumor, initially mistaken for gastrointestinal stromal tumor, was correctly diagnosed as uterine adenosarcoma after comprehensive genomic profiling revealed a JAZF1-BCORL1 rearrangement.
  • * The identification of this rearrangement not only confirmed the diagnosis but also indicated that the abdominal tumor was a metastasis from the uterine adenosarcoma, emphasizing the need for better diagnostic approaches in detecting
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Background: Active surveillance (AS) has been suggested for managing extra-abdominal desmoid fibromatosis (EADF), but a substantial percentage of such patients transitioned to invasive secondary treatments. The anti-keloid medication tranilast is frequently used in Japan but its effectiveness for EADF is not well understood.

Methods: We retrospectively analyzed the medical records of EADF patients treated with tranilast between January 2009 and March 2021.

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  • This study analyzed the effectiveness of two chemotherapy regimens in high-risk soft tissue sarcoma patients: gemcitabine plus docetaxel (GD) versus the standard Adriamycin plus ifosfamide (AI).
  • Results showed that after treatment, the estimated 3-year overall survival was 91.4% for AI compared to 79.2% for GD, indicating that GD was not as effective as AI.
  • Despite GD having milder side effects, it should not be adopted as a standard treatment for this type of cancer, as per the findings from the trial.
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Background/aim: Carbon-ion radiotherapy (CIRT) has been reported to obtain favorable results in the treatment of bone and soft tissue malignancies; however, studies on CIRT for soft tissue sarcomas (STS) of the extremities are limited. Here, we have retrospectively evaluated the therapeutic efficacy and adverse events associated with scanning CIRT (sCIRT) for STS of the extremities at our institution.

Patients And Methods: Thirteen consecutive patients with STS who underwent sCIRT between January 2017 and January 2020 were included in the study.

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  • The JCOG1610 trial aimed to compare preoperative denosumab treatment to curettage with local therapy for patients with giant cell tumor of bone, focusing on relapse-free survival as the main outcome.
  • Patient enrollment started in October 2017 but was halted in December 2020 due to low participant numbers, with only 18 patients registered across 13 institutions at that time.
  • Results indicated that preoperative denosumab did not show superiority over the traditional method in preventing tumor relapse, with similar relapse-free survival rates observed in both treatment groups after one and two years.
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Purpose: To evaluate the imaging findings and transitional changes in spacer materials used in carbon-ion radiation therapy MATERIALS: Medical records were retrospectively reviewed, and the maximum thickness, volume, and CT value of spacers were calculated from CT scans. Procedure-related complications were recorded.

Results: A spacer was surgically placed in six patients in retroperitoneal, presacral, or peritoneal sites.

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Background: Preoperative chemotherapy is widely applied to high-grade localized soft tissue sarcomas (STSs); however, the prognostic significance of histological response to chemotherapy remains controversial. This study aimed to standardize evaluation method of histological response to chemotherapy with high agreement score among pathologists, and to establish a cut-off value closely related to prognosis.

Methods: Using data and specimens from the patients who had registered in the Japan Clinical Oncology Group study, JCOG0304, a phase II trial evaluating the efficacy of perioperative chemotherapy with doxorubicin (DOX) and ifosfamide (IFO), we evaluated histological response to preoperative chemotherapy at the central review board.

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Article Synopsis
  • Adipocytic tumors, the most common soft tissue tumors, mainly consist of lipomas and atypical lipomatous tumor/well-differentiated liposarcomas (ALT/WDL), making preoperative differentiation crucial for treatment decisions.! -
  • The study involved 20 cases where fluorescence in situ hybridization (FISH) was used to assess MDM2 amplification, while cytological parameters were evaluated by multiple cytotechnologists to identify characteristics of lipoma versus ALT/WDL.! -
  • Results showed that certain atypical cell features were more common in ALT/WDL, but their detection sensitivity was low, indicating the need for thorough evaluation of cytological features and suggesting that improvements in FISH techniques could
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Introduction: Several prognostic factors for survival in synovial sarcoma have been proposed, but the role of adjuvant chemotherapy and radiotherapy is a matter of debate. The study aim was to clarify the effect of high-dose ifosfamide-containing chemotherapy and adjuvant radiotherapy for patients with localized synovial sarcoma.

Materials And Methods: Five tertiary musculoskeletal oncology hospitals participated in this retrospective study.

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Large bone defects that occur after resection of calvarial tumours are commonly remedied using titanium meshes or bone prostheses. However, these methods have several problems. While intraoperative extracorporeal radiotherapy for bone flaps could avoid these problems, there have been only a few reports wherein meningiomas were treated with 120 Gy irradiation.

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The time course of the response to each drug is important to avoid inappropriate termination of treatment by misjudging tumor progression; however, little is known about soft tissue sarcoma (STS) regarding this matter. This study aimed to perform a time-lapse analysis of tumor response in patients with STS treated with trabectedin from 2 phase II clinical trials. We examined 66 patients with translocation-related sarcoma registered in 2 Japanese phase II clinical trials.

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A 23-year-old man was admitted to our hospital with a huge pelvic tumor. MRI showed a tumor mixed with a solid component and polycystic cyst with maximum diameter of about 20 cm. Percutaneous tumor needle biopsy was performed and diagnosis was Ewing sarcoma.

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The genomic characteristics of dedifferentiated liposarcoma (DDLPS) that are associated with clinical features remain to be identified. Here, we conduct integrated whole exome and RNA sequencing analysis in 115 DDLPS tumors and perform comparative genomic analysis of well-differentiated and dedifferentiated components from eight DDLPS samples. Several somatic copy-number alterations (SCNAs), including the gain of 12q15, are identified as frequent genomic alterations.

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Article Synopsis
  • Soft-tissue sarcomas (STS) are rare but aggressive tumors typically resistant to chemotherapy; this study followed the 10-year results of a previous trial focusing on perioperative chemotherapy with doxorubicin and ifosfamide for high-risk STS.
  • The study involved 72 patients treated with specific chemotherapy regimens, and the primary outcomes analyzed were progression-free survival (PFS) and overall survival, using statistical methods to estimate these rates.
  • After 10 years, the results showed a PFS of 65.7% and overall survival of 78.1%, indicating stable and favorable long-term outcomes, particularly related to tumor size differences.
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A 34-year-old man presented with scrotal pain and slight fever. The scrotal pain was improved by the treatment of antibiotics, but the slight fever remained and an abdominal protuberance appeared. Computed tomography showed a 22 cm abdominal tumor with lipid density.

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Background: Soft tissue sarcomas (STS) are rare malignant tumors. The efficacy of preoperative chemotherapy for STS is evaluated using various tumor size-based radiological response criteria. However, it is still unclear which set of criteria would show the best association with pathological response and survival of the patients with STS.

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Background: Pathological fracture of the proximal femur is a main cause of cancer patients losing their ability to walk. Although both osteosynthetic devices (predominantly intramedullary nails) and prosthetic replacement have been widely performed for treatment, controversies exist regarding which procedure should be used for the various conditions. In order to decide the eligibility criteria of a planned randomized prospective study about the treatment of pathological fractures of the proximal femur, we assessed the factors affecting the selection of operative procedures using questionnaires sent to the members of the Bone and Soft Tissue Tumor Study Group (BSTTSG) of the Japan Clinical Oncology Group (JCOG).

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Background: Trabectedin is reported as effective, especially against translocation-related sarcomas (TRSs) after failure of or intolerance to standard chemotherapy. We conducted two phase II studies of TRS, confirming high efficacy of 1.2 mg/m trabectedin.

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Objective: Patients aged ≥65 years requiring surgery for soft-tissue sarcoma are a concern in an aging society. We aimed to reveal the association of clinical/geriatric factors with survival period or postoperative events in such patients who underwent surgery.

Methods: We enrolled patients aged ≥65 years who underwent surgery for localized soft-tissue sarcoma at five institutions.

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