A Clinical Study of Soft Tissue Sarcoma in Orthopedic Surgery

Kim, Sang Jin; Lee, Ho Yun

Abstract

The soft tissue sarcoma ih the Orthopedic surgery is not common, occuring in less than one percent of all malignant tumors. Whille the sarcoma is comparatively highly malignant, its treatment has been varied, and the effect of the each treatment has been controversial and generally poor on statisties. We studied 58 cases of soft tissue sarcoma in the Orthopedic department of Pusan Gospei Hospital in the 6 years period from March, 1975 to March, 1981. We confirmed the sarcoma diagnosis by biopsy, and measured the size, the degree of local infilteration and occurrence of metastasis with the help of plain X-ray, angiography, lung and bone scan, and computerized tomograms. We made treatment plans according to above results. We classified the soft tissue sarcoma into 8 histologic types and obtained following conclusions: l. Among the 58 cases of soft tissue sarcoma, and majority is consisted of fibrosarcoma, liposarcoma and rhabdomyosarcoma. 2. There were 41 cases occurred in the lower extremity and 17 cases in the upper extremity. Thus soft tissue sarcoma are more frequent in the lower extremity, especially in thigh (2 patients). 3. We found 19 cases between the age of 41 to 50 years. In general, the soft tissue sarcoma are more frequent between the age of 31 to 50 years. 4. Among the 58 cases, 10 patient came to our hospital because of recurrence of soft tissue sarcoma, after receiving local excision in other hospitals. In other words 17 percent of our cases showed recurred sarcoma and duration of recurrence was within 16 months. 5. Metastasis of the soft tissue sarcoma had taken place in 17 patients (29%), most frequently metastasis to the lung in 12 cases (70%). 6. We treated 30 cases by chemotherapy and radiotherapy after excision or amputation. In 15 sarcomas that could not be excised, but the medical treatment with chemotherapy and radiotherapy. 7. The follow-up study revealed better result obtained in the group of aggresive treatment with anticancer chemotherapy and radiotherapy after excision or amputation.