Adult Pelvic Sarcomas: A Heterogeneous Collection of Sarcomas?

[摘要] Introduction. Adult pelvic soft tissue sarcomas are a rare group of heterogeneous malignancies. These sarcomas differ fromextremity and trunk soft tissue sarcomas in presentation, characteristics and response to treatment.Methods. A retrospective analysis of patient and tumor characteristics, treatment and prognosis and prognostic factors wasperformed.Results. Between 1977 and 1997, a total of 33 adult patients with soft tissue sarcomas involving the pelvis but excludinguterine leiomyosarcoma were identified. Leiomyosarcomas (18), including six GIST, and rhabdomyosarcomas (eight) werethe most commonly seen tumors. At first presentation, nine patients already had metastases. The mean follow-up was52 months (1–200). Recurrences developed in 15 of the 24 cases (63%) with tumors without metastases at first presentation;in six (25%) recurrence was locally only, in nine distant metastases occurred. The nine patients with metastatic diseaseat first presentation died of the disease, while eight of the 24 patients with localized disease at presentation died. One patientdied of an unrelated cause, four were alive with disease, and 11 patients were alive and free of disease. The only identifiableprognostic factor of disease-free interval and overall survival was histological grade.Conclusion. Soft tissue sarcomas of the pelvis appear to be associated with increased rate of metastasis at the time of diagnosisand higher rates of local recurrence. In this study, multi-modality treatment for most primary tumors did not show asignificant benefit in recurrence rate, DFI and OST, when compared to single modality approach. Although the number ofpatients in this study is small, and different types of sarcomas were studied, the only identifiable predictor for survival waslow histological grade of the tumors. The differences of this heterogeneous group of pelvic sarcomas with retroperitoneal,trunk and extremity sarcomas should be taken into consideration in the management of these sarcomas.

[学科分类] 肿瘤学