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was equally common in both genders (38%), as so was Table 3: Primary outcomes
leiomyosarcoma (men 9.5%, women 9.8%). Fibrosarcoma Outcome Group A (%) Group B (%)
was found to be more than twice as common in
men (14.9%) than women (6.6%). Liposarcomas, Recurrence 10 (14) 12 (19)
fibrosarcomas, synovial sarcomas and chondrosarcomas Metastases 7 (10) 15 (23)
occurred usually in young adults and in middle-aged Survival 50 (70) 37 (58)
people. Among elderly patients’ liposarcomas and
pleomorphic sarcomas were the most common tumors. operation. Twenty-two of all patients (16%) got a
The incidence of leiomyosarcomas was same in all age recurrence during 2 years’ follow-up.
groups studied.
In Group A, 8 out of 10 recurrences were high-grade
Tumor location tumors (7 pleomorphic sarcoma, 1 leiomyosarcoma).
In this study, 78 patients (58%) had a tumor in their Two tumors were low-grade sarcomas (liposarcomas).
lower limb and 20 tumors were diagnosed below the Six of the 10 patients died with recurrences during the
knee [Table 2]. Thirty-one patients (23%) had a tumor follow-up time of 5 years.
in the trunk, 22 (16%) in the upper limb and 3 (2%) in In Group B, 12 tumors recurred, from which 5 were
the head or neck region. In Group A, 46 patients (65%) pleomorphic sarcomas, 3 liposarcomas, 2 fibrosarcomas,
had sarcoma in the lower limb, 14 (20%) in the trunk, and 2 angiosarcomas. Ten of these 12 tumors were
10 (14%) in the upper limb and 1 (1%) in the head and high-grade tumors. One was a low-grade liposarcoma,
neck region. which was diagnosed by incisional biopsy. Four patients
In the latter Group B, 32 patients (50%) had sarcoma in were diagnosed with an excisional biopsy, and 3 were
the lower limb, 17 (27%) in the trunk, 12 (19%) in the operated intralesionally for diagnosis. Four patients got
upper limb and 2 (3%) in the head and neck. lung metastases and 8 died during the follow-up time.
There were no significant differences in local recurrence
Sampling method between the 2 groups.
In this study, 89 tumors (66%) were diagnosed with core
needle biopsy (CNB), 5 (4%) with a fine-needle biopsy, while A total of 22 patients (16%) had metastases, of which
24 tumors (18%) were excised for the histology and 14 (10%) the most common sites were lung, bone and lymph
were analyzed by incisional biopsy (excision with positive nodes [Table 3]. Two skin metastases were found in
margins). In Group A, 47 were (66%) diagnosed with CNB, patients with pleomorphic sarcoma, 5 patients had
11 (16%) with excisional resection, 2 (3%) with fine-needle lymph nodes metastases (chondrosarcoma, liposarcoma,
aspiration biopsy (FNAB) and 9 (13%) with incisional pleomorphic sarcoma and fibrosarcoma), and 4 patients
biopsy. In the Group, B 42 were (66%) diagnosed with CNB, had bone metastases (pleomorphic sarcoma, liposarcoma
13 (20%) with excisional resection, 3 (5%) with FNAB and and malignant schwannoma).
5 (8%) with incisional resection. The number of tumors that During the follow-up time, 7 patients (10%) in Group A
were diagnosed by incisional biopsy was found to be high got metastases, whereas in the Group B incidence of
if the tumor was located in the upper limb (P = 0.002). metastases was higher (15 patients, 23%) (P = 0.033).
These incisional biopsies were performed in tertiary centers
or in local hospitals without consulting specialists. However, A total of 48 patients (36%) died during the follow-up
there were no statistical difference between the sampling time. Seventeen patients were treated conservatively
methods used when occurrence of metastases, local without surgical intervention. These patients were either
recurrence or death were analyzed. unsuitable for operation because of their co-morbidity,
or they declined the surgery. Among all the patients who
Treatment underwent surgery, mortality rate was 23% (31 patients).
The most common surgical treatment was wide local In Group A, 21 patients (30%) died during the follow-up
excision (56 patients, 42%). Total myectomy was done for period whereas 27 patients (42%) died in the Group B.
49 patients (36%) and amputation for 13 patients (10%). All deaths occurred within 22 months after the
Seventeen patients (13%) were treated conservatively. diagnosis (range: 1 month–6 years with a median period
When comparing the groups, there were no differences of 12.5 months). There were no statistical significance
between operation methods except for the amputation differences in overall survival between the groups for the
rate. Limb amputation were done to 11 patients in follow-up period but there was a difference in the survival
Group A, whereas only 2 in Group B. In this study, for the 1st year [Figure 1]. The 1st year survival was 100%
63 patients (47%) received radiotherapy and 15 patient’s in the Group A and 87% in the Group B.
chemotherapy (11%). There were no differences in
adjuvant therapy between the 2 groups.
DISCUSSION
Survival
In Group A, 10 patients (14%) got a recurrence The present study shows that increasing the general
tumor during the follow-up period and in Group B awareness about STS management among general
12 patients (19%) [Table 3]. All the recurrences occurred practitioners did not improve either the results or the
within 2.5 years (range: 1–27 months) after the primary survival. But it may have improved the referral rate

100 Plast Aesthet Res || Vol 1 || Issue 3 || Dec 2014