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3 - In Soft Tissue Sarcomas Our Treatment Results
Mehtap Dalkılıç Çalış, Alpaslan Maayadağlı, Oktay İncekara
Purpose: In adult cancers %0.8 of soft tissue sarcoma. Its seen in all age groups but with age occurrence percentage increases. Factors affecting prognosis in soft tissue sarcomas have not been definitely determined yet. Radiotheraphy has taken its place in the standard treatment of soft tissue sarcomas and chemotheraphys place is being questioned. In this study, patients that came to our clinic with soft tissue sarcoma have been investigated regarding relapse, metastasis and total survival retrospectively and statistically evaluated (Kaplan Meier and Long rank tests are used, p<0.05 is accepted meaningful)
Material and Procedure: 144 patients diagnosed soft tissue sarcoma have been followed up between the years 1990-2000. the average age is 43(3-83 years) and %39 is over the age of 55.76 of the patients are male and 68 are female. The male/female ratio is 1.1. The most often seen one is Leiomyosarcoma (%20, n=29), 2nd often seen one is Liposarcoma (%12, n-12). Malignant fibrous histiocytoma is seen mostly in the thigh gluteal area and shoulder. Leiomyosarcoma in the abdomen and pelvis, liposarcoma in the retroperitoneum. The tumour often develops at the lower extremities (n-27, %18). Tumours avarage diameter is 12 cm. (2-40 cm). Of these patients 55 were stage IV (%38), 56 were stage III (%39) and 23 were stage I (%23). Metastasis has been seen in the lungs mostly (42 patients). 114 patients (%80) had systematic chemotheraphy, 76 patients (%55) had radiotheraphy and 56 patients had both chemotheraphy and radiotheraphy. Mostly MEID protocol had been applied (n=98, %87). 1,3 and 5 year survival percentage is 62%, 26% and 15% respectively.
Conclusion: In our working group factors effecting survival were found as: age (p=0.0029), stage (p-0,0000), lymph node involvement (p=0,0000), radiotheraphy (p=0,0372) [postoperative p=(0,0000)[, chemotherapy (neo-adjuvant or adjuvant (p-0,0000), MEID application as chemotheraphy regime (p-0,0197), presence of metastasis (p-0.0001) and application of metastasectomy (p-0.0296): factors effecting recurrence were found as: histopathological subtype (p-0.0499), deeply embedded tumour (p=0.0366) and lymph node involvement (p-0.0000). Factors effecting metastasis were found as: histopathological subtype (p = 0.0496), (p = 0.0363) and location (p-0.0210).
Keywords: Soft tissue sarcomas, prognostic factors, surgery, radiotheraphy, chemotherapy.
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