Management of soft tissue sarcoma of extremities in adults

ABSTRACT

Soft-tissue sarcomas [STS] are a group of rare malignant tumors, many of which arise in the limbs. To review the results of managements of STS of extremities in adults treated in the period between December 1997 till December 2000, in Oncology Unit Menufia University Hospital [MUH]. Sixteen adult patients had STS in their extremities. Seven males and 9 females with a mean age of 45.3 years. Variables studied were; clinical presentation and its duration, tumor characteristics [site, size, pathological type and grade, lymph node status], treatment given, and its outcome, as well as the disease free survival [DFS]. The most common type of presentation was a painless mass for 5 months +/- 2. Most sarcomas were located in the lower extremity [81%]; all the patients underwent conservative surgical excision except one underwent disarticulation. Eight patients had adjuvant radiotherapy and 5 patients had chemotherapy. The commonest histopathology found was liposarcomas [7 cases, 43%], followed by fibrosarcoma [4 cases, 18%], and 50% of patients had high-grade tumours. The tumour size, type, and grade were independent risk factors for poorer disease free survival. The disease free survival for all patients, for 5 years was 81.25%. With limb salvage surgery and radiotherapy delivery, local control of STS in the extremity has become feasible. Other modalities, as hormonal treatment and immunetherapy should be further studied to optimize the outcome and improve DFS