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I had an unplanned incision of a large (football) Soft

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Tissue Sarcoma of the UPS...
I had an unplanned incision of a large (football) Soft Tissue Sarcoma of the UPS (Undifferentiated Pleomorphic Sarcoma) category. I was staged as 2b by the old system and stage III by the newly released classification system. I had no spread to lymph nodes, lungs or anywhere else that could be detected by PET/CT and MRI. This was January 17th 2018.I just finished 2 rounds of AIM & 1 round of Sutent. I am looking for help translating this MRI report. Please let me know if its positive, neutral or negative. I am adding copies of the MRI report. Is anything here a good or a bad prognostic factor?http://i1363.photobucket.com/albums/r718/CollectiblesNJ/image2_zps6snt8o6c.jpeg
http://s1363.photobucket.com/user/CollectiblesNJ/media/image1_zpsbb4cxcn6.jpeg.html
http://s1363.photobucket.com/user/CollectiblesNJ/media/image1%202_zps0laivqiq.jpeg.html
Submitted: 1 month ago.Category: Oncology
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Answered in 53 minutes by:
3/10/2018
Oncologist: Dr. David, Doctor (MD) replied 1 month ago
Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 49,141
Experience: Experienced Oncology Physician trained in New York City. I'm ready to help.
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Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

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Oncologist: Dr. David, Doctor (MD) replied 1 month ago

wow, sounds like a big surgery

you should review this MRI scan with your surgeon

you may need additional biopsies of the 2.2cm peripherally enhancing mass and the 1.5cm mass to see if they also contain sarcoma or if they are just secondary from the surgery.

did you consult with a radiation oncology doctor to see if you need radiation therapy after your surgery?

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Customer reply replied 1 month ago
unfortunately the original surgeon was not trained with a specialty in sarcoma so his surgical reports suggest this is residual left from the original procedure that he could not get. As its been present in the same locations on all prior scansI am planning on reviewing this report on Monday with both my Medical Oncologist and Surgical Oncologist Monday. The thought was to treat any micro spread since I was high risk and they were attempting to reduce the size of the tumour to be able to obtain clear margins without re-secting my sciatic nerve. Brachyl <-- spelling? seed radiation and additional chemo are planned if clear margins can be obtained.
Customer reply replied 1 month ago
Would you consider this report to be mixed neutral good or bad?
Oncologist: Dr. David, Doctor (MD) replied 1 month ago

the report is mixed.

I am glad you are going to see a surgical oncologist monday.

it sounds like you have a good cancer team working with you now.

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Customer reply replied 1 month ago
But is this what you would call a partial response to the chemo ? Or no response ?
Oncologist: Dr. David, Doctor (MD) replied 1 month ago

that depends on what your scan showed before your chemotherapy.

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Customer reply replied 1 month ago
I posted a copy of my pre chemo MRI as well
Customer reply replied 1 month ago
See report dated 1-17-2018 that was pre chemo
Oncologist: Dr. David, Doctor (MD) replied 1 month ago

it doesn't sound like your first surgeon cut out the whole sarcoma

you needed a better surgery

the chemotherapy should be given after the whole sarcoma has been removed by surgery.

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Customer reply replied 1 month ago
but once they messed it up (the first surgery)my doctors at John Theurer Cancer Center thought systemic benefit outweighed amputation or crippling my leg if it can be avoided by shrinking the tumor. What does a signal change to heterogeneous indicate? Could this be indicative of necrosis of the tumor? I will rate this post shortly
Oncologist: Dr. David, Doctor (MD) replied 1 month ago

it could be from necrosis of tumor or blood product in the area or scar tissue in the region or tumor growth

it can be difficult to know in these cases

it is not always 100% clear what heterogeneous signals mean

your doctor may want to continue with the current treatment for a few more cycles and get a repeat MRI scan to see if things change.

you may benefit from genetic evaluation of your sarcoma to look for mutations which could be targeted with newer agents

because you are so young, you may benefit from genetic counseling and genetic testing as well

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