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Distal extremities soft tissue sarcomas: Are they so different from other limb localizations?
Jean-Camille Mattei1,2, Véronique Brouste3, Philippe Terrier4
1Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Départment de Chirurgie Orthopédique des Prs. Curvale et Rochwerger, Marseille, France.
Journal of Surgical Oncology
|January 5, 2019
Summary
Soft tissue sarcomas in the distal extremities (DESTS) are rare but aggressive. Despite higher amputation rates, DESTS have similar survival and recurrence rates compared to other limb localizations (OLSTS).
Area of Science:
- Oncology
- Surgical Oncology
- Epidemiology
Background:
- Soft tissue sarcomas (STS) in the distal extremities (DESTS) are uncommon.
- Limited literature exists on DESTS behavior and outcomes.
- This study compares DESTS to other limb localizations (OLSTS).
Purpose of the Study:
- To assess epidemiological characteristics of DESTS.
- To compare outcomes and prognosis of DESTS versus OLSTS.
- To inform treatment decisions for DESTS.
Main Methods:
- Retrospective analysis of adult DESTS and OLSTS from 1980-2010 across 22 centers.
- Data collected included demographics, tumor type, and treatment modalities.
- Primary endpoints were overall survival and local/metastatic recurrence.
Main Results:
- 205 DESTS and 3001 OLSTS were analyzed.
- DESTS patients were younger, with smaller tumors and a higher proportion of females.
- DESTS had similar 5-year survival (78.2%) to OLSTS (68.6%), with localization not impacting recurrence.
Conclusions:
- DESTS are aggressive despite smaller size and rarity.
- Prognosis for DESTS is comparable to OLSTS, even with higher amputation rates.
- Limb-sparing surgery versus amputation requires careful consideration for DESTS, particularly high-grade or poor-prognosis subtypes.
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