Scandinavian Sarcoma Group: 22nd meeting, Reykjavik, May 7–9, 1996

Abstract

According to figures from the National cancer registries in the Nordic countries the incidence of all soft tissue sarcomas is highest in Iceland, especially in the capital area of Reykjavik. The reasons for this is unknown but referral pattern, autopsy figures or geographic factors may he of importance. Possible explanations will he discussed. The incidence of bone sarcomas, on the other hand, is similar to that in the other countries. We evaluated incidence, diagnostic and treatment policy and prognostic factors for soft tissue and bone sarcomas in Iceland during a 40-year-period which is unique for a whole nation. Patients and methods: 17 I soft tissue sarcomas were reported to the cancer registry (excluding sarcomas in internal organs such as uterus and gastrointestinal tract, dermatotibrosis protuberans, Kaposi sarcoma and mesothelioma). The average age-standardized incidence was 1.8/100.000 for men and 1.6/100.000 for women. Malignant fibrous histiocytoma, liposarcoma and leiomyosarcoma comprised more than half of the tumors diagnosed. All tumors were examined by microscopic slides by two independent pathologists (BAA and KRB). All cases were graded using both a three (1-111) and four (I-IV) scale system. 107 bone sarcomas were reported to the cancer registry during the period with chondrosarcoma (38 cases) and osteosarcotna (2 1 cases) being commonest. The age-standardized incidence is 1.0/100.00 for women and 1.6/100.000 for men. Re.su1t.s; Prognostic factors for survival were assessed by Cox's multivariate analysis and included: age, sex, tumor localization, histopathological subtype, tumor size malignancy grade, year of diagnosir and DNA ploidy status. The strongest prognostic factors for wf t tissue sarcomas were malignancy grade, tumor size, and year of diagnosis. There has been a more than 50% reduction in mortality risk during the period. We did not find DNA ploidy status as a prognostic factors for the soft tissue sarcomas. Exact prognostic figures for the bone sarcomas are not available at this time. Conclusion: During the last two decades the prognostic procedures have changed dramatically with the advent of fine needle aspiration, CT scans and more recently the MRI technique. Concurrently the surgical treatment has changed to better margins, more limb sparing procedures and the treatment and follow up has been more centralized. A close collaboration with the SSG has enabled us to discuss all complicated newly diagnosed cases and several have been sent to Lund for treatment. This cooperation has had a very positive impact for both doctors and patients with more favourable survival experience and better quality of life of our patients.