DOI QR코드

DOI QR Code

Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

  • Ngan, Roger (Department of Clinical Oncology, Queen Elizabeth Hospital) ;
  • Wang, Edward (Department of Orthopaedics, University of the Philippines, Philippine General Hospital) ;
  • Porter, David (Medical Oncology, Auckland Regional Cancer and Blood Service) ;
  • Desai, Jayesh (Department of Medical Oncology, Royal Melbourne Hospital) ;
  • Prayogo, Nugroho (Department of Medical Oncology, Dharmais Hospital National Cancer Center) ;
  • Devi, Beena (Department of Radiotherapy, Oncology and Palliative Care, Sarawak General Hospital) ;
  • Quek, Richard (Department of Medical Oncology, National Cancer Centre)
  • Published : 2013.11.30

Abstract

Background: Soft-tissue sarcomas require tailored and multidisciplinary treatment and management. However, little is known about how sarcomas are treated and managed throughout the Asia-Pacific region. Materials and Methods: MEDLINE was systematically searched using prespecified criteria. Publications (previous 10 years) that reported tumour characteristics, treatment patterns, survival outcomes, and/or safety outcomes of patients with soft-tissue sarcoma were selected. Exclusion criteria were studies of patients <18 years of age; ${\leq}10$ patients; countries other than Australia, Hong Kong, Indonesia, Korea, Malaysia, New Zealand, Philippines, Singapore, Taiwan, or Thailand; >20% benign tumours; sarcomas located in bones or joints; gastrointestinal stromal tumour; Kaposi's sarcoma; or not reporting relevant outcomes. Results: Of the 1,822 publications retrieved, 35 (32 studies) were included. Nearly all patients (98%, 1,992/2,024; 31 studies) were treated with surgery, and more studies used adjuvant radiotherapy than chemotherapy (24 vs 17 studies). Survival outcomes and recurrence rates varied among the studies because of the different histotypes, sites, and disease stages assessed. Only 5 studies reported safety findings. Conclusions: These findings highlight the lack of specific data available about soft-tissue sarcomas in the Asia-Pacific region. Better efforts to understand how the sarcoma is managed and treated will help improve patient outcomes in the region.

Keywords

Asia-Pacific;incidence;sarcoma;soft-tissue neoplasms;survival

References

  1. Acuin J, Firestone R, Htay TT, et al (2011). Southeast Asia: an emerging focus for global health. Lancet, 377, 534-5. https://doi.org/10.1016/S0140-6736(10)61426-2
  2. An JY, Heo JS, Noh JH, et al (2007). Primary malignant retroperitoneal tumors: analysis of a single institutional experience. Eur J Surg Oncol, 33, 376-82. https://doi.org/10.1016/j.ejso.2006.10.019
  3. Campbell C, Gallagher J, Dickinson I (2004). Synovial sarcoma--towards a simplified approach to prognosis. ANZ J Surg, 74, 727-31. https://doi.org/10.1111/j.1445-1433.2004.03144.x
  4. Casali PG, Blay JY, ESMO/CONTICANET/EUROBONET Consensus Panel of experts (2010). Soft tissue sarcomas: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol, 21, 198-203. https://doi.org/10.1093/annonc/mdq209
  5. Chan CY, Janarthan N, Vivek AS, Jayalakshmi P (2008). The outcome of pleomorphic sarcoma at University Malaya Medical Center--a fifteen-year review. Med J Malaysia, 63, 311-4.
  6. Cho SY, Moon KC, Cheong MS, et al (2011). Significance of microscopic margin status in completely resected retroperitoneal sarcoma. J Urol, 186, 59-65. https://doi.org/10.1016/j.juro.2011.03.030
  7. Chongsuvivatwong V, Phua KH, Yap MT, et al (2011). Health and health-care systems in southeast Asia: diversity and transitions. Lancet, 377, 429-37. https://doi.org/10.1016/S0140-6736(10)61507-3
  8. Choong PF, Nizam I, Ngan SY, et al (2003). Thallium-201 scintigraphy--a predictor of tumour necrosis in soft tissue sarcoma following preoperative radiotherapy? Eur J Surg Oncol, 29, 908-15. https://doi.org/10.1016/j.ejso.2003.09.003
  9. Clark MA, Fisher C, Judson I, Thomas JM (2005). Soft-tissue sarcomas in adults. N Engl J Med, 353, 701-11. https://doi.org/10.1056/NEJMra041866
  10. Colombo C, Randall RL, Andtbacka RH, Gronchi A (2012). Surgery in soft tissue sarcoma: more conservative in extremities, more extended in the retroperitoneum. Expert Rev Anticancer Ther, 12, 1079-87. https://doi.org/10.1586/era.12.80
  11. Dickinson IC, Whitwell DJ, Battistuta D, et al (2006). Surgical margin and its influence on survival in soft tissue sarcoma. ANZ J Surg, 76, 104-9. https://doi.org/10.1111/j.1445-2197.2006.03615.x
  12. Fletcher C, Rydholm A, Singer S, Sundaram M, Coindre J (2002a). Soft tissue tumours: Epidemiology, clinical features, histopathological typing and grading. In Fletcher C, Unni K,Mertens F (eds): Pathology and genetics of tumours of soft tissue and bone. Lyon, France; IARC Press, International Agency for Research on Cancer, 12-8.
  13. Fletcher C, Unni K, Mertens F (2002b). Pathology and Genetics of Tumours of Soft Tissue and Bone. Lyon, France; IARC Press, International Agency for Research on Cancer.
  14. Gronchi A, Casali PG, Mariani L, et al (2005). Status of surgical margins and prognosis in adult soft tissue sarcomas of the extremities: a series of patients treated at a single institution. J Clin Oncol, 23, 96-104. https://doi.org/10.1200/JCO.2005.04.160
  15. Gronchi A, Miceli R, Colombo C, et al (2011). Primary extremity soft tissue sarcomas: outcome improvement over time at a single institution. Ann Oncol, 22, 1675-81. https://doi.org/10.1093/annonc/mdq643
  16. Han I, Kang HG, Kang SC, Choi JR, Kim HS (2011). Does delayed reexcision affect outcome after unplanned excision for soft tissue sarcoma? Clin Orthop Relat Res, 469, 877-83. https://doi.org/10.1007/s11999-010-1642-8
  17. Hong SH, Kim KA, Woo OH, et al (2010). Dedifferentiated liposarcoma of retroperitoneum: spectrum of imaging findings in 15 patients. Clin Imaging, 34, 203-10. https://doi.org/10.1016/j.clinimag.2009.12.025
  18. Hsieh CH, Lin H, Huang CC, et al (2003). Leiomyosarcoma of the uterus: a clinicopathologic study of 21 cases. Acta Obstet Gynecol Scand, 82, 74-81. https://doi.org/10.1034/j.1600-0412.2003.820114.x
  19. Hsu HC, Huang EY, Wang CJ (2004). Treatment results and prognostic factors in patients with malignant fibrous histiocytoma. Acta Oncol, 43, 530-5. https://doi.org/10.1080/02841860410018421
  20. Huang HY, Kang HY, Li CF, et al (2006). Skp2 overexpression is highly representative of intrinsic biological aggressiveness and independently associated with poor prognosis in primary localized myxofibrosarcomas. Clin Cancer Res, 12, 487-98. https://doi.org/10.1158/1078-0432.CCR-05-1497
  21. Huang HY, Huang WW, Wu JM, et al (2008). Flow cytometric analysis of DNA ploidy and S-phase fraction in primary localized myxofibrosarcoma: correlations with clinicopathological factors, Skp2 expression, and patient survival. Ann Surg Oncol, 15, 2239-49. https://doi.org/10.1245/s10434-008-9968-0
  22. Huang HY, Li CF, Fang FM, et al (2010). Prognostic implication of ezrin overexpression in myxofibrosarcomas. Ann Surg Oncol, 17, 3212-9. https://doi.org/10.1245/s10434-010-1185-y
  23. Hui AC, Ngan SY, Wong K, Powell G, Choong PF (2006). Preoperative radiotherapy for soft tissue sarcoma: the Peter MacCallum Cancer Centre experience. Eur J Surg Oncol, 32, 1159-64. https://doi.org/10.1016/j.ejso.2006.04.003
  24. Jun HJ, Lee J, Lim do H, et al (2010). Expression of MET in alveolar soft part sarcoma. Med Oncol, 27, 459-65. https://doi.org/10.1007/s12032-009-9234-8
  25. Kiatisevi P, Asavamongkolkul A, Phimolsarnti R, Waikakul S, Benjarassamerote S (2006). The outcomes and prognostic factors of patients with soft-tissue sarcoma. J Med Assoc Thai, 89, 334-42.
  26. Kim EY, Kim SJ, Choi D, et al (2008a). Recurrence of retroperitoneal liposarcoma: imaging findings and growth rates at follow-up CT. AJR Am J Roentgenol, 191, 1841-6. https://doi.org/10.2214/AJR.07.3746
  27. Kim HS, Lee J, Yi SY, et al (2009). Liposarcoma: exploration of clinical prognostic factors for risk based stratification of therapy. BMC Cancer, 9, 205. https://doi.org/10.1186/1471-2407-9-205
  28. Kim HS, Han KH, Chung HH, et al (2010). Neutrophil to lymphocyte ratio for preoperative diagnosis of uterine sarcomas: a case-matched comparison. Eur J Surg Oncol, 36, 691-8. https://doi.org/10.1016/j.ejso.2010.05.004
  29. Kim MS, Cho WH, Song WS, Lee SY, Jeon DG (2007). Prognostic significance of ezrin expression in pleomorphic malignant fibrous histiocytoma. Anticancer Res, 27, 1171-8.
  30. Kim WY, Lee JW, Choi CH, et al (2008b). Low-grade endometrial stromal sarcoma: a single center’s experience with 22 cases. Int J Gynecol Cancer, 18, 1084-9. https://doi.org/10.1111/j.1525-1438.2007.01159.x
  31. Kim YB, Shin KH, Seong J, et al (2008c). Clinical significance of margin status in postoperative radiotherapy for extremity and truncal soft-tissue sarcoma. Int J Radiat Oncol Biol Phys, 70, 139-44. https://doi.org/10.1016/j.ijrobp.2007.05.067
  32. Koh KH, Cho EY, Kim DW, Seo SW (2009). Multivariate analysis of prognostic factors in synovial sarcoma. Orthopedics, 32, 824.
  33. Lee SY, Goh BK, Teo MC, et al (2011). Retroperitoneal liposarcomas: the experience of a tertiary Asian center. World J Surg Oncol, 9, 12. https://doi.org/10.1186/1477-7819-9-12
  34. Lin CN, Chou SC, Li CF, et al (2006). Prognostic factors of myxofibrosarcomas: implications of margin status, tumor necrosis, and mitotic rate on survival. J Surg Oncol, 93, 294-303. https://doi.org/10.1002/jso.20425
  35. Liu CY, Yen CC, Chen WM, et al (2010). Soft tissue sarcoma of extremities: the prognostic significance of adequate surgical margins in primary operation and reoperation after recurrence. Ann Surg Oncol, 17, 2102-11. https://doi.org/10.1245/s10434-010-0997-0
  36. Luis AM, Aguilar DP, Martin JA (2010). Multidisciplinary management of soft tissue sarcomas. Clin Transl Oncol, 12, 543-53. https://doi.org/10.1007/s12094-010-0552-2
  37. Mankin HJ, Hornicek FJ (2005). Diagnosis, classification, and management of soft tissue sarcomas. Cancer Control, 12, 5-21.
  38. Miki Y, Ngan S, Clark JC, Akiyama T, Choong PF (2010). The significance of size change of soft tissue sarcoma during preoperative radiotherapy. Eur J Surg Oncol, 36, 678-83. https://doi.org/10.1016/j.ejso.2010.05.021
  39. Moncrieff MD, Kroon HM, Kam PC, et al (2008). Isolated limb infusion for advanced soft tissue sarcoma of the extremity. Ann Surg Oncol, 15, 2749-56. https://doi.org/10.1245/s10434-008-0045-5
  40. National Comprehensive Cancer Network (2012). NCCN Clinical Practice Guidelines in Oncology. Soft Tissue Sarcoma.
  41. Ng YC, Tan MH (2009). Liposarcoma of the extremities: a review of the cases seen and managed in a major tertiary hospital in Singapore. Singapore Med J, 50, 857-61.
  42. Park JH, Kang CH, Kim CH, Chae IJ (2010). Highly malignant soft tissue sarcoma of the extremity with a delayed diagnosis. World J Surg Oncol, 8, 84. https://doi.org/10.1186/1477-7819-8-84
  43. 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, 573-81. https://doi.org/10.1002/cncr.23592
  44. Pisters PW, Leung DH, Woodruff J, Shi W, Brennan MF (1996). Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities. J Clin Oncol, 14, 1679-89. https://doi.org/10.1200/JCO.1996.14.5.1679
  45. Pisters PW, O'Sullivan B, Maki RG (2007). Evidence-based recommendations for local therapy for soft tissue sarcomas. J Clin Oncol, 25, 1003-8. https://doi.org/10.1200/JCO.2006.09.8525
  46. Ray-Coquard I, Thiesse P, Ranchere-Vince D, et al (2004). Conformity to clinical practice guidelines, multidisciplinary management and outcome of treatment for soft tissue sarcomas. Ann Oncol, 15, 307-15. https://doi.org/10.1093/annonc/mdh058
  47. Rudiger HA, Ngan SY, Choong PF (2009). Surgical outcome of soft tissue sarcomas of the adductor compartment. J Orthop Surg (Hong Kong), 17, 284-7. https://doi.org/10.1177/230949900901700307
  48. Sankaranarayanan R, Swaminathan R (2011). Cancer Survival in Africa, Asia, the Caribbean and Central America. Lyon, France; International Agency for Research on Cancer.
  49. Singer S, Corson JM, Gonin R, Labow B, Eberlein TJ (1994). Prognostic factors predictive of survival and local recurrence for extremity soft tissue sarcoma. Ann Surg, 219, 165-73. https://doi.org/10.1097/00000658-199402000-00008
  50. Singer S, Demetri GD, Baldini EH, Fletcher CD (2000). Management of soft-tissue sarcomas: an overview and update. Lancet Oncol, 1, 75-85. https://doi.org/10.1016/S1470-2045(00)00016-4
  51. Stojadinovic A, Leung DH, Hoos A, et al (2002). Analysis of the prognostic significance of microscopic margins in 2,084 localized primary adult soft tissue sarcomas. Ann Surg, 235, 424-34. https://doi.org/10.1097/00000658-200203000-00015
  52. Wang CP, Chang YL, Ting LL, et al (2009). Malignant fibrous histiocytoma of the sinonasal tract. Head Neck, 31, 85-93. https://doi.org/10.1002/hed.20936
  53. Wang L, Tan MH (2010). The natural history and prognosticative factors of adult extremity soft tissue sarcomas: an Asian perspective. Ann Acad Med Singapore, 39, 771-7.
  54. Woll PJ, Reichardt P, Le Cesne A, et al (2012). Adjuvant chemotherapy with doxorubicin, ifosfamide, and lenograstim for resected soft-tissue sarcoma (EORTC 62931): a multicentre randomised controlled trial. Lancet Oncol, 13, 1045-54. https://doi.org/10.1016/S1470-2045(12)70346-7
  55. Wong CK, Lam YL, So YC, Ngan KC, Wong KY (2004). Management of extremity soft tissue sarcoma after unplanned incomplete resection: experience of a regional musculoskeletal tumour centre. Hong Kong Med J, 10, 117-22.
  56. Wu TI, Chang TC, Hsueh S, et al (2006). Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma. Gynecol Oncol, 100, 166-72. https://doi.org/10.1016/j.ygyno.2005.08.010

Cited by

  1. Computed Tomography Manifestations of Histologic Subtypes of Retroperitoneal Liposarcoma vol.15, pp.15, 2014, https://doi.org/10.7314/APJCP.2014.15.15.6041
  2. Adult Urological Soft Tissue Sarcomas: A Multicenter Study of the Anatolian Society of Medical Oncology (ASMO) vol.16, pp.11, 2015, https://doi.org/10.7314/APJCP.2015.16.11.4777
  3. Incidences of Primary Soft Tissue Sarcoma Diagnosed on Extremities and Trunk Wall vol.94, pp.41, 2015, https://doi.org/10.1097/MD.0000000000001696
  4. Clinical characteristics and outcomes of extremity soft tissue sarcomas at Thailand’s national tertiary referral center vol.7, pp.2046-1402, 2018, https://doi.org/10.12688/f1000research.15793.1