Soft tissue sarcoma-review of experience at a tertiary care cancer centre

This study is a retrospective analysis of prospective data base of soft tissue sarcoma (STS) maintained in the department of Surgical Oncology, Bhim Rao Ambedkar Institute Rotary Cancer Hospital (BRA-IRCH), All India Institute of Medical Sciences, which is a tertiary care cancer centre. A total of 300 patients of STS were treated between 1995 and 2006. The mean age at presentation was 40.6 years and males were more affected then females. Extremity sarcomas were more common than non extremity sarcoma and lower limb dominated upper limb. The median size of tumor was 8 cm (range 1-40 cm). MRI scan was the preferred imaging modality and tissue diagnosis was obtained by core biopsy. Synovial Sarcoma and Malignant Fibrous Histiocytoma were the common histology. Majority (75%) tumors were of high grade. Patients were staged according to MSKCC staging system. Limb Salvage Surgery was offered to all patients where ever feasible. Wide excision with a gross three dimensional tumor free margin of 2 cm was performed. Adjuvant external beam radiotherapy was offered to all high grades, large and recurrent tumors along with perioperative brachytherapy implant for tumor bed. High grade tumors were also offered adjuvant Adriamycin based Chemotherapy. Limb salvage rate was 68% in extremity sarcoma. During follow up 114 (38%) patients had relapse of disease mainly systemic, lungs being the commonest site.