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Sarcomas de alto grau: estudo retrospectivo de 131 casos High-grade soft tissue sarcomas: a retrospective analysis of 131 cases

By Wilmar José Manoel, Bruno José de Queiroz Sarmento, Luiz de Paula Silveira Júnior, Deidimar Cássia Batista de Abreu, Iron Pires de Abreu Neto and Erika Chaul Ferreira

Abstract

OBJETIVO: Relatar as características clínicas dos sarcomas de partes moles de alto grau e apresentar a experiência do Hospital Araújo Jorge no tratamento destes sarcomas. MÉTODO: Análise retrospectiva dos casos de sarcoma de alto grau em adultos admitidos no Hospital Araújo Jorge (HAJ) entre 1996 e 2000. Idade, sexo, características anátomo-patológicas (tamanho e tipo histológico), localização, tratamentos oncológicos realizados (cirurgias de preservação de órgãos e membros, margens, quimioterapia, radioterapia), recorrência local, recorrência distante e sobrevida foram estudados. Análise descritiva, curvas de Kaplan-Meier, log-rank test e teste &divide;² foram usados quando pertinentes. RESULTADOS: Foram registrados 235 pacientes com sarcomas de partes moles entre 1996 - 2000, sendo que 131 eram de alto grau. A média de idade foi de 47,2 anos. O tipo histológico não foi determinado em 23,7% dos casos. O tipo mais freqüente foi o leiomiossarcoma (13,7%), seguido do sarcoma sinovial (10,7%) e rabdomiossarcoma (9,2%). O tamanho mediano foi de 10 cm (2-48 cm). A distribuição nos estádios II,III e IV foi de 15%, 55% e 30%, respectivamente. Nos pacientes com estádios II e III, a margem cirúrgica adequada foi obtida em 51,9% dos pacientes. Radioterapia e quimioterapia adjuvantes foram indicadas em 33,7% e 26,1% dos casos, respectivamente. As recorrências locais e distantes ocorreram em 31,5% e 34,8% dos pacientes, respectivamente. A sobrevida global em 5 anos foi 61,8%. CONCLUSÃO: A maioria dos pacientes atendidos no HAJ é portadora de lesões localmente avançadas, volumosas ou com metástase ao diagnóstico. Os pacientes apresentaram evolução adversa, com altas taxas de recorrência local e distante.<br>BACKGROUND: To describe clinical presentation of high-grade soft tissue sarcomas, oncologic management and results at Araújo Jorge Hospital (HAJ). METHODS: We analyzed 131 patients with high-grade soft sarcomas in adults admitted at Araújo Jorge Hospital between 1996 and 2000. We studied, age, gender, pathological characteristics (size and histological type), localization, oncology treatment (organ or limb-sparing approach, margins, chemotherapy, and radiotherapy), local recurrence, distant recurrence and overall survival. We used descriptive analysis, Kaplan-Meier methodology, log-rank test and Chi-square test. RESULTS: Two hundred thirty-five patients with soft tissue sarcomas were admitted between 1996 and 2000. A hundred thirty-one were high-grade sarcomas. Median age was 47.2 years. We could not determinate a histological type in 23.7% of cases. The more frequents types were leiomyosarcoma (13.7%), synovial sarcoma (10.7%) and rhabdomyosarcoma (9.2%). Median size was 10cm (2-48cm). The distribution for stages II, III e IV was 15%, 55% and 30%, respectively. For stages II and III, surgical margins were adequate in 51.9% of cases. Radiotherapy and chemotherapy were performed in 33.7% and 26.1% of cases, respectively. Local recurrences occurred in 31.5% and distant recurrences in 34.8% of patients. The 5-year overall survival was 61.8%. CONCLUSION: Most of the patients that were treated at Araújo Jorge Hospital have large and locally advanced tumors, with metastatic spread at first presentation. The patients with high-grade sarcomas presented adverse clinical evolution, high rates of local and distant recurrences as described in the literature

Topics: Neoplasias, Sarcoma, Cirurgia, Quimioterapia, Radioterapia, Neoplasms, Sarcoma, Surgery, Drug therapy, Radiotherapy, LCC:Surgery, LCC:RD1-811, LCC:Medicine, LCC:R, DOAJ:Surgery, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: Colégio Brasileiro de Cirurgiões
Year: 2008
DOI identifier: 10.1590/S0100-69912008000200004
OAI identifier: oai:doaj.org/article:a6b6d7025ce44ba0930407a6de649c4d
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