The soft tissue sarcomas are relatively rare malignant neoplasms and frequently present problems in histologic classification due to various histologic types. They extend directly within muscle bundles or along contiguous fascial planes well beyond the confines of the visible and palpable tumor; furthermore, these tumors may arise in multicentric foci, so local recurrence and distant metastasis are frequent.
In this regard, the author has reviewed 105 cases of soft tissue sarcoma which had been confirmed histologically from Jan. 1973 to Dec. 1982 at Severance Hospital, Yonsei Medical Cencer.
The results are as follows:
1) Fourteen histologic types were identified; major histologic types were malignant fibrous histiocytoma (21.9%), rhabdomyosarcoma(20.0%), fibrosarcoma(14.3%) and liposarcoma (10.5%).
2) Male to female sex ratio was 1.76:1 and mean age was 34.1 years.
3) Major occurrence sites were lower extremity(41.0%), head and neck(21.9%) and trunk (13.3%).
4) Excision plus adjuvant therapy group showed a relatively lower recurrence rate than than the excision alone group; high grade sarcomas were related to a higher local recurrence ratend a higher distant metastasis rate than the low grade sarcomas.
5) The actuarial 5 year survival rate was 34.9% in all cases. According to stage, 100% in stage Ⅰ, 64.3% in stage Ⅱ, 25.4% in stage Ⅲ and 0% in stage Ⅳ.
6) Cases with poor prognosis included those with large tumor size (over 10 cm), those in advanced stages, high grade tumors and, specifically, rhabclomyosarcoma.
In this regard, for the treatment of soft tissue sarcomas, correct identification of histologic type and grade is essential. Radical soft part resection or adjuvant radiation therapy is needc in some cases. For high grade sarcomas which are related to a high rate of distant metastasis arid poor prognosis, adjuvant chemotherapy is recommended.
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