Abstract
Sarcomas are a heterogeneous group of relatively rare neoplasms. The only established risk factors of soft tissue sarcomas, which represent 80% of all sarcomas, are ionizing radiation and alkylating agents used in chemotherapy. Extensive research on a possible etiologic role of dioxin, chlorophenoxy herbicides, and chlorophenols has not provided definite evidence of a causal association. A part from an effect of high-level exposure to ionizing radiation detected in historical studies of radiologists and radium-exposed workers, no occupational risk factors have been identified for bone sarcoma.
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References
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68:7–30.
Fletcher CDM, Bridge JA, Hogendoorn PCW, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: International Agency for Research on Cancer; 2013.
Bray F, Colombet M, Mery L, et al., editors. Cancer incidence in five continents, vol. XI. Lyon: International Agency for Research on Cancer; 2017.
ESMO/European Sarcoma Network Working Group. Soft tissue and visceral sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25(Suppl 3):ii102–12.
van der Graaf WT, Orbach D, Judson IR, et al. Soft tissue sarcomas in adolescents and young adults: a comparison with their paediatric and adult counterparts. Lancet Oncol. 2017;18:e166–75.
Pisters PW, Leung DH, Woodruff J, et al. Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas on the extremities. J Clin Oncol. 1996;14:1679–89.
Clark MA, Fisher C, Judson I, et al. Soft-tissue sarcomas in adult. N Engl J Med. 2005;353:701–11.
Gatta G, Trama A, Capocaccia R, et al. Epidemiology of rare cancers and inequalities in oncologic. Eur J Surg Oncol. 2019;45:3–11.
Brennan P, Scélo G, Hemminki K, et al. Second primary cancers among 109 000 cases of non-Hodgkin’s lymphoma. Br J Cancer. 2005;93:159–66.
Chaturvedi AK, Engels EA, Gilbert ES, et al. Second cancers among 104,760 survivors of cervical cancer: evaluation of long-term risk. J Natl Cancer Inst. 2007;99:1634–43.
Dores GM, Metayer C, Curtis RE, et al. Second malignant neoplasms among long-term survivors of Hodgkin’s disease: a population-based evaluation over 25 years. J Clin Oncol. 2002;20:3484–94.
Huang J, Mackillop WJ. Increased risk of soft tissue sarcoma after radiotherapy in women with breast carcinoma. Cancer. 2001;92:172–80.
Mellemkjaer L, Friis S, Olsen JH, et al. Risk of second cancer among women with breast cancer. Int J Cancer. 2006;118:2285–92.
Mery CM, George S, Bertagnolli MM, et al. Secondary sarcomas after radiotherapy for breast cancer: sustained risk and poor survival. Cancer. 2009;115:4055–63.
Schaapveld M, Visser O, Louwman MJ, et al. Risk of new primary nonbreast cancers after breast cancer treatment: a Dutch population-based study. J Clin Oncol. 2008;26:1239–46.
Virtanen A, Pukkala E, Auvinen A. Angiosarcoma after radiotherapy: a cohort study of 332,163 Finnish cancer patients. Br J Cancer. 2007;97:115–7.
Inskip PD, Curtis RE. New malignancies following childhood cancer in the United States, 1973-2002. Int J Cancer. 2007;121:2233–40.
Maule M, Scélo G, Pastore G, et al. Second malignancies after childhood noncentral nervous system solid cancer: results from 13 cancer registries. Int J Cancer. 2011;129:1940–52.
Neglia JP, Friedman DL, Yasui Y, et al. Second malignant neoplasms in five-year survivors of childhood cancer: childhood cancer survivor study. J Natl Cancer Inst. 2001;93:618–29.
Ray-Coquard I, Montesco MC, Coindre JM, et al. Sarcoma: concordance between initial diagnosis and centralized expert review in a population-based study within three European regions. Ann Oncol. 2012;23:2442–9.
Reilly KM, Kim A, Blakely J, et al. Neurofibromatosis type 1-associated MPNST state of the science: outlining a research agenda for the future. J Natl Cancer Inst. 2017;109:djx124.
Strong LC, Williams WR, Tainsky MA. The Li-Fraumerni syndrome: from clinical epidemiology to molecular genetics. Am J Epidemiol. 1992;135:190–9.
De Marchi A, Brach del Prever EM, et al. Accuracy of core-needle biopsy after contrast enhanced ultrasound in soft-tissue tumours. Eur Radiol. 2010;20:2740–8.
Hoeber I, Spillane AJ, Fisher C, et al. Accuracy of biopsy techniques for limb and limb girdle soft tissue tumors. Ann Surg Oncol. 2001;8:80–7.
Coindre JM, Troiani M, Contesso G, et al. Reproducibility of a histopathologic grading system for adult soft tissue sarcoma. Cancer. 1986;58:306–9.
Trojani M, Contesso G, Coindre JM, et al. Soft-tissue sarcomas of adults: study of pathological prognostic variables and definition of a histopathological grading system. Int J Cancer. 1984;33:37–42.
Eriksson M, Hardell L, Berg NO, et al. Soft-tissue sarcomas and exposure to chemical substances: a case-referent study. Br J Ind Med. 1981;38:27–33.
Eriksson M, Hardell L, Adami HO. Exposure to dioxins as a risk factor for soft tissue sarcoma: a population-based case-control study. J Natl Cancer Inst. 1990;82:486–90.
Hardell L, Sandström A. Case-control study: soft-tissue sarcomas and exposure to phenoxyacetic acids or chlorophenols. Br J Cancer. 1979;39:711–7.
Hardell L, Eriksson M. The association between soft tissue sarcomas and exposure to phenoxyacetic acids. A new case-referent study. Cancer. 1988;62:652–6.
Reif JS, Pearce NE, Fraser J. Cancer risks among New Zealand meat workers. Scand J Work Environ Health. 1989a;15:24–9.
Reif J, Pearce N, Kawachi I, et al. Soft-tissue sarcoma, non-Hodgkin’s lymphoma and other cancers in New Zealand forestry workers. Int J Cancer. 1989b;43:49–54.
Smith AH, Pearce NE, Fisher DO, et al. Soft tissue sarcoma and exposure to phenoxyherbicides and chlorophenols in New Zealand. J Natl Cancer Inst. 1984;73:1111–7.
Smith AH, Pearce NE. Update on soft tissue sarcoma and phenoxyherbicides in New Zealand. Chemosphere. 1986;15:1795–8.
Hoar SK, Blair A, Holmes FF, et al. Agricultural herbicide use and risk of lymphoma and soft-tissue sarcoma. JAMA. 1986;256:1141–7.
Hoar Zahm S, Blair A, Holmes FF, et al. A case-referent study of soft-tissue sarcoma and Hodgkin’s disease. Farming and insecticide use. Scand J Work Environ Health. 1988;14:224–30.
Woods JS, Polissar L, Severson RK, et al. Soft tissue sarcoma and non-Hodgkin’s lymphoma in relation to phenoxyherbicide and chlorinated phenol exposure in western Washington. J Natl Cancer Inst. 1987;78:899–910.
Smith JG, Christophers AJ. Phenoxy herbicides and chlorophenols: a case control study on soft tissue sarcoma and malignant lymphoma. Br J Cancer. 1992;65:442–8.
Serraino D, Franceschi S, La Vecchia C, et al. Occupation and soft-tissue sarcoma in northeastern Italy. Cancer Causes Control. 1992;3:25–30.
Vineis P, Terracini B, Ciccone G, et al. Phenoxy herbicides and soft-tissue sarcomas in female rice weeders. A population-based case-referent study. Scand J Work Environ Health. 1987;13:9–17.
Greenwald P, Kovasznay B, Collins DN, et al. Sarcomas of soft tissues after Vietnam service. J Natl Cancer Inst. 1984;73:1107–9.
Kang HK, Weatherbee L, Breslin PP, et al. Soft tissue sarcomas and military service in Vietnam: a case comparison group analysis of hospital patients. J Occup Med. 1986;28:1215–8.
Kang H, Enzinger FM, Breslin P, et al. Soft tissue sarcoma and military service in Vietnam: a case-control study. J Natl Cancer Inst. 1987;79:693–9.
Kogevinas M, Becher H, Benn T, et al. Cancer mortality in workers exposed to phenoxy herbicides, chlorophenols, and dioxins. An expanded and updated international cohort study. Am J Epidemiol. 1997;145:1061–75.
Kogevinas M, Kauppinen T, Winkelmann R, et al. Soft tissue sarcoma and non-Hodgkin’s lymphoma in workers exposed to phenoxy herbicides, chlorophenols, and dioxins: two nested case-control studies. Epidemiology. 1995;6:396–402.
Bodner KM, Collins JJ, Bloemen LJ, Carson ML. Cancer risk for chemical workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin. Occup Environ Med. 2003;60:672–5.
Boers D, Portengen L, Bueno-de-Mesquita HB, et al. Cause-specific mortality of Dutch chlorophenoxy herbicide manufacturing workers. Occup Environ Med. 2010;67:24–31.
Collins JJ, Bodner K, Aylward LL, et al. Mortality rates among trichlorophenol workers with exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin. Am J Epidemiol. 2009a;170:501–6.
Flesch-Janys D, Steindorf K, Gurn P, et al. Estimation of the cumulated exposure to polychlorinated dibenzo-p-dioxins/furans and standardized mortality ratio analysis of cancer mortality by dose in an occupationally exposed cohort. Environ Health Perspect. 1998;106(Suppl 2):655–62.
Hooiveld M, Heederik DJ, Kogevinas M, et al. Second follow-up of a Dutch cohort occupationally exposed to phenoxy herbicides, chlorophenols, and contaminants. Am J Epidemiol. 1998;147:891–901.
Lynge E. Cancer incidence in Danish phenoxy herbicide workers, 1947-1993. Environ Health Perspect. 1998;106(Suppl 2):683–8.
McBride DI, Burns CJ, Herbison GP, et al. Mortality in employees at a New Zealand agrochemical manufacturing site. Occup Med. 2009;59:255–63.
Steenland K, Piacitelli L, Deddens J, et al. Cancer, heart disease, and diabetes in workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin. J Natl Cancer Inst. 1999;91:779–86.
‘t Mannetje A, McLean D, Cheng S, et al. Mortality in New Zealand workers exposed to phenoxy herbicides and dioxins. Occup Environ Med. 2005;62:34–40.
Collins JJ, Bodner K, Aylward LL, et al. Mortality rates among workers exposed to dioxins in the manufacture of pentachlorophenol. J Occup Environ Med. 2009b;51:1212–9.
Ruder AM, Yiin JH. Mortality of US pentachlorophenol production workers through 2005. Chemosphere. 2011;83:851–61.
Iaia TE, Bartoli D, Calzoni P, et al. [Cohort study of mortality among leather tanners in the Lower Valdarno area]. Med Lav. 2002;93:95–107.
Mikoczy Z, Schütz A, Hagmar L. Cancer incidence and mortality among Swedish leather tanners. Occup Environ Med. 1994;51:530–5.
Mikoczy Z, Hagmar L. Cancer incidence in the Swedish leather tanning industry: updated findings 1958-99. Occup Environ Med. 2005;62:461–4.
Seniori Costantini A, Paci E, Miligi L, et al. Cancer mortality among workers in the Tuscan tanning industry. Br J Ind Med. 1989;46:384–8.
Stern FB. Mortality among chrome leather tannery workers: an update. Am J Ind Med. 2003;44:197–206.
Asp S, Riihimäki V, Hernberg S, et al. Mortality and cancer morbidity of Finnish chlorophenoxy herbicide applicators: an 18-year prospective follow-up. Am J Ind Med. 1994;26:243–53.
Blair A, Dosemeci M, Heineman HF. Cancer and other causes of death among male and female farmers from twenty-three states. Am J Ind Med. 1993;23:729–42.
Briggs NC, Levine RS, Hall HI, et al. Occupational risk factors for selected cancers among African American and White men in the United States. Am J Public Health. 2003;93:1748–52.
Demers PA, Davies HW, Friesen MC, et al. Cancer and occupational exposure to pentachlorophenol and tetrachlorophenol (Canada). Cancer Causes Control. 2006;17:749–58.
Fleming LE, Bean JA, Rudolph M, et al. Mortality in a cohort of licensed pesticide applicators in Florida. Occup Environ Med. 1999;56:14–21.
Gambini GF, Mantovani C, Pira E, et al. Cancer mortality among rice growers in Novara Province, northern Italy. Am J Ind Med. 1997;31:435–41.
Green LM. A cohort mortality study of forestry workers exposed to phenoxy acid herbicides. Br J Ind Med. 1991;48:234–8.
Hansen ES, Lander F, Lauritsen JM. Time trends in cancer risk and pesticide exposure, a long-term follow-up of Danish gardeners. Scand J Work Environ Health. 2007;33:465–9.
Swaen GM, van Vliet C, Slangen JJ, et al. Cancer mortality among licensed herbicide applicators. Scand J Work Environ Health. 1992;18:201–4.
Swaen GM, van Amelsvoort LG, et al. Cancer mortality in a cohort of licensed herbicide applicators. Int Arch Occup Environ Health. 2004;77:293–5.
McLean D, Pearce N, Langseth H, et al. Cancer mortality in workers exposed to organochlorine compounds in the pulp and paper industry: an international collaborative study. Environ Health Perspect. 2006;114:1007–12.
Rix BA, Lynge E. Soft tissue sarcomas among female paper sorters in Denmark. Cancer Causes Control. 1997;8:259.
Rix BA, Villadsen E, Engholm G, et al. Hodgkin’s disease, pharyngeal cancer, and soft tissue sarcomas in Danish paper mill workers. J Occup Environ Med. 1998;40:55–62.
Hoppin JA, Tolbert PE, Herrick RF, et al. Occupational chlorophenol exposure and soft tissue sarcoma risk among men aged 30-60 years. Am J Epidemiol. 1998;148:693–703.
Hoppin JA, Tolbert PE, Flanders WD, et al. Occupational risk factors for sarcoma subtypes. Epidemiology. 1999;10:300–6.
Hossain A, McDuffie HH, Bickis MG, et al. Case-control study on occupational risk factors for soft-tissue sarcoma. J Occup Environ Med. 2007;49:1386–93.
Pahwa P, McDuffie HH, Dosman JA, et al. Exposure to animals and selected risk factors among Canadian farm residents with Hodgkin’s disease, multiple myeloma, or soft tissue sarcoma. J Occup Environ Med. 2003;45:857–68.
Pahwa P, McDuffie HH, Dosman JA, et al. Hodgkin lymphoma, multiple myeloma, soft tissue sarcomas, insect repellents, and phenoxyherbicides. J Occup Environ Med. 2006;48:264–74.
Pahwa P, Karunanayake CP, Dosman JA, et al. Soft-tissue sarcoma and pesticides exposure in men: results of a Canadian case-control study. J Occup Environ Med. 2011;53:1279–86.
Tuomisto JT, Pekkanen J, Kiviranta H. Soft-tissue sarcoma and dioxin: a case-control study. Int J Cancer. 2004;108:893–900.
Tuomisto J, Pekkanen J, Kiviranta H, et al. Dioxin cancer risk—example of hormesis? Dose Response. 2010;3:332–41.
Consonni D, Pesatori AC, Zocchetti C, et al. Mortality in a population exposed to dioxin after the Seveso, Italy, accident in 1976: 25 years of follow-up. Am J Epidemiol. 2008;167:847–58.
Pesatori AC, Consonni D, Rubagotti M, et al. Cancer incidence in the population exposed to dioxin after the “Seveso accident”: twenty years of follow-up. Environ Health. 2009;8:39.
Mundt KA, Dell LD, Austin RP, et al. Historical cohort study of 10 109 men in the North American vinyl chloride industry, 1942-72: update of cancer mortality to 31 December 1995. Occup Environ Med. 2000;57:774–81.
Ward E, Boffetta P, Andersen A, et al. Update of the follow-up of mortality and cancer incidence among European workers employed in the vinyl chloride industry. Epidemiology. 2001;12:710–8.
Laplanche A, Clavel-Chapelon F, Contassot JC, et al. Exposure to vinyl chloride monomer: results of a cohort study after a seven year follow up. Br J Ind Med. 1992;49:134–7.
Smulevich VB, Fedotova IV, Filatova VS. Increasing evidence of the rise of cancer in workers exposed to vinyl chloride. Br J Ind Med. 1988;45:93–7.
Thériault G, Allard P. Cancer mortality of a group of Canadian workers exposed to vinyl chloride monomer. J Occup Med. 1981;23:671–6.
Boffetta P, Matisane L, Mundt KA, et al. Meta-analysis of studies of occupational exposure to vinyl chloride in relation to cancer mortality. Scand J Work Environ Health. 2003;29:220–9.
Kreuzer M, Walsh L, Schnelzer M, et al. Radon and risk of extrapulmonary cancers: results of the German uranium miners’ cohort study, 1960-2003. Br J Cancer. 2008;99:1946–53.
Schubauer-Berigan MK, Daniels RD, Pinkerton LE. Radon exposure and mortality among white and American Indian uranium miners: an update of the Colorado Plateau cohort. Am J Epidemiol. 2009;169:718–30.
Vacquier B, Caer S, Rogel A, et al. Mortality risk in the French cohort of uranium miners: extended follow-up 1946-1999. Occup Environ Med. 2008;65:597–604.
Cardis E, Vrijheid M, Blettner M, et al. Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries. Br Med J. 2005;331:77.
Bleyer A, O’Leary M, Barr R, et al. Cancer epidemiology in older adolescents and young adults 15 to 29 years of age, including SEER incidence and survival: 1975-2000. NIH Pub. No. 06-5767. Bethesda: National Cancer Institute; 2006.
Stiller CA, Bielack SS, Jundt G, et al. Bone tumours in European children and adolescents, 1978-1997. Report from the automated childhood cancer information system project. Eur J Cancer. 2006;42:2124–35.
Merletti F, Richiardi L, Bertoni F, et al. Occupational factors and risk of adult bone sarcomas: a multicentric case-control study in Europe. Int J Cancer. 2006;118:721–7.
Berrington A, Darby SC, Weiss HA, et al. 100 years of observation on British radiologists: mortality from cancer and other causes 1897–1997. Br J Radiol. 2001;74:507–19.
Matanoski GM, Seltser R, Sartwell PE, et al. The current mortality rates of radiologists and other physician specialists: deaths from all causes and from cancer. Am J Epidemiol. 1975;101:188–98.
Matanoski GM, Sternberg A, Elliott EA. Does radiation exposure produce a protective effect among radiologists? Health Phys. 1987;52:637–43.
Smith PG, Doll R. Mortality from cancer and all causes among British radiologists. Br J Radiol. 1981;54:187–94.
Berrington de González A, Ntowe E, Kitahara CM, et al. Long-term mortality in 43 763 U.S. radiologists compared with 64 990 U.S. psychiatrists. Radiology. 2016;281:847–57.
Martland HS. Occupational poisoning in manufacture of luminous watch dials. JAMA. 1929;92:466–73.
Polednak AP, Stehney AF, Rowland RE. Mortality among women first employed before 1930 in the U.S. radium dial-painting industry. A group ascertained from employment lists. Am J Epidemiol. 1978;107:179–95.
Pukkala E, Martinsen JI, Weiderpass E, et al. Occupation and cancer—follow up of 15 million people in five Nordic countries. Acta Oncol. 2009;48:646–790.
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Comandone, A., Garzaro, G., Pira, E., Boffetta, P. (2020). Soft Tissue and Bone Sarcomas. In: Anttila, S., Boffetta, P. (eds) Occupational Cancers. Springer, Cham. https://doi.org/10.1007/978-3-030-30766-0_22
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