Retrospective Analysis of 498 Primary Soft Tissue Sarcomas in a Single Turkish Centre

  • Duman, Berna Bozkurt (Department of Oncology, Medical Faculty, Cukurova University) ;
  • Gunaldi, Meral (Department of Oncology, Medical Faculty, Cukurova University) ;
  • Ercolak, Vehbi (Department of Oncology, Medical Faculty, Cukurova University) ;
  • Afsar, Cigdem Usul (Department of Oncology, Medical Faculty, Cukurova University) ;
  • Sahin, Berksoy (Department of Oncology, Medical Faculty, Cukurova University) ;
  • Erkisi, I. Melek Koksal (Department of Oncology, Medical Faculty, Cukurova University) ;
  • Kara, Oguz (Department of Oncology, Medical Faculty, Cukurova University) ;
  • Paydas, Semra (Department of Oncology, Medical Faculty, Cukurova University) ;
  • Gonlusen, Gulfiliz (Department of Pathology, Medical Faculty, Cukurova University) ;
  • Sertdemir, Yasar (Department of Bioistatistics, Medical Faculty, Cukurova University)
  • Published : 2012.08.31


Background: Soft tissue sarcomas (STS) must be managed with a team involving pathologists, radiologists, surgeons, radiation therapists and medical oncologists. Treatment modalities and demographic charasteristics of Turkish STS were analysed in the current study. Material-Methods: Primary adult STS followed between 1999-2010 in Cukurova University Medical Faculty Department of Medical Oncology were analzied retrospectively Results: Of the total of 498 patients, 238 were male and 260 female. The most seen adult sarcomas were leomyosarcoma (23%). Localization of disease was upper extremity (8.8%), lower extremity (24.7%), head-neck 8.2%, thoracic 8%, retroperitoneal 5.6%, uterine 12.4%, abdominal 10%, pelvic region 3.6 and other regions 10%. Some 13.1% were early stage, 10.2% locally advanced, 8.2% metastatic and 12.2% recurrent disease. Patients were treated with neoadjuvant/adjuvant (12%) or palliative chemotherapy (7.2%) and 11.4% patients did not receive chemotherapy. Surgery was performed as radical or conservative. The most preferred regimen was MAID combination chemotherapy in the rate of 17.6%. The most common metastatic site was lung (18.1%). The overall survival was 45 months (95%CI 30-59), 36 months in men and 55 months in women, with no statistically significant difference (p=0.5). The survival rates were not different between the group of adjuvant and palliative chemotherapy (respectively 28 versus 18 months) (p=0.06), but radical surgery at 37 months was better than 22 months for conservative surgery (p=0.0001). No differences were evident for localization (p=0.152). Locally advanced group had higher overall survival rates (72 months) than other stages (p=0.0001). Conclusion: STS can be treated successfully with surgery, chemotherapy and radiotherapy. The survival rates of Turkish people were higher in locally advanced group; these results show the importance of multimodality treatment approach and radical surgery.


  1. Alkis N, Muallaoğlu S, Koçer M, et al (2011). Primary adult soft tissue sarcomas: analysis of 294 patients. Med Oncol, 28, 391-6.
  2. Baratti D, Pennacchioli E, Casali PG, et al (2007). Epithelioid sarcoma: prognostic factors and survival in a series of patients treated at a single institution. Ann Surg Oncol, 14, 3542.
  3. Bissler JJ, McCormack FX, Young LR, et al (2008). Sirolimus for angiomyolipoma in tuberous sclerosis complex or lymphangioleiomyomatosis. N Engl J Med, 358, 140-51.
  4. Bramwell VH, Anderson D, Charette ML (2003). Sarcoma disease site group. Doxorubicin-based chemotherapy for the palliative treatment of adult patients with locally advanced or metastatic soft tissue sarcoma. Cochrane Database Syst Rev, 3, 3293.
  5. Butrynski JE, D'Adamo DR, Hornick JL, et al (2010). Crizotinib in ALK-rearranged inflammatory myofibroblastic tumor. N Engl J Med, 363, 1727-33.
  6. Cesne AL, Cresta S, Maki RG, et al (2012). A retrospective analysis of antitumour activity with trabectedin in translocation-related sarcomas. Eur J Cancer, ?, ?-?.
  7. Coindre JM, Terrier P, Guillou L, et al (2001). Predictive value of grade for metastasis development in the main histologic types of adult soft tissue sarcomas: a study of 1240 patients from the French Federation of Cancer Centers Sarcoma Group. Cancer, 91, 1914-26.<1914::AID-CNCR1214>3.0.CO;2-3
  8. Cormier JN, Pollock RE (2004). Soft tissue sarcomas. CA Cancer J Clin, 54, 94-109.
  9. Clasby R, Tilling K, Simith MA, Fletcher CD (1997). Varaible management of soft tissue sarcoma regional audit with implication for specialist care. Br J Surg, 84, 1692-6.
  10. DeLaney TF, Trofimov AV, Engelsman M, Suit HD (2005). Advanced-technology radiation therapy in the management of bone and soft tissue sarcomas. Cancer Control, 12, 27-35.
  11. Ducimetière F, Lurkin A, Ranchère-Vince D, et al (2011). Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing. PLoS One, 6, 20294.
  12. Fletcher CDM, Unni KK, Mertens F (2002). World Health Organization Classification of tumours: Pathology and Genetics of tumours of soft tissue and bone, IARC Press, Lyon 2002.
  13. Hensley ML, Maki R, Venkatraman E, et al (2002).Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol, 20, 2824-31.
  14. Lawrence W Jr, Donegan WL, Natarajan N, et al (1987). Adult soft tissue sarcomas. A pattern of care survey of the American college of surgeons. Ann Surg, 205, 349.
  15. Maki RG, Wathen JK, Patel SR, et al (2007). Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of sarcoma alliance for research through collaboration study 002 [corrected]. J Clin Oncol, 25, 2755-63.
  16. Maki RG, D'Adamo DR, Keohan ML, et al (2009). Phase II study of sorafenib in patients with metastatic or recurrent sarcomas. J Clin Oncol, 27, 3133-40.
  17. Pervaiz N, Colterjohn N, Farrokhyar F, et al (2008). A systematic meta-analysis of randomized controlled trials of adjuvant chemotherapy for localized resectable soft-tissue sarcoma. Cancer, 113, 573.
  18. Sakharpe A, Lahat G, Gulamhusein T, et al (2011). Epithelioid sarcoma and unclassified sarcoma with epithelioid features: clinicopathological variables, molecular markers, and a new experimental model. Oncologist, 16, 512.
  19. Siegel R, Naishadham D, Jemal A (2012). Cancer statistics. CA Cancer J Clin, 62, 10
  20. Sleijfer S, Ray-Coquard I, Papai Z, et al (2009). Pazopanib, a multikinase angiogenesis inhibitor, in patients with relapsed or refractory advanced soft tissue sarcoma: a phase II study from the European organisation for research and treatment of cancer-soft tissue and bone sarcoma group (EORTC study 62043). J Clin Oncol, 27, 3126-32.
  21. Stacchiotti S, Longhi A, Ferraresi V, et al (2012). Phase II study of imatinib in advanced chordoma. J Clin Oncol, 30, 914-20.
  22. Stacchiotti S, Negri T, Libertini M, et al (2012). Sunitinib malate in solitary fibrous tumor (SFT). Ann Oncol, ?, ?-?.

Cited by

  1. Computed Tomography Manifestations of Histologic Subtypes of Retroperitoneal Liposarcoma vol.15, pp.15, 2014,
  2. Adult Urological Soft Tissue Sarcomas: A Multicenter Study of the Anatolian Society of Medical Oncology (ASMO) vol.16, pp.11, 2015,
  3. Clinicopathologic characteristics, treatment outcomes, and prognostic factors of primary thoracic soft tissue sarcoma: A multicenter study of the Anatolian Society of Medical Oncology (ASMO) vol.6, pp.1, 2015,