Posters— Surgical Treatment of Sarcomas

ADULT PELVIC SARCOMAS

Dekker C¹, Houtkarnp R¹, Peterse JL² and van Coevorden F¹ Department of Surgical Oncology¹ and Pathology² The Netherlands Cancer Institute / Antoni van Leeuwenhoek ziekenhuis

Introduction: Soft tissue sarcomas in the pelvis, excluding uterine sarcomas, are rare malignancies. In a retrospective study in our national cancer referral center 33 patients, 21 males and 12 females were seen in a 25-year period. In 26 patients either a leiomyosarcoma (18) or a rhabdomyosarcorna (8) was seen. 31 out of the 33 sarcomas were intermediate or high grade.

Recurrent disease: Unlike soft tissue sarcomas in extremities, a high rate of local and distant recurrence (66%) was seen. In 7/22 (32%) of cases with recurrent disease, only local recurrence was seen, while in the other 15 cases (68%) recurrence presented as distant disease, synchronous with local recurrence in only one of these 15. At first presentation 9 patients already had metastatic disease. Unlike in extremity sarcoma, metastatic disease presented as pulmonary metastases in 5/22 patients (23%) only.

Survival: All patients with primary metastatic disease eventually died of disease, as did 8 of the other 24 patients. Four of the 24 have evidence of disease, one died of unrelated causes and the remaining 11 patients are alive and well. Adults (adolescents) with rhabdomyosarcoma has a 25% NED survival vs those with leiomyosarcoma (33%). Among the others patients with liposarcoma did best. In this retrospective study, multimodality approach of these tumors did not appear to be more effective than single modality treatment.

Conclusion: Pelvic sarcomas differ from most other sarcomas in presentation and outcome. In the management of these pelvic sarcomas these particular characteristics should be taken into consideration.