Distal extremities soft tissue sarcomas: Are they so different from other limb localizations?
Corresponding Author
Jean-Camille Mattei MD, PhD
Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Départment de Chirurgie Orthopédique des Prs. Curvale et Rochwerger, Marseille, France
Faculté de Médecine de la Timone, Génétique Médicale et génomique fonctionnelle, UMR S910 Inserm, Université Aix-Marseille 2, Marseille, France
Correspondence Jean-Camille Mattei, Secretariat Orthopedie 3A Pavillon Mistral, Hopital Nord, Chemin des Bourrely, 13015 Marseille, France. Email: [email protected]
Search for more papers by this authorVéronique Brouste MD
Institut Bergonie, INSERM U 897, Département Biostatistique, ISPED, Université Victor Segalen Bordeaux 2, Case 11, Bordeaux, France
Search for more papers by this authorPhilippe Terrier MD
Département de Biologie et de Pathologie Médicales, Institut de Cancérologie Gustave-Roussy, Villejuif, France
Search for more papers by this authorSylvie Bonvalot MD
Institut Curie, Département de Chirurgie 8, PSL Research University, Paris, France
Search for more papers by this authorAxel Lecesne MD
Department of Medical Oncology, Gustave Roussy, Villejuif, France
Search for more papers by this authorEberhard Stoeckle MD
Department of Surgery, Institut Bergonié, Regional Cancer Centre, Bordeaux, France
Search for more papers by this authorAntoine Italiano MD, PhD
Departement d'oncologie Medicale, CLCC Institut Bergonie, Bordeaux, France
Search for more papers by this authorDominique Ranchere-Vince MD
Department of Pathology, Leon Berard Center, Lyon, France
Search for more papers by this authorPierre Meeus MD
Department of Surgery, Centre Leon Berard, University Lyon 1, Lyon, France
Search for more papers by this authorMarick Laé MD
Service de Pathologie, Institut Curie, Paris Sciences Lettres Research University, Département de Médecine Diagnostique et Théranostique, Paris, France
Service de Pathologie, Centre Henri Becquerel, INSERM U1245, UNIROUEN, Normandie Université, rue d'Amiens, Rouen, France
Search for more papers by this authorPhilippe Rosset MD, PhD
Département Chirurgie Orthopédique et Traumatologique 2, Hôpital Trousseau, Université François-Rabelais de Tours, CHU de Tours, Tours, France
Search for more papers by this authorAlexandre Rochwerger MD, PhD
Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Départment de Chirurgie Orthopédique des Prs. Curvale et Rochwerger, Marseille, France
Faculté de Médecine de la Timone, Génétique Médicale et génomique fonctionnelle, UMR S910 Inserm, Université Aix-Marseille 2, Marseille, France
Search for more papers by this authorJean Michel Coindre MD, PhD
Département d'anatomo-pathologie de l'Institut Bergonié
Search for more papers by this authorSébastien Salas MD, PhD
Faculté de Médecine de la Timone, Génétique Médicale et génomique fonctionnelle, UMR S910 Inserm, Université Aix-Marseille 2, Marseille, France
Department of Oncology, Assistance Publique Hôpitaux de Marseille Timone Hospital, Marseille, France
Search for more papers by this authorCorresponding Author
Jean-Camille Mattei MD, PhD
Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Départment de Chirurgie Orthopédique des Prs. Curvale et Rochwerger, Marseille, France
Faculté de Médecine de la Timone, Génétique Médicale et génomique fonctionnelle, UMR S910 Inserm, Université Aix-Marseille 2, Marseille, France
Correspondence Jean-Camille Mattei, Secretariat Orthopedie 3A Pavillon Mistral, Hopital Nord, Chemin des Bourrely, 13015 Marseille, France. Email: [email protected]
Search for more papers by this authorVéronique Brouste MD
Institut Bergonie, INSERM U 897, Département Biostatistique, ISPED, Université Victor Segalen Bordeaux 2, Case 11, Bordeaux, France
Search for more papers by this authorPhilippe Terrier MD
Département de Biologie et de Pathologie Médicales, Institut de Cancérologie Gustave-Roussy, Villejuif, France
Search for more papers by this authorSylvie Bonvalot MD
Institut Curie, Département de Chirurgie 8, PSL Research University, Paris, France
Search for more papers by this authorAxel Lecesne MD
Department of Medical Oncology, Gustave Roussy, Villejuif, France
Search for more papers by this authorEberhard Stoeckle MD
Department of Surgery, Institut Bergonié, Regional Cancer Centre, Bordeaux, France
Search for more papers by this authorAntoine Italiano MD, PhD
Departement d'oncologie Medicale, CLCC Institut Bergonie, Bordeaux, France
Search for more papers by this authorDominique Ranchere-Vince MD
Department of Pathology, Leon Berard Center, Lyon, France
Search for more papers by this authorPierre Meeus MD
Department of Surgery, Centre Leon Berard, University Lyon 1, Lyon, France
Search for more papers by this authorMarick Laé MD
Service de Pathologie, Institut Curie, Paris Sciences Lettres Research University, Département de Médecine Diagnostique et Théranostique, Paris, France
Service de Pathologie, Centre Henri Becquerel, INSERM U1245, UNIROUEN, Normandie Université, rue d'Amiens, Rouen, France
Search for more papers by this authorPhilippe Rosset MD, PhD
Département Chirurgie Orthopédique et Traumatologique 2, Hôpital Trousseau, Université François-Rabelais de Tours, CHU de Tours, Tours, France
Search for more papers by this authorAlexandre Rochwerger MD, PhD
Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Départment de Chirurgie Orthopédique des Prs. Curvale et Rochwerger, Marseille, France
Faculté de Médecine de la Timone, Génétique Médicale et génomique fonctionnelle, UMR S910 Inserm, Université Aix-Marseille 2, Marseille, France
Search for more papers by this authorJean Michel Coindre MD, PhD
Département d'anatomo-pathologie de l'Institut Bergonié
Search for more papers by this authorSébastien Salas MD, PhD
Faculté de Médecine de la Timone, Génétique Médicale et génomique fonctionnelle, UMR S910 Inserm, Université Aix-Marseille 2, Marseille, France
Department of Oncology, Assistance Publique Hôpitaux de Marseille Timone Hospital, Marseille, France
Search for more papers by this authorAbstract
Background and Objectives
Soft tissue sarcoma localization in distal extremities (DESTS) of the limbs (hand/fingers, and foot/toes) is unusual. The literature is scarce about their behavior and this study was designed to assess their epidemiological characteristics, outcomes, and prognosis compared to other limb localizations (OLSTS).
Methods
From 1980 to 2010, adult DESTS and OLSTS in 22 centers were included. Demographics, tumor type, treatment modalities, and latest follow-up status were collected. Primary endpoints were overall survival and local/metastatic recurrence incidences.
Results
Two hundred five DESTS and 3001 OLSTS were included. The patients were younger, with more female and smaller tumors in DESTS. There were more clear cell/epithelioid sarcomas, synovial sarcomas, and myxoid liposarcomas vs more dedifferentiated liposarcomas in OLSTS. DESTS tumors were less irradiated and more often amputated (24.3% vs 3.4%). The five-year survival rate was 78.2% compared to 68.6% in OLSTS and after multivariate analysis, STS localization did not impact survival or local/metastatic recurrence.
Conclusion
Though rare and smaller than other limb localizations, DESTS are to be considered as aggressive. Despite a higher amputation rate, the prognosis remains the same as in OLSTS. Limb sparing vs amputation should be carefully assessed in DESTS, especially if grade 3 or of a poor prognosis histological subtype.
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