Outcomes of surgical treatment of soft-tissue sarcomas in adults

Abstract

Background: Soft-tissue sarcomas (STS) are rare mesenchymal tumors with several histologic subtypes and different clinical patterns.
Objective: The aim of this study was to describe the clinical and pathological characteristics and surgical outcomes of a series of patients with STS.
Material and methods: The clinical records of 2403 undergoing surgery between October 2014 and April 2018 were retrospectively reviewed. Twenty-two patients (0.91%) presented STS.
Results: Mean age was 52 years (range: 19-92) and 13(59%) were women. The tumors were located in the lower extremities in 12 cases, head and neck in five, trunk in three and upper extremities in two. Fourteen cases (63.6%) were high-grade tumors. Pleomorphic sarcoma was the most common histologic type (32%) followed by synovial sarcoma (18%), liposarcoma (14%), and other types (36%). All the tumors were completely resected and five patients(35.7%) required amputation, four in the lower extremity and on in the upper extremity. Different reconstructive procedures were performed accor- ding to tumor size and location, including three free flaps. Those patients with high-grade sarcomas or with positive margins received postoperative radiotherapy. After a mean follow-up of 16 months, six patients presented local recurrences and four patients had synchronous metastatic disease in the lungs; all these patients had high-grade tumors. Overall survival was 86.4%.
Conclusion: STS are rare and invasive neoplasms, widely distributed, requiring aggressive and occa- sionally complex surgical procedures. It is necessary to consider adjuvant treatments in selected cases and to maintain regular follow-up due to the high rate of recurrences and distant metastases.