[Primary soft tissue sarcoma of the chest in adults: a retrospective study of 40 cases]

Primary thoracic soft tissue sarcomas (PTSTS) include parietal, pulmonary and mediastinal tumors. Management and prognostic factors of these rare tumors are poorly known. The aim of the study was to report a series of 40 patients with PTSTS, with analysis of their clinico-pathological characteristics, management, and prognostic factors.

Data were collected from a prospective database. Survival were analyzed by Kaplan-Meier method and compared with log-rank test. Prognostic factors were identified with a Cox model.

The median age was 48 years. The male/female ratio was 15/25. The most common subtype was malignant histiocytofibroma (11 cases). Twenty-one tumors were high-grade sarcomas. The commonest location was chest wall (26 cases). Thirty-two sarcomas were treated surgically, including 22 who had radical resections (free margins). Associated treatments were neoadjuvant (n = 8) or adjuvant (n = 8) chemotherapy, and postoperative radiotherapy (n = 17). The 5-year overall survival was 45%. In univariate analysis, prognostic factors were age (p = 0.05), Karnofsky index (p = 0.008), absence of metastases at initial presentation (p = 0.0003), radical resection (p = 0.043), and adjuvant chemotherapy (p = 0.04). The tumor location had no prognostic value.

Management of PTSTS needs a multidisciplinary approach, and is mainly based on radical resection. Prognosis of pulmonary, chest wall and mediastinal sarcomas is similar.