The combination of the mammalian target of rapamycin and proteasome inhibitors is a new treatment strategy for various tumors. Herein, we investigated the synergistic effect of everolimus and bortezomib on tumor growth and metastasis in bone and soft tissue sarcomas. The antitumor effects of everolimus and bortezomib were assessed in a human fibrosarcoma (FS) cell line (HT1080) and mouse osteosarcoma (OS) cell line (LM8) by MTS assays and Western blotting. The effects of everolimus and bortezomib on HT1080 and LM8 tumor growth in xenograft mouse models were evaluated using tumor volume and the number of metastatic nodes of the resected lungs. Immunohistochemistry was used to evaluate cleaved PARP expression. The combination therapy decreased FS and OS cell proliferation compared with either drug alone. This combination induced more intense p-p38, p-JNK, and p-ERK and activated apoptosis signals, such as caspase-3, compared with single-agent treatment. The combination treatment reduced p-AKT and MYC expression, decreased FS and OS tumor volumes, and suppressed lung metastases of OS. The combination therapy inhibited tumor growth in FS and OS and metastatic progression of OS via the JNK/p38/ERK MAPK and AKT pathways. These results could aid in the development of new therapeutic strategies for sarcomas.

Background: Recently, the lymphocyte-to-CRP ratio (LCR) was found to have a prognostic role in many cancers. However, the clinical significance of LCR in patients with soft tissue sarcoma (STS) has not yet been established. This study aimed to determine whether LCR can predict disease-specific survival (DSS) and event-free survival (EFS) in patients with STS. Methods: In this study, 132 patients were enrolled. The mean follow-up periods were 76.5 months. Blood examinations were performed prior to treatment for all patients. Results: The 5-year DSS in patients with higher and lower LCR was 86.5% and 52.8%, respectively (p < 0.001). Patients with lower LCR had worse survival than those with higher LCR. The 5-year EFS in patients with higher and lower LCR was 66.2% and 31.2%, respectively (p < 0.001). On Receiver operating characteristic analysis, however, there was no significant difference in the area under curve (AUC) between CRP level (AUC = 0.72) and LCR (AUC = 0.711). Conclusions: LCR may be a prognostic factor for predicting oncological events in multivariate analysis, although ROC analysis could not show the superiority of LCR to CRP for predicting oncological outcomes in patients with STS.

Background: The spontaneous regression of osteochondromas is rare, and only a few cases have been reported. Furthermore, the precise mechanism underlying spontaneous regression is unknown. This study aimed to examine the radiological findings of osteochondromas that had spontaneous regression and to identify potential indicators of this uncommon phenomenon in skeletally immature patients with osteochondromas. Methods: We included 28 patients (15 males and 13 females) who met the eligibility criteria between 2002 and 2019. The mean age at initial diagnosis was 9.7 years old (2–16 years). The mean follow-up period was 6.4 years (3–16 years). Results: Of the 28 patients, 10 (35.7%) had osteochondroma resolution. The osteochondroma resolved in one patient and regressed in nine. Tumor shrinkage is related to the thickness of the cartilage cap. The thickness of the cartilage cap did not correlate with age. Conclusions: Tumor shrinkage is associated with a thinner cartilage cap on magnetic resonance imaging. The thickness of the cartilage cap may be an important predictor of spontaneous regression in pediatric patients with osteochondroma.

Background: Sarculator is a validated nomogram designed to predict overall survival (OS) in extremity soft tissue sarcoma (STS). Inflammation plays a critical role in cancer development and progression. There were no reports which investigated the relationship between Sarculator and inflammation. Methods: A total of 217 patients with extremity STS were included. The Sarculator-predicted 10-year probability of OS (pr-OS) was stratified into two subgroups: lower risk (10-year pr-OS ≥ 60%) and higher risk (10-year pr-OS < 60%). The modified Glasgow prognostic score (mGPS) varied from 0 to 2. Results: Out of the 217 patients, 67 were classified as higher risk, while 150 were lower risk. A total of 181 patients had an mGPS of 0, and 36 had a score of 1 or 2. The 5-year OS was 83.3%. When patients were divided into two groups according to the 10-year pr-OS, those with a higher risk had poorer OS than those with a lower risk. Among the patients with a higher risk, those with an mGPS of 1 or 2 had poorer OS compared to those with a score of 0. Conclusions: The mGPS could potentially play an important role in identifying patients who are at high risk of death and metastasis in the higher-risk group on the Sarculator.

Background/Objectives: The aim of this study was to review the clinical course of schwannoma in 176 patients and elucidate the clinical outcome in a patient who received surgical treatment and one who did not. Methods: Between August 2006 and December 2021, 176 patients with solitary and sporadic schwannomas were enrolled in our institution. There were 94 men and 82 women, with a mean age of 57 years. During follow-up, 76 patients received surgical treatment, and the remaining 100 did not. Results: The mean tumor size at initial presentation was 30 mm. The major tumor locations were the thigh, lower leg, upper arm, and forearm. The major nerves affected by the schwannoma were the intramuscular branch, sciatic nerve, and ulnar nerve. At least one symptom in addition to a palpable mass was observed in 133 patients (76%). The variables that indicated surgical treatment were tumor size at initial presentation, age, and any other existing symptoms. After surgery, pain-related symptoms including pain, irradiated pain and tenderness were resolved completely in 42 of 44 patients (95%) who had displayed them preoperatively. Neurological deficit was observed in 26 patients (34%). Among the 26 patients with neurological deficit, neurological sensory deficit was observed in 23 patients, and the remaining three had sensory and motor deficits. Multivariate analysis showed that patients with major nerve schwannoma, those with paresthesia preoperatively, and those who developed preoperative symptoms and had undergone surgery had a higher risk of the development of postoperative neurological deficit. Conclusions: Our findings should be considered while planning surgery and obtaining informed consent.

Background/Objectives: To elucidate the role of the CALLY index in 172 adult patients with primary soft tissue sarcoma (STS) and to evaluate whether the CALLY index is superior to the modified Glasgow prognostic score (mGPS) and prognostic nutrition index (PNI). Methods: The study cohort included 100 men and 72 women with a mean age of 63 years. Receiver operating characteristic (ROC) curve analysis was performed to determine the threshold value of the CALLY index for identifying the risk of identifying oncological events at 2 years. Results: ROC analysis identified 2.07 as the threshold of the CALLY index for predicting the risk of identifying oncological events at 2 years. The 5-year disease-specific survival (DSS) rate was 50.9% in patients with a lower CALLY index compared to 84% in those with a higher CALLY index. All patients with mGPS scores of 1 or 2 had lower CALLY indices, whereas all patients with a higher CALLY index had an mGPS score of 0. Patients with a lower CALLY index and mGPS of 0 had better DSS than those with a lower CALLY index and mGPS of 1 or 2. No substantial differences in DSS and disease-free survival (DFS) were observed between patients with a higher CALLY index and those with a lower CALLY index and an mGPS of 0. Conclusions: The CALLY index is a useful marker for predicting oncological outcomes in patients with primary STS. In particular, the CALLY index was a statistically significant prognostic variable for survival in patients with UPS and DDLPS individually. However, we suggest that the mGPS remains a reliable system for identifying patients with primary STSs who are at a high risk of death and relapse because we showed the significant difference for survival and event-free survival between the patients with mGPS of 1 and 2.