Epidemiology of Adult Soft-Tissue Sarcomas in Germany

We conducted a retrospective cohort study using data compiled from the regional German cancer registries by the Centre for Cancer Registry Data (ZfKD) at the Robert Koch Institut (RKI) to describe the epidemiology of adult soft-tissue sarcomas (STS) in Germany in 2003–2012, focusing on advanced STS. We identified 33,803 incident adult cases of STS (other than the Kaposi sarcoma and gastrointestinal stromal tumors). The incidence of STS was 6.05 (95% confidence interval (CI), 5.82–6.29) per 100,000 in 2012 (4,079 cases). During 2003–2012, the most common histologic categories were leiomyosarcoma (19%), liposarcoma (16%), and STS not otherwise specified (14%). The overall STS-specific mortality rate in 2012 was 2.31 (95% CI, 2.06–2.57) per 100,000, and the median overall survival from initial diagnosis was 5.83 (95% CI, 5.50–6.08) years. Using STS mortality rates as a proxy for incidence of advanced STS in Germany and applying the age- and sex-specific rates to the corresponding German population, we estimated that 1,581 incident adult advanced STS cases occurred in Germany in 2012. Our findings contribute to a refined understanding of the population burden of STS in Germany, including the number of patients with advanced STS who may be candidates for systemic treatment.

Download Full-text

Sarcomas of Soft Tissue and Bone

10.2310/im.1187 ◽

2011 ◽

Author(s):

Adam Lerner ◽

Huihong Xu ◽

Karen H Antman

Keyword(s):

Soft Tissue ◽

Meta Analysis ◽

Survival Rates ◽

Fibrous Tissue ◽

Soft Tissue Sarcomas ◽

Kaposi Sarcoma ◽

Uterine Leiomyosarcoma ◽

Increased Risk ◽

Bone Sarcomas ◽

Epidemiologic Features

Sarcomas originate from bone or soft tissue. The most common bone sarcomas are osteosarcomas, Ewing sarcomas, and chondrosarcomas. Soft tissue sarcomas develop in fibrous tissue, fat, muscle, blood vessels, and nerves. Historically, soft tissue sarcomas of the trunk and extremities were reported separately from those of visceral organs (e.g., gastrointestinal and gynecologic sarcomas). This chapter discusses the classification, epidemiology, diagnosis, staging, and treatment of sarcomas of bone and cartilage, and classic soft tissue sarcomas. Management of Kaposi sarcoma, gastrointestinal stromal tumors (GISTs), mesothelioma, and rhabdomyosarcoma is also described. Figures include images of patients with osteosarcoma, liposarcoma, uterine leiomyosarcoma, GIST, and osteosarcoma in a patient with Paget disease of bone. Tables list epidemiologic features of sarcomas, a summary of sarcomas by histology, familial syndromes associated with increased risk of sarcoma, survival rates in sarcoma patients, staging of soft tissue sarcomas, and results of a meta-analysis of doxorubicin-based adjuvant chemotherapy for localized resectable soft tissue sarcoma. This chapter contains 126 references.

Download Full-text

Detection of pulmonary metastases in patients with osteogenic and soft-tissue sarcomas: the superiority of CT scans compared with conventional linear tomograms using dynamic analysis.

Journal of Clinical Oncology ◽

10.1200/jco.1985.3.9.1261 ◽

1985 ◽

Vol 3 (9) ◽

pp. 1261-1265 ◽

Cited By ~ 50

Author(s):

H I Pass ◽

A Dwyer ◽

R Makuch ◽

J A Roth

Keyword(s):

Soft Tissue ◽

Dynamic Analysis ◽

Pulmonary Metastases ◽

Soft Tissue Sarcomas ◽

Ct Scans ◽

Surgical Exploration ◽

Positive Study ◽

Median Size ◽

Number Of Patients ◽

Serial Evaluation

A prospective serial evaluation in 19 patients with soft-tissue and osteogenic sarcomas was performed to determine whether computerized tomography (CT) or conventional linear tomography (LT) detected pulmonary metastases earlier. Analysis of the metastatic nodules was performed radiographically with histologic confirmation by obtaining serial CTs and LTs followed by metastasectomy. Nodules were classified as stable, growing, or developing and by detection on CT and/or LT. CT was the first positive study in a significantly greater number of patients (13 CT, 1 LT; P less than .005), and CT detected the nodules earlier than LT (56 CT first v 7 LT first; P less than .0001). Ninety of 166 nodules resected were detected by CT, LT, or both (54%). The median size of metastatic nodules documented at surgical exploration and first detected by CT was significantly smaller than that first detected by LT (7.6 mm for CT v 13.2 mm for LT; P less than .05). Of 55 histologically documented metastases detected initially either by CT or LT, CT was markedly superior to LT with 50 (91%) first detected only by CT (P less than .001). These data reveal that CT detects more pulmonary metastases earlier than LT and that developing or growing nodules in patients with sarcomas are usually metastases. Decisions regarding metastasis resection in sarcoma patients, therefore, should be based primarily on CT findings.

Download Full-text

Incidence and time trends of sarcoma (2000-2013): results from the French Network of Cancer registries (FRANCIM)

10.21203/rs.2.19497/v1 ◽

2019 ◽

Author(s):

Brice Amadeo ◽

Nicolas Penel ◽

Jean-Michel Coindre ◽

Isabelle Ray-coquard ◽

Karine Ligier ◽

...

Keyword(s):

Time Trends ◽

Kaposi Sarcoma ◽

Cancer Registries ◽

Population Based ◽

Incidence Rates ◽

Histological Subtypes ◽

Annual Percent Change ◽

Pathological Review ◽

Recurrent Translocation ◽

Using Data

Abstract Background : The exhaustive collection of new sarcoma cases and their second histologic review offer a unique opportunity to study their incidence and time trends in France according to the major subtypes. Methods : Data were collected from population-based cancer registries covering 22% of the French population. Crude and world age-standardized incidence rates (ASR) were estimated according to anatomic, histological and genetic groups, age and sex over the 2010-2013 period. Results: Time trends in incidence were calculated by the annual percent change over the 2000-2013 period. During the most recent period (2010-2013), 3,942 patients with sarcoma were included. The ASR of soft-tissue and bone sarcomas, and gastro-intestinal stromal tumors (GIST) were 2.1, 1.0 and 0.6, respectively. For the four most frequent histological subtypes (unclassified, leiomyosarcoma, GIST and liposarcoma), the ASR ranged from 0.4 to 0.7. ASRs were 1.9 for complex genomic and 1.3 for recurrent translocation sarcomas. The time-trend analysis showed a significant increase of sarcoma incidence rate between 2000 and 2005, which stabilized thereafter. Incidence rates increased for four histological subtypes (GIST, chondrosarcoma, myxofibrosarcoma, solitary fibrous tumors) and decreased for three (leiomyosarcomas, Kaposi sarcoma and fibrosarcoma). Conclusion : To our knowledge, this study is the first to investigate sarcoma incidence based on a systematic pathological review of these cancers and on the updated sarcoma classifications. Due to the paucity of literature on sarcomas, future studies using data from population-based cancer registries should consider a standardized inclusion criterion presented in our study to better describe and compare data between countries.

Download Full-text

Impact of NICE guidelines on the survival of patients with soft-tissue sarcomas

The Bone & Joint Journal ◽

10.1302/0301-620x.103b3.bjj-2020-0743.r1 ◽

2021 ◽

Vol 103-B (3) ◽

pp. 569-577

Author(s):

Tomohiro Fujiwara ◽

Robert J. Grimer ◽

Scott Evans ◽

Manuel Ricardo Medellin Rincon ◽

Yusuke Tsuda ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcomas ◽

High Grade ◽

Nice Guidelines ◽

Number Of Patients ◽

Mean Size ◽

The Mean ◽

The Uk ◽

The Impact ◽

Grade Tumour

Aims Urgent referral to a specialist centre for patients with a soft-tissue sarcoma (STS) has been recommended by the National Institute for Health and Care Excellence (NICE) in the UK since 2006. However, the impact of this recommendation on the prognosis for these patients remains unclear. We aimed to determine the impact of the NICE guidelines on the disease-specific survival (DSS) of patients with an STS. Methods A total of 2,427 patients with an STS referred to a supraregional centre in the ten-year periods before (n = 1,386) and after (n = 1,041) the issue of the NICE guidelines were evaluated. Results The mean size of the tumour was significantly smaller at the time of diagnosis (10.3 cm (SD 6.5) vs 9.1 cm (SD 6.2); p < 0.001) and the number of patients who had undergone an inadvertent excision significantly decreased (28% (n = 389) vs 20% (n = 204); p < 0.001) following the introduction of the NICE guidelines. The five-year DSS was 63% in the pre-NICE and 71% in post-NICE groups (p < 0.001). The improved survival was more significant for those with a high-grade tumour (pre-NICE, 48%; post-NICE, 68%; p < 0.001). In those with a high-grade tumour, the mean size of the tumour (11.6 cm (SD 6.2) vs 9.6 cm (SD 5.8); p < 0.001) and the number of patients with metastasis at the time of diagnosis (15% (n = 124 vs 10% (n = 80); p = 0.007) significantly decreased in the post-NICE group. Conclusion An improvement in survival was seen after the introduction of the NICE guidelines, especially in patients with a high-grade STS. More patients were referred at an earlier stage, indicating a clearer pathway after the issue of national policy for the management of STSs in the UK. Cite this article: Bone Joint J 2021;103-B(3):569–577.

Download Full-text

Sarcomas of the Soft Tissue and Bone

10.2310/fm.1187 ◽

2011 ◽

Author(s):

Adam Lerner ◽

Huihong Xu ◽

Karen H Antman

Keyword(s):

Soft Tissue ◽

Meta Analysis ◽

Survival Rates ◽

Fibrous Tissue ◽

Soft Tissue Sarcomas ◽

Kaposi Sarcoma ◽

Uterine Leiomyosarcoma ◽

Increased Risk ◽

Bone Sarcomas ◽

Epidemiologic Features

Download Full-text

Ascertainment of Veterans With Metastatic Prostate Cancer in Electronic Health Records: Demonstrating the Case for Natural Language Processing

JCO Clinical Cancer Informatics ◽

10.1200/cci.21.00030 ◽

2021 ◽

pp. 1005-1014

Author(s):

Patrick R. Alba ◽

Anthony Gao ◽

Kyung Min Lee ◽

Tori Anglin-Foote ◽

Brian Robison ◽

...

Keyword(s):

Prostate Cancer ◽

Natural Language Processing ◽

Natural Language ◽

Language Processing ◽

Metastatic Prostate Cancer ◽

Cancer Registries ◽

Veterans Affairs ◽

Department Of Veterans Affairs ◽

Cancer Registry Data ◽

Number Of Patients

PURPOSE Prostate cancer (PCa) is among the leading causes of cancer deaths. While localized PCa has a 5-year survival rate approaching 100%, this rate drops to 31% for metastatic prostate cancer (mPCa). Thus, timely identification of mPCa is a crucial step toward measuring and improving access to innovations that reduce PCa mortality. Yet, methods to identify patients diagnosed with mPCa remain elusive. Cancer registries provide detailed data at diagnosis but are not updated throughout treatment. This study reports on the development and validation of a natural language processing (NLP) algorithm deployed on oncology, urology, and radiology clinical notes to identify patients with a diagnosis or history of mPCa in the Department of Veterans Affairs. PATIENTS AND METHODS Using a broad set of diagnosis and histology codes, the Veterans Affairs Corporate Data Warehouse was queried to identify all Veterans with PCa. An NLP algorithm was developed to identify patients with any history or progression of mPCa. The NLP algorithm was prototyped and developed iteratively using patient notes, grouped into development, training, and validation subsets. RESULTS A total of 1,144,610 Veterans were diagnosed with PCa between January 2000 and October 2020, among which 76,082 (6.6%) were identified by NLP as having mPCa at some point during their care. The NLP system performed with a specificity of 0.979 and sensitivity of 0.919. CONCLUSION Clinical documentation of mPCa is highly reliable. NLP can be leveraged to improve PCa data. When compared to other methods, NLP identified a significantly greater number of patients. NLP can be used to augment cancer registry data, facilitate research inquiries, and identify patients who may benefit from innovations in mPCa treatment.

Download Full-text

Quality of Cancer Registry Data: Botswana Experience, Demonstrating Improvements Over Time

Journal of Global Oncology ◽

10.1200/jgo.2016.004176 ◽

2016 ◽

Vol 2 (3_suppl) ◽

pp. 43s-43s

Author(s):

Malebogo Pusoentsi ◽

Bame P. Shatera ◽

Setlogelo Motlogi ◽

Tuduetso Monagen ◽

Neo Tapela ◽

...

Keyword(s):

Data Quality ◽

Cancer Registry ◽

Death Certificate ◽

Kaposi Sarcoma ◽

Cancer Registries ◽

Health Systems Strengthening ◽

Registry Data ◽

Cancer Registry Data ◽

Over Time

Abstract 69 Background: One of the challenges to addressing the growing burden of cancer in low- and middle-income countries is insufficient data and limitations in quality of cancer registries. The Botswana National Cancer Registry (BNCR), first established in 1999, is an IARC-endorsed population-based registry covering a population of 2.1 million. Here we assess BNCR's data quality over time. Methods: We conducted a retrospective review of BNCR data that was collected between January 1, 2005 and December 31, 2010. We assessed basis of cancer diagnosis, as well as key data quality indices (completeness, consistency, uniqueness, and accuracy) over two time periods: 2005–2007 and 2008–2010. We assessed cancer incidence and distribution during this time period, and reviewed Botswana Ministry of Health operational documents to identify major health care initiatives that may have had a bearing on cancer registry data quality. Results: In total, 8,938 cancer cases were registered 2005-2010. Kaposi sarcoma was the most commonly diagnosed cancer (n=1766, 19.4%), followed by cervical cancer (n=1252, 13.8%) and then breast cancer (n=801, 8.8%). During 2005-2007, 79% of all cancers were morphologically verified and 6% of were verified by death certificate alone. By 2008-2010, 89% of cancers were morphologically verified while none (0%) were verified by death certificate alone. There was a marked difference for basis of Kaposi sarcoma diagnosis (26% in 2005-2007, 43.8% 2008-2010), which changed from mainly clinical to pathology-based diagnosis. Factors that have contributed to this improvement include targeted initiatives such as clinician training, as well as broader health system developments such as general laboratory diagnostic capacitation that has facilitated use of histopathology services for cancer. Conclusion: BNCR data quality has improved over the years. These improvements enhance utility of cancer registry data for healthcare planning, and highlight the merit of cross-cutting health systems strengthening developments. This assessment, and the initiatives that have contributed to BNCR data improvement may be relevant to cancer registries in similar settings. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

Download Full-text

Prognosis of Patients with Metastatic Soft Tissue Sarcoma: Advances in Recent Years

Oncology Research and Treatment ◽

10.1159/000509519 ◽

2020 ◽

Vol 43 (11) ◽

pp. 613-619

Author(s):

Jakob Lochner ◽

Franka Menge ◽

Nikolaos Vassos ◽

Peter Hohenberger ◽

Bernd Kasper

Keyword(s):

Soft Tissue ◽

Metastatic Disease ◽

Medical Center ◽

Treatment Strategies ◽

Soft Tissue Sarcomas ◽

High Volume ◽

Prognostic Indicators ◽

Metastatic Soft Tissue Sarcoma ◽

Using Data ◽

Clinical Records

Objective: The objective of this study was to investigate the prognosis of patients with metastatic soft tissue sarcomas (STS) and to define prognostic indicators for overall survival (OS). Methods: All patients who were treated at the Sarcoma Unit at the Mannheim University Medical Center between 2010 and 2016 and who developed metastatic disease deriving from a STS were included in this retrospective analysis. OS was investigated using data from clinical records and German registry offices. Clinical and pathological characteristics were recorded and analyzed. Results: A total number of 212 patients developed metastatic disease from STS during that period. Median OS after first documentation of metastatic disease was 24 months (95% CI 21–33). 1-, 2-, and 5-year OS rates were 70.0% (95% CI 64–77), 49.9% (95% CI 43–58), and 24.8% (95% CI 19–33), respectively. In multivariate analysis, significant predictors for mortality appeared to be gender, age, location and size of the primary tumor, histology, and disease-free interval. Conclusion: Being treated in a high-volume STS reference center in Germany, patients with metastatic disease could demonstrate an increased OS compared to former analyses. These data can be used as a benchmark for upcoming studies and highlight that further research on treatment strategies in this rare disease is urgently needed.

Download Full-text

Epidemiology of Soft Tissue Sarcoma and Bone Sarcoma inItaly: Analysis of Data from 15 Population-Based Cancer Registries

Sarcoma ◽

10.1155/2020/6142613 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Sabrina Fabiano ◽

Paolo Contiero ◽

Giulio Barigelletti ◽

Anna D’Agostino ◽

Andrea Tittarelli ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Incidence Rate ◽

Central Italy ◽

Soft Tissue Sarcomas ◽

Bone Sarcoma ◽

Cancer Registries ◽

Population Based ◽

South Italy ◽

The North

Sarcomas are a heterogeneous group of rare cancers of mesenchymal origin. In this study, we provide updated, world age-standardised incidence rate (ASR) and European age-standardised incidence rate for malignant soft tissue sarcoma (ICD-O-3 topographic code C47–C49) and bone sarcoma (C40, C41) in Italy, by area (north, centre, and south) and by cancer registry. We also assess morphology in relation to site and area and assess metastases at diagnosis. We analysed 1,112 cases, with incidence 2009–2012, provided by 15 cancer registries (CRs) affiliated to the Association of Italian Cancer Registries (AIRTUM). Overall, ASR was 1.7/100,000/year for soft tissue sarcoma and 0.7 for bone sarcoma. Central Italy had the highest (2.4) ASR and south Italy had the lowest (1.6) ASR for soft tissue sarcoma. Central Italy had the highest (1.1) ASR and north Italy had the lowest (0.7) ASR for bone sarcoma. By CR, ASRs ranged from 1.1 to 2.6 for soft tissue sarcoma and from 0 to 1.4 for bone sarcoma. The most frequent soft tissue sarcomas were sarcoma not otherwise specified (NOS) (29.4%) and liposarcoma (22.2%); the most common bone sarcoma was chondrosarcoma (37.6%). Soft tissue sarcomas occurred most frequently (35.6%) in lower limb connective tissue; bone sarcomas arose mainly (68.8%) in long bones. The frequencies of morphologies arising at different sites varied considerably by Italian area; for example, 20% of hemangiosarcomas occurred in the head and neck in south Italy with 17% at this site in the centre and 6% in the north. For soft tissue sarcoma, the highest ASRs of 2.6 and 2.4 contrast with the lowest ASRs 1.1 and 1.3, suggesting high-risk hot spots that deserve further investigation. The marked variations in morphology distribution with site and geography suggest geographic variation in risk factors that may also repay further investigation particularly since sarcoma etiology is poorly understood.

Download Full-text

Oral soft-tissue sarcomas diagnosed in an oral pathology service: a 16year experience

Clinical and Laboratorial Research in Dentistry ◽

10.11606/issn.2357-8041.clrd.2021.184424 ◽

2021 ◽

Author(s):

Paulo Sérgio Souza Pina ◽

Mariana Lobo Bergamini ◽

Fábio Luiz Coracin ◽

Suzana Cantanhede Orsini Machado de Sousa

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcomas ◽

Kaposi Sarcoma ◽

Oral Pathology ◽

Clinical Aspect ◽

Clinical Appearance ◽

Male Patients ◽

School Of Dentistry ◽

All Diseases ◽

Oral Soft Tissue

Objective: This study analyzed the prevalence and clinic-pathological features of soft-tissue sarcomas diagnosed in a single-center of oral pathology from a School of Dentistry in Brazil. Materials and methods: All consecutive cases of intra-oral soft-tissue sarcomas diagnosed between January of 2002 and December of 2018 were retrieved from the files; patient data (sex, age and race) and characteristics of the lesions (site, size, clinical aspect and duration of injury) were collected. Results: Among a total of 62,255 biopsies diagnosed in the studied period, soft-tissue oral sarcomas comprised 76 cases (0.12%). Kaposi sarcoma, rhabdomyosarcoma, leiomyosarcoma encompassed 64.5% of the cases, and 53% of these were diagnosed as Kaposi Sarcoma. Male patients were more affected (59.2%) and white patients comprised 50%. In general, 39.4% of the patients were between 21-40yo. Conclusion: Soft-tissue sarcomas are rare in oral soft-tissue and in our pathology service, they comprised only 0.12% of all diseases diagnosed in the studied period. Kaposi sarcoma was the most frequent, followed by leiomyosarcoma and rhabdomyosarcoma. Thus, it is important for stomatologists and pathologists to be aware of their characteristics when examining oral mucosa, mainly their peculiarities regarding patient’s age, clinical appearance, and site of occurrence.

Download Full-text