The Demographic Features and Clinical Characteristics of Soft Tissue Sarcoma; Single Center Experience

Abstract

Giriş: Yumuşak doku sarkomları (YDS) son derece nadir görülmektedir. Çalışmamızda YDS tanısı ile takip ve tedavisi yapılan hastaların klinikopatolojik ve demografik verilerinin incelenmesi ve evrelere göre sağkalımlarının geriye dönük olarak incelenmesi amaçlandı. Materyal: Çalışmaya 2010-2019 yılları arasında onkoloji kliniğinde YDS tanısı ile takip ve tedavisi yapılan hastalar alındı. Çalışmaya 18 yaş üzerinde, YDS dışında malignitesi olmayan ve verilerine eksiksiz ulaşılabilen tüm hastalar alındı. Bulgular: Çalışmaya 32 (%52,5) kadın 29 (%47,5) erkek olmak üzere toplam 61 hasta alındı. Hastaların ortanca yaşı 61 yıl (22-81) idi. Hastaların 43 (%70,5) ü non-metastatik evrede iken, 18 (%29,5) hasta tanı anında metastatik evrede idi. 36 (%59) extremite dışı yerleşimli, 25 (%41) hasta ekstremite yerleşimli idi. 58 (%95,1) hastaya primer tümörüne cerrahi uygulanmıştı. Metastatik evrede olan hastalarda en sık metastaz lokalizasyonu Akciğer olup 8 (%13.1) hastada vardı. Non- metastatik olan 18 (%41,9) hastada nüks gelişmişti. En sık nüks lokalizasyonu olarak lokal nüks 11(%57,9) hastada gelişmişti. Histolojik alt tip olarak en sık Leiomiyosarkom 15 (%24,6) hastada gözlenmişti. Non metastatik olan 5 (%11,6) hastaya neoadjuvan tedavi, 19 (%44,2) hastaya adjuvan kemoterapi, 11 (%30,6) hastaya adjuvan radyoterapi verilmişti. Metastatik olan ve nüks gelişen hastalardan 25 (%69,4) üne ilk seri kemoterapi verilmişti. Non metastatik olan hastalarda evreler arasında (evre I,II ve III) hastalıksız sağkalım ve genel sağkalım açısından istatistiksel olarak fark yoktu(p= 0.508, p=0.331 sırasıyla). Metastatik hastalarda genel sağkalım 21 ay saptanırken, non-metastatik olan hastalarda genel sağkalım süresine ulaşılamamıştı (p<0.001) Tartışma ve sonuç: Çalışmamızda bölgemizdeki YDS incelenmiş olup, hastaların 1/3 metastatik evrede başvurduğu, yarısından fazlasının ekstremite dışı olduğu, histolojik olarak en sık leiomyosarkom görüldüğü gözlendi. Ayrıca metastatik olanların en sık akciğer metastazı ile başvurduğu, Non-metastatik olanlarda ise en sık lokal nüks ile nüks ettiği gözlendi.

Introduction: Soft tissue sarcomas (STS) are extremely rare. In our study, it was aimed to examine the clinicopathological and demographic data of the patients who were followed-up and treated with the diagnosis of STS and to examine their survival retrospectively according to stages. Materials and methods: Patients who were followed-up and treated with the diagnosis of STS in oncology clinic between 2010-2019 were included in the study. All patients over the age of 18, with no malignancy other than STS and whose data were fully available were included in the study. Results: A total of 61 patients, 32 (52.5%) female and 29 (47.5%) male, were included in the study. The median age of the patients was 61 years (22-81). While 43 (70.5%) patients were in the non-metastatic stage, 18 (29.5%) patients were in the metastatic stage at the time of diagnosis. 36 (59%) were located outside the extremity and 25 (41%) patients were located in the extremity. Surgery was applied to the primary tumor in 58 (95.1%) patients. The most common metastasis localization in patients with metastatic stage is Lung and it was present in 8 (13.1%) patients. Recurrence occurred in 18 (41.9%) patients who were non-metastatic. The most common recurrence was local recurrence in 11 (57.9%) patients. Leiomyosarcoma was the most common histological subtype in 15 (24.6%) patients. Neoadjuvant therapy was given to 5 (11.6%) patients who were non-metastatic, adjuvant chemotherapy was given to 19 (44.2%) patients, and adjuvant radiotherapy to 11 (30.6%) patients. The first series of chemotherapy was given to 25 (69.4%) of the patients who developed metastatic and relapse. In patients with non-metastatic, there was no statistical difference between stages (stages I, II and III) in terms of disease-free survival and overall survival (p = 0.508, p = 0.331 respectively). While overall survival was 21 months in metastatic patients, overall survival was not achieved in non-metastatic pat ients (p <0.001). Discussion and Conclusion: In our study, STS in our region was examined, and it was observed that the patients applied at 1/3 metastatic stage, more than half of them were out of limbs, and the most frequent leiomyosarcoma was observed histologically. In addition, it was observed that those with metastatic most frequently applied with lung metastasis, while those with non-metastatic recurred with local recurrence most frequently.