بررسي 1470 بيمار مبتلا به ساركوم مراجعه كننده به بيمارستان امام خميني تهران در مدت 11 سال

1470 cases of sarcoma referring to Imam Khomeini hospital during an 11-year period

Background: Sarcoma is a malignant neoplasm arising in mesenchymal tissue. It comprises 1% of adult malignancies and 15% of childhood neoplasms. The present study was designed to review the clinical characteristics of 1470 sarcoma cases and related predictors of out come, relapse and survival. Materials and methods: For this retrospective study, 1470 medical files of patients with sarcoma who had referred during 1991-2002 to Imam Khomeini Hospital were studied. Results: Sarcoma comprised 11% of all cases referring to our hospital. The mean age of patients with sarcoma was 30 years and male to female ratio was 3/2. Bone to soft tissue sarcoma ratio was 3.1 in children and 1.3 in adults. Osteosarcoma, Ewing and rhabdomyosarcoma presented 83% of children tumors, however, in adults osteosarcoma, synovial sarcoma and malignant fibrous histocytoma (MFH) were the most common subtypes. The main prognostic factors for survival were tumor size, margin of surgery, neurovascular involvement in pathological report, initial metastasis and complete response to initial therapy. Adjuvant radiotherapy, small tumor size, curative surgery with chemotherapy and free surgical margins were significantly associated with reduced recurrence. Conclusion: Complete response to primary therapy is the main independent variable of overall survival of patients. Earlier diagnosis and experienced team including surgical, medical and radiotherapy oncologist is needed for better response and longer survival rate.