Correlation between Clinicopathological Features of Soft Tissue Sarcoma and Clinical Outcomes; A Retrospective Study

Abstract

Abstract Background Sarcoma is a rare and diverse mesenchymal cancer that accounts for fewer than 1% of all adult cancers and 10% of paediatric tumours. Around 11,000 new cases are diagnosed each year in the United States, accounting for <1% of all cancers. Approximately 80% of sarcoma originate from soft tissue, and the rest originate from bone. Most sarcomas (about 55%) affect mainly the extremities, mostly the legs, and about 15% affect the head and neck area or trunk, the rest are retroperitoneal or intraperitoneal. Objective The primary objective is to determine the clinicopathological features and treatment strategies of soft tissue sarcoma and its correlation to clinical outcomes in the form of Overall survival, Disease free survival and Progression free survival in the period from January 2017 to December 2021. Methods This study is a retrospective study that included 151 patients diagnosed with soft tissue sarcoma attending the sarcoma unit at the Clinical Oncology Department, Ain Shams University, in the period between the start of January 2017 to the end of December 2021 Results 151 patients were eligible for overall survival evaluation in which median OS was 80 months. Disease free survival was calculated in 133 patients in our study with median DFS 36 months. Patients presented with metastasis from the start represented 10.5% of the population. Meanwhile 23% of the studied population developed metastasis later on, with median PFS 17 months. The most common site of metastasis was lung in 36.5%. Metastasis at initial presentation had a negative impact on overall survival with p value < 0.001. Resection margin had high impact on overall survival outcomes and recurrence with p value <0.001 and <0.018, respectively. Other clinicopathological factors that had a statistical significance on OS and DFS and local recurrence were; Age, ECOG, tumor size, stage and resection margin. Conclusion STS represents a heterogenous group of malignancies that require multidisciplinary team and referral to experienced tertiary centers. Treatment patterns for STS have evolved with increased utilization of neoadjuvant radiation therapy for patients diagnosed with resectable disease aiming for less toxicity with lower dose and smaller treatment volume, limb sparing surgery with free resection margins and better quality of life. We concluded that the most significant predictors of survival and prognostic factors are; stage at initial presentation, type of surgery and margin status.