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Analysis of Clinical Outcomes of Patients with Soft Tissue Sarcoma

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Abstract

The aim of this study was to evaluate the outcome of patients with soft tissue sarcoma of the extremity and abdominal wall. This is the retrospective analysis of patients from a prospectively maintained data base from a single institute. We identified 79 patients with intermediate- to high-grade soft tissue sarcomas who were treated at our institute between Jan 2015 and July 2018. Low-grade tumors were excluded. There were 60 males and 19 females with a mean age of 44.6 years. Of the 79 sarcomas, 50 were in the lower limb and 24 in the upper limb and 5 were in abdominal wall. The commonest subtypes were undifferentiated pleomorphic sarcoma (n = 21) and synovial sarcoma (n = 19). Only 9 patients had metastatic disease at presentation. All 79 patients underwent surgical resection with an intent to achieve clear margins. Amputation was done in 19 patients while wide excision of the tumor was done in 60 patients. Adjuvant radiotherapy was given in 49 patients while adjuvant chemotherapy was given in 35 patients. At last follow-up (73 patients), 48 patients are alive without disease, 9 are alive with disease, 12 patients had died of disease, and 4 patients died due to other causes. Overall survival (OS) for 3 year is 77.6%, and estimated mean survival is 55.05 months. Relapse-free surviva (RFS)l at 3 year is 74.3%, and estimated mean RFS is 51.78. The only independent factor that affected the OS was the dimension of primary tumor (p = 0.02). For disease-free survival, the independent factors that affected outcome were stage at presentation (p = 0.04) and dimension of the tumor (p = 0.04). Short-term results shown by this study shows good outcome in patient with intermediate- to high-grade sarcomas when multidisciplinary approach is utilized for the management. Patients who had metastatic disease at presentation did worse than patients who did not.

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References

  1. Hun JY (2016) Epidemiology and etiology of sarcomas. Surg Clin North Am 96:901–914

    Article  Google Scholar 

  2. Ross JA, Severson RK, Davis S, Brooks JJ (1993) Trends in the incidence of soft tissue sarcomas in the United States from 1973 through 1987. Cancer 72:486–490

    Article  CAS  Google Scholar 

  3. Levi F, Vecchia CL, Randimbison L, Te VC (1999) Descriptive epidemiology of soft tissue sarcomas in Vaud, Switzerland. Eur J Cancer 35:1711–1716

    Article  CAS  Google Scholar 

  4. Gustafson P (1994) Soft tissue sarcoma. Epidemiology and prognosis in 508 patients. Acta Orthop Scand Suppl. 259:1–31

    CAS  PubMed  Google Scholar 

  5. Zahm SH, Fraumeni JF Jr (1997) The epidemiology of sofi tissue sarcoma. Semin Oncol 24:504–514

    CAS  PubMed  Google Scholar 

  6. Abarca T, Gao Y, Monga V, Tanas MR et al (2018) Improved survival for extremity soft tissue sarcoma treated in high-volume facilities. J Surg Oncol 117(7):1479–1486

    Article  Google Scholar 

  7. Sim FH, Edmonson JH, Wold LE (1993) Soft-tissue sarcoma. Clin Orthop Rel Res 289:106–112

    Article  Google Scholar 

  8. Berlin O, Stener B, Angervall L, Kindblom LG, Markhede G, Oden A (1990) Surgery of soft tissue sarcoma in the extremities: a multivariate analysis of the 6–26 year prognosis in 137 patients. Acta Orthop Scand 53:475–486

    Article  Google Scholar 

  9. Gaynor JJ, Tan CC, Casper ES, Collin CF, Friedrich C, Shiu M, Hajdu SI et al (1992) Refinement of clinicopathologic staging for localised soft tissue sarcoma of the extremity: a study of 423 adults. J Clin Oncol 10:1317–1329

    Article  CAS  Google Scholar 

  10. Clark MA, Fisher C, Judson I, Thomas JM (2005) Soft-tissue sarcomas in adults. N Engl J Med 353:701–711

    Article  CAS  Google Scholar 

  11. Woll PJ, Reichardt P, Le Cesne A, Bonvalot S, Azzarelli A, Hoekstra HJ, EORTC Soft Tissue and Bone Sarcoma Group and the NCIC Clinical Trials Group Sarcoma Disease Site Committee et al (2012) Adjuvant chemotherapy with doxorubicin, ifosfamide, and lenograstim for resected soft-tissue sarcoma (EORTC 62931): a multicenterrandomised controlled trial. Lancet Oncol 13:1045–1054

    Article  CAS  Google Scholar 

  12. Zhao R, Yu X, Feng Y, Wang J, Mao Y, Yin W et al (2018) The influence of anatomoic location on outcomes in patients with localized primary soft tissue sarcoma. Jpn J Clin Oncol 48(9):799–805

    Article  Google Scholar 

  13. Sinha S, Peach AH (2010) Diagnosis and management of soft tissue sarcoma. BMJ 341:c7170

    Article  Google Scholar 

  14. Kane JM 3rd (2004) Surveillance strategies for patients following surgical resection of soft tissue sarcomas. Curr Opin Oncol 16:328–332

    Article  Google Scholar 

  15. Patel SR, Zagars GK, Pisters PW (2003) The follow-up of adult soft-tissue sarcomas. Semin Oncol 30:413–416

    Article  Google Scholar 

  16. Jacobs AJ, Michels R, Stein J, Levin AS (2015) Improvement in overall survival from extremity soft tissue sarcoma over twenty years. Sarcoma 2015:1–9

    Article  Google Scholar 

  17. Anonymous. Adjuvant chemotherapy for localized resectable soft tissue sarcoma of adults: meta-analysis of individual data. Sarcoma Meta-analysis Collaboration. Lancet. 1997; 350(9092):1647–54.

  18. Lewis JJ, Brennan MF (1996) Soft tissue sarcomas. Curr Probl Surg 33(10):817–872

    Article  CAS  Google Scholar 

  19. Peiper M, Zurakowski, Zoring C (1997) Survival in primary soft tissue sarcoma of the extremities and trunk. Langenbecks Arh Chir. 382:203–208

    CAS  Google Scholar 

  20. Schreiber D, Rineer J, Katsoulakis E, Sroufe RL, Lange CS, Nwokedi E et al (2012) Impact of postoperative radiation on survival for high-grade soft tissue sarcoma of the extremities after limb sparing radical resection. Am J Clin Oncol 35(1):13–17

    Article  Google Scholar 

  21. Zagars GK, Ballo MT (2003) Significance of dose in postoperative radiotherapy for soft tissue sarcoma. Int J Radiat Oncol Biol Phys 56(2):473–481

    Article  Google Scholar 

  22. Gerrand CH, Wunder JS, Kandel RA, O’Sullivan B, Catton CN, Bell RS et al (2001) Classification of positive margins after resection of soft-tissue sarcoma of the limb predicts the risk of local recurrence. J Bone Joint Surg Br 83(8):1149–1155

    Article  CAS  Google Scholar 

  23. Kawaguchi N, Ahmed AR, Matsumoto S, Manabe J, Matsushita Y (2004) The concept of curative margin in surgery for bone and soft tissue sarcoma. Clin Orthop Relat Res. 419:165–72

    Article  Google Scholar 

  24. Cakır S, Dincbas FO, Uzel O, Koca S, Okkan S (1995) Multivariate analysis of prognostic factors in 75 patients with soft tissue sarcoma. Radiother Oncol 37(1):10–16

    Article  Google Scholar 

  25. Trovik CS, Bauer HC, Berlin O, Tukiainen E, Erlanson M, Gustafson P et al (2001) Local recurrence of deep-seated, high grade, soft tissue sarcoma:459 patients from the Scandinavian Sarcoma Group Register. Acta Ortop Scand 72(2):160–166

    Article  CAS  Google Scholar 

  26. Venkatesan M, Richards CJ, McCulloch TA, Perks AG, Raurell A (2012) Ashford RU; East Midlands Sarcoma Service. Inadvertent surgical resection of soft tissue sarcomas. Eur J Surg Oncol 38(4):346–51

    Article  CAS  Google Scholar 

  27. Chandrasekar CR, Wafa H, Grimer RJ, Carter SR, Tillman RM, Abudu A (2008) The effect of an unplanned excision of a soft-tissue sarcoma on prognosis. J Bone Joint Surg Br 90:203–208

    Article  CAS  Google Scholar 

  28. Bianchi G, Sambri A, Cammelli S, et al. Impact of residual disease after ‘unplanned excision’ of primary localized adult soft tissue sarcoma of the extremities: evaluation of 452 cases at a single institution. Musculoskelet Surg 2017.

  29. Peabody TD, Monson D, Montag A, Schell MJ, Finn H (1994) A comparison of the prognosis for deep and subcutaneous sarcomas of the extremities. J Bone J Surg 76:1167–1173

    Article  CAS  Google Scholar 

  30. Ogura K, Higashi T, Kawai A (2017) Statistics of soft-tissue sarcoma in Japan: report from bone and soft tissue tumor registry in Japan. J Orthop Sci 22:755–764

    Article  Google Scholar 

  31. Italiano A, Mathoulin-Pelissier S, Cesne AL et al (2011) Trends in survival for patients with metastatic soft-tissue sarcoma. Cancer 117(5):1049–1054

    Article  Google Scholar 

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Authors and Affiliations

  1. Musculoskeletal Oncology, Dharamshila Narayana Superspecialty Hospital, New Delhi, India

    Lokesh Garg

  2. Tata Memorial Hospital, Mumbai, Maharastra, India

    Manish Pruthi

  3. Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

    Ullas Batra, D. C. Doval, Sunil Pasricha & Jiten Jaipuria

  4. Paras Hospital, Panchkula, Haryana, India

    Jagandeep Singh Virk

  5. Max Hospital, Delhi, India

    Akshay Tiwari

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  1. Lokesh Garg
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Correspondence to Manish Pruthi.

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Garg, L., Pruthi, M., Batra, U. et al. Analysis of Clinical Outcomes of Patients with Soft Tissue Sarcoma. Indian J Surg Oncol 13, 518–524 (2022). https://doi.org/10.1007/s13193-022-01510-0

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  • DOI: https://doi.org/10.1007/s13193-022-01510-0

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