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included tumor characteristics necessitating referral 2009 [Table 1]. Seventy-four (55%) of them were men
to specialized units. These were a fast-growing mass, and 61 (45%) women. Average age for the all patients
diameter wider than 5 cm, location close to the deep was 59 years (64 mean [13–89]). Only 2 of the patients
fascia, development of pain in a previously painless lump were under 18 years. The mean follow-up time was
and a newly formed tumor in the same location as benign 68 months (range: 12–149).
tumor noted previously. Annual incidence of STS in Group A was
In order to measure the impact of the multidisciplinary 1.39/100, 000 (inhabitants) and 1.89/100,000 in
groups and clinical guidelines, we divided the time period Group B.
into 2 parts and compared the results of treatment. The Soft tissue sarcoma histology
first period, Group A, comprised the early part of the When the total time period (2000–2009) was
study (2000–2005) when the knowledge was still poor. The analyzed, the most common sarcomas in descending
last 4 years after introduction of guidelines (2006–2009) order were found to be pleomorphic sarcoma (37%),
comprised the second period as Group B.
liposarcoma (26%), fibrosarcoma (10.4%) and
The aim of this study was to determine, if there were leiomyosarcoma (9.6%) [Table 2]. Pleomorphic sarcoma
any differences in the outcome of STS in Hospital District
of North Savo, when diagnostic methods, the treatment Table 1: Patient demographics
results, local recurrences, metastases, and overall survival Characteristics Total (%) Group A (%) Group B (%)
were analyzed between the 2 periods. Gender
Male 74 (55) 39 (55) 35 (55)
METHODS Female 61 (45) 32 (45) 29 (45)
Total 135 71 64
All the material was retrospectively collected from the files Age
of multidisciplinary sarcoma group meetings. Accordingly Median 64 64 65
the patients’ medical reports were reviewed for medical Operation 118 (87) 63 (90) 55 (84)
data. The patient demographics were collected [Table 1]. Oncological treatment
The interval between the symptoms and the histological Chemotherapy 15 (11) 10 (14) 5 (8)
sample collection was measured, and information Radiotherapy 63 (47) 31 (44) 32 (50)
about tumor characteristics (the type of the sarcoma, Recurrence 22 (16) 10 (14) 12 (19)
tumor size, location, grade, sample collection method, Metastases 22 (16) 7 (10) 15 (23)
metastasis, and recurrence) were clarified [Table 1]. In Survival
addition, we studied if there were any previous condition, Deaths 48 (36) 21 (30) 27 (42)
which required surgical intervention in the sarcoma site. Description of patients, treatment and survival characteristics of the
Furthermore, the patients’ previous oncological treatments 135 patients with soft tissue sarcoma treated in Kuopio University
Hospital years 2000–2006 (Group A) and 2006–2009 (Group B)
before the sarcoma diagnosis were examined [Table 1].
Desmoid tumors were excluded from the study.
Table 2: Tumor characteristics
Samples were studied by an experienced Characteristics Total (%) Group A (%) Group B (%)
pathologist, (Professor Ylermi Soini), and classified
according to the guidelines of the World Health Histology
Organization: classification of soft tissue and bone tumors Pleomorphic sarcoma 50 (37) 25 (35) 25 (39)
using routine H and E staining and immunohistochemistry Liposarcoma 35 (26) 20 (15) 15 (23)
7 (11)
8 (11)
15 (11)
Fibrosarcoma
including vimentin, desmin, S-100, protein CD34, Leiomyosarcoma 13 (10) 8 (11) 5 (8)
sytokeratin PAN (AE1/AE3), Ki67 (all from Roche Angiosarcoma 3 (2) 0 (0) 3 (5)
Biotechnology) and desmin (Dako, Glostrup, Denmark) Chondrosarcoma 4 (3) 2 (3) 2 (3)
and stained with an automatic immunostainer (Ventana Synovialsarcoma 4 (3) 2 (3) 2 (3)
and Dako). Other a 11 (8) 6 (9) 5 (8)
Site
Statistical analyses were done with Statistical Package
for the Social Sciences SPSS Base version 18 (SPSS, Inc., Lower limb 78 (58) 46 (65) 32 (50)
®
Chicago, Illinois, USA). Trunk 31 (23) 14 (20) 17 (27)
Upper limb 22 (16) 10 (14) 12 (19)
The study was approved by the Ethical Committee of Head and neck 3 (2) 1 (1) 2 (3)
Kuopio University Hospital, and all patients gave their Sampling method
written informed consent for participation in the study CNB b 89 (66) 47 (66) 42 (66)
15/2009. Excisional 24 (18) 11 (16) 13 (20)
FNB c 5 (4) 2 (3) 3 (5)
RESULTS Incisional 14 (10) 9 (13) 5 (8)
Description of histology, site and sampling method characteristics of
the 135 patients with soft tissue sarcoma treated in Kuopio University
One hundred and thirty-five patients with STS were Hospital years 2000–2006 (Group A) and 2006–2009 (Group B).
treated in Kuopio University Hospital between 2000 and a Malignant schwannoma, Core needle biopsy, Fine needle biopsy
c
b
Plast Aesthet Res || Vol 1 || Issue 3 || Dec 2014 99