Franel le Grange

University College London Hospitals NHS Foundation Trust | uclh · Department of Oncology

Objective Globally, head & neck sarcoma care pathways remain unclear. In 2018, the London Sarcoma Service (LSS) set up a dedicated head and neck sarcoma (HNS) multidisciplinary team (MDT) with a clear objective to provide formal access to super-specialist expertise in diagnosis, treatment planning and management of HNS. The aim of the study is to p...

Background: Spindle cell/sclerosing (SRMS) is a rare malignancy which was first described in 2000. SMRS is histologically characterised by abundant hyaline sclerosis and pseudovascular growth pattern. Current WHO classification divides rhabdomyosarcoma (RMS) into four subtypes - embryonal, alveolar, pleomorphic and spindle cell/sclerosing. SRMS was...

Bone tumors are a group of histologically diverse diseases that occur across all ages. Two of the commonest, osteosarcoma (OS) and Ewing sarcoma (ES), are regarded as characteristic adolescent and young adult (AYA) cancers with an incidence peak in AYAs. They are curable for some but associated with unacceptably high rates of treatment failure and...

Background Pleomorphic dermal sarcoma (PDS) describes rare dermal-based malignant tumours that are morphologically similar to atypical fibroxanthoma (AFX). PDS may be differentiated from AFX by the presence of one or more of the following histologic features: subcutaneous invasion, tumour necrosis, lymphovascular invasion (LVI), and/or perineural i...

This Clinical Practice Guideline provides key recommendations on the management of bone sarcomas. // Recommendations have been agreed following a consensus meeting of representatives from ESMO, EURACAN, GENTURIS and ERNPaedCan. // Authorship includes a multidisciplinary group of experts from different institutions and countries worldwide.

Gastrointestinal stromal tumours (GISTs) are malignant mesenchymal tumours with a variable clinical behaviour, marked by differentiation towards the interstitial cells of Cajal. GISTs belong to the family of soft tissue sarcomas (STSs) but are treated separately due to their peculiar histogenesis, clinical behaviour and specific therapy. This Europ...

Soft tissue sarcomas (STSs) comprise ∼80 entities defined by the World Health Organization (WHO) classification based on a combination of distinctive morphological, immunohistochemical and molecular features.1 These ESMO–EURACAN–GENTURIS (European Society for Medical Oncology; European Reference Network for Rare Adult Solid Cancers; European Refere...

Bone tumors are a group of histologically diverse diseases which occur across all ages. Two of the commonest, osteosarcoma (OS) and Ewing sarcoma (ES), are regarded as characteristic AYA cancers with an incidence peak in AYAs. They are curable for some but associated with unacceptably high rates of treatment failure and morbidity. The introduction...

Epithelioid hemangioendothelioma (EHE) is an ultra-rare, translocated, vascular sarcoma. EHE clinical behavior is variable, ranging from that of a low-grade malignancy to that of a high-grade sarcoma and it is marked by a high propensity for systemic involvement. No active systemic agents are currently approved specifically for EHE, which is typica...

Radiotherapy is an important modality in the management of the primary tumour in bone and soft tissue sarcomas. Traditionally radiotherapy for sarcomas has been delivered with a three-dimensional conformal technique (3DCRT). In extremity soft tissue sarcomas this frequently leads to high doses of radiation being given to normal soft tissues outside...

Objective Aim of the manuscript is to discuss how to improve margins in sacral chordoma. Background Chordoma is a rare neoplasm, arising in half cases from the sacrum, with reported local failure in >50% after surgery. Methods A multidisciplinary meeting of the “Chordoma Global Consensus Group” was held in Milan in 2017, focusing on challenges in...

Introduction: Phyllodes tumours of the breast are rare and there are currently no treatment consensus guidelines to determine optimal management. Methods: Data were analysed for patients diagnosed with phyllodes tumour of the breast during 2009-2019 at UCLH. Results: A total of 50 cases were identified and the median age at diagnosis was 46 years (...

Introduction: Soft tissue sarcomas of the extremities (STSE) are rare malignancies. We report current UK practice for immobilisation of soft tissue sarcoma of STSE, as part of the initial study set-up within the IMRiS trial, a phase II study of intensity modulated radiotherapy (IMRT) in primary bone and soft tissue sarcoma. Methods: A facility q...

Chordomas and chondrosarcomas are rare bone malignancies which are locally invasive. We report the demographics, dosimetric characteristics and prognostic factors of patients from UCLH who received high-dose radiotherapy(>45Gy EqD2) for extracranial chordoma and chondrosarcomas between December 2002 and October 2017. 72 patients with chordomas(n=4...

Target definition in radiotherapy treatment planning (RTP) of oesophageal cancer is challenging and guided by a combination of diagnostic modalities. This planning study aimed to evaluate the contribution of single positron emission tomography-computed tomography (PET-CT) in the treatment position to RTP. Nineteen patients referred for radiotherapy...

Aims To evaluate tumour volume changes after preoperative radiotherapy (PRT) for borderline operable soft tissue sarcomas (STS) Materials and Methods A retrospective review was performed of 68 patients who received PRT between December 2004 and July 2011. Endpoints were radiological response, surgical margins, local control and survival. Results...

Since 2005, University College London Hospital (UCLH) has operated a hotel-based Ambulatory Care Unit (ACU) for hematology and oncology patients requiring intensive chemotherapy regimens and hematopoietic stem cell transplants. Between January 2005 and 2011 there were 1443 patient episodes, totaling 9126 patient days, with increasing use over the 6...

A diagnosis of cervical cancer during pregnancy often requires difficult management decisions. This review focuses on the current literature and practice with regards to diagnosis and management. We explore the role of surgery, chemoradiation and neo-adjuvant chemotherapy. Treatment decisions are influenced by the stage of the cancer, the histologi...

This is a brief review of the origin and normal variations of the genial tubercles, and specifically, a mandibular spine as an anatomical variation or abnormality. The case presented is that of abnormal genial tubercles observed during dissection of the floor of the mouth. A review and description on the morphology of the genial tubercles are given...