Öz
Aim: To analyze the epidemiologic, and survival characteristics of 3179 bone and soft tissue
sarcomas that were diagnosed as cancer and were treated in Ege University Hospital between 1992
and 2017, and compare the results with resources.
Materials and Methods: The data of the bone, and soft tissue sarcomas collected in Ege University
Cancer Research Center were recorded in the CANREG special computer program, and the analyses
were performed after grouping in the basis of the WHO, and SEER systems. The Chi-square, General
Linear Model, Kaplan Meier survival analyses were performed in statistical analyses. Log Rank
(Mantel-Cox), Breslow (Generalized Wilcoxon), and Tarone-Ware statistics were used in Kaplan Meier
survival analysis. p<0.05 was accepted statistically significant in statistical analyses.
Results: The ratio of the bone, and soft tissue sarcomas were detected as 2.7%(n:3179) among the
117.139 cases in Ege University Hospital Cancer data system. 58% (n:795) of cases with bone tumor
were men, and 42%(n:566) were women. Majority of the cases were aged between 10-19 (30.8%)
years, and 20-29 (14.8%) years. The most common settlement region was the lower extremity long
bones (42.5%). The most common histological diagnoses were osteosarcoma, Ewing sarcoma, and
chondrosarcoma. We found that 41%(n:663) of the cases that could be staged presented with
localized tumor, and 33.2% presented with locally advanced stage, and 25.8% presented with distant
metastasis. The survival evaluation showed that the total 5 years overall survival in bone tumors was
62%, and 10 years overall survival was detected as 53%. 5, and 10 years overall survival in
accordance with the stages was 71%, and 65% in localized tumors, 58%, and 54% in locally advanced
stage, and 43%, and 36% in metastatic period.
53% (n: 970) of the soft tissue sarcoma cases were men, and 47%(n:847) were women. 49.9%(n:739)
of the cases that could be staged were found to have presented with localized tumor, 24.1% with
locally advanced stage, and 26.2% presented with distant metastasis. 5 years overall survival was
59%, and 10 years overall survival was detected as 49% in survival evaluation in soft tissue sarcomas.
The overall survival in men in soft tissue sarcomas was detected to be poorer compared with the
overall survival in women. Although 5 years, and 10 years overall survival was detected as 62%, and
53% in women, the overall survival in 5 years, and 10 years decreased to 56%, and 45%, respectively
in men.
Conclusion: The bone, and soft tissue sarcomas are found in a ratio of 2.7%(n:3179) among 117.139
cases included in Ege University Hospital cancer data system. The survival evaluation showed that 5
years overall survival was 62%, and 10 years overall survival was 53% in bone tumors. The 5 years
overall survival in soft tissue sarcomas was 59%, and 10 years overall survival was detected as 49%.
Kaynakça
- Weiss, S.; Goldblum, J. General considerations. In: Weiss, S.; Goldblum, J., editors. Enzinger and Weiss’s Soft Tissue Tumors. St Louis, Missouri: CV Mosby, 2001: 1-19.
- Unni KK, Inwards CY. Dahlin’s Bone Tumors, 6th ed. Philadelphia: Wolters Kluwer, Lippincott Williams & Wilkins, 2010.
- Greenspan A, Jundt G, Remagen W. Differential diagnosis in orthopeadic oncology. 2 nd ed. Philadelphia: Lippincott Williams & Wilkins, 2007.
- Fuchs B, Ossendorf C, Leerapun T, Sim FH: Intercalary segmental reconstruction after bone tumor resection. EJSO 2008; 34 (12): 1271-6.
- Mathew R, Di Caprio MD, Gary E, Friedlaender MD: Malign bone tumors; Limb sparing versus amputations. Journal of the American Academiy of Orthopaedic Surgeons 2003; 11: 25-37.
- Picci P. Osteosarcoma (osteogenic sarcoma). Orphanet J Rare Dis 2007; 2: 6.
- Böhm P, Fritz J, Thiede S, Budach W: Reimplantation of extracorporeal irradiated bone segments in musculoskeletal tumor surgery: clinical experience in eight patients and review of the literature. Langenbecks Arch Surg 2003; 387: 355-65.
- Trautmanna F, Schulerb M, Schmitta J. Burden of soft-tissue and bone sarcoma in routine care Estimation of incidence, prevalence and survival for health services research. Cancer Epidemiology 2015; 39: 440-6.
- Stiller CA, Trama A, Serraino D, Rossi S, Navarro C, Chirlaque MD, et al. Descriptive epidemiology of sarcomas in Europe: report from the RARECARE project. Eur J Cancer 2013; 49 (3): 684–95.
- C.D.M. Fletcher. WHO Classification of Tumours of Soft Tissue and Bone. IARC. 4th Ed. 2013: 240-2.
- Wibmer C, Leithner A, Zielonke N, Sperl M, Windhager R. Increasing incidence rates of soft tissue sarcomas? A population-based epidemiologic study and literature review. Annals of Oncology 2010; 21: 1106–11. 12.Murphey MD, Walker EA, Wilson AJ, Kransdorf MJ, Temple HT, Gannon FH. From the archives of the AFIP: imagining of primary chondrosarcoma: radiologic-pathologic correlation. Radiographics. 2003; 23 (5): 1245-78. 13.Weis SW, Goldblum JR. Soft Tissue Tumors. 5th. Ed. Mosby, 2008. 14.Cotterill SJ, Ahrens S, Paulussen M, Jurgens HF, Voute PA, et al. Prognostic factors in Ewing’s tumor of bone: Analysis of 975 patients from the European İntergroup Cooperative Ewing’s sarcoma Study Group. J of Clinical Oncology 2000; 18 (3): 108-14.
Öz
Amaç: Ege Üniversitesi Hastanesinde 1992-2017 arası kanser tanı ve tedavisi yapılan 3179 kemik ve
yumuşak doku sarkomunun epidemiyolojik ve sağ kalım özelliklerinin analizi ve sonuçların kaynaklarla
karşılaştırılmasıdır.
Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezi tarafından toplanan
kemik ve yumuşak doku sarkomu verileri CANREG özel bilgisayar programına kayıt edilmiş, DSÖ ve
SEER sistemleri temelinde gruplanarak analizler yapılmıştır. İstatistik analizlerde Ki-kare, General Linear
Model, Kaplan Meier sağ kalım analizleri uygulanmıştır. Kaplan Meier sağ kalım analizinde Log Rank
(Mantel-Cox), Breslow (Generalized Wilcoxon) ve Tarone-Ware istatistikleri kullanılmıştır. İstatistik
analizlerde p<0,05 istatistiksel olarak anlamlı kabul edilmiştir.
Bulgular: EÜH Kanser veri sisteminde bulunan 117.139 olgu arasında kemik ve yumuşak doku sarkomları
%2,7 (n=3179) oranında gözükmektedir. Kemik tümörlü olgularımızın %58’i (n:795) erkek, %42’si (n:566)
kadındır. Olgularımızın büyük bölümü 10-19 (%30,8) ve 20-29 (%14,8) yaş aralığındadır. En sık yerleşim
yeri alt ekstremite uzun kemiklerindedir (%42,5). Histolojik tanılarda ise en sık osteosarkom ardından
Ewing sarkomu ve kondrosarkom görülmektedir. Evrelendirmesi yapılabilen olguların %41’nin (n:663)
lokalize tümör, %33,2’sinin lokal ileri evre ve %25,8’inin ise uzak metastaz ile başvurduğu görüldü. Yapılan
sağ kalım değerlendirmesinde kemik tümörlerinde toplam beş yıllık GSK %62, 10 yıllık ise %53 saptandı.
Evrelere göre beş ve 10 yıllık GSK sırasıyla; lokalize tümörlerde %71 ve %65, lokal ileri evrede %58 ve
%54, metastatik dönemde ise %43 ve %36’dır.
Yumuşak doku sarkomu olgularımızın %53’ü (n: 970) erkek, %47’si (n:847) kadındır. Evrelendirmesi
yapılabilen olguların (n:739) %49,9’unun lokalize tümör, %24,1’inin lokal ileri evre ve %26,2’sinin ise uzak
metastaz ile başvurduğu görüldü. Yumuşak doku sarkomlarında toplam sağ kalım değerlendirmesinde beş
yıllık GSK %59, 10 yıllık %49 saptandı. YDS da GSK’nin erkek hastalarda kadın hastalara göre daha kötü
olduğu görüldü. Kadınlarda beş ve 10 yıllık GSK sırasıyla %62 ve %53 olarak saptanırken erkeklerde bu
oranlar %56 ve %45’e düşmektedir.
Sonuç: EÜH Kanser veri sisteminde bulunan 117.139 olgu arasında kemik ve yumuşak doku sarkomları
%2,7 (n=3179) oranında gözükmektedir. Yapılan sağ kalım değerlendirmesinde kemik tümörlerinde beş
yıllık GSK %62, 10 yıllık ise %53 saptandı. Yumuşak doku sarkomlarında beş yıllık GSK %59, 10 yıllık %49
saptandı.
Anahtar Kelimeler
Kemik ve Yumuşak doku sarkomu epidemiyoloji mortalite genel sağ kalım
Kaynakça
- Weiss, S.; Goldblum, J. General considerations. In: Weiss, S.; Goldblum, J., editors. Enzinger and Weiss’s Soft Tissue Tumors. St Louis, Missouri: CV Mosby, 2001: 1-19.
- Unni KK, Inwards CY. Dahlin’s Bone Tumors, 6th ed. Philadelphia: Wolters Kluwer, Lippincott Williams & Wilkins, 2010.
- Greenspan A, Jundt G, Remagen W. Differential diagnosis in orthopeadic oncology. 2 nd ed. Philadelphia: Lippincott Williams & Wilkins, 2007.
- Fuchs B, Ossendorf C, Leerapun T, Sim FH: Intercalary segmental reconstruction after bone tumor resection. EJSO 2008; 34 (12): 1271-6.
- Mathew R, Di Caprio MD, Gary E, Friedlaender MD: Malign bone tumors; Limb sparing versus amputations. Journal of the American Academiy of Orthopaedic Surgeons 2003; 11: 25-37.
- Picci P. Osteosarcoma (osteogenic sarcoma). Orphanet J Rare Dis 2007; 2: 6.
- Böhm P, Fritz J, Thiede S, Budach W: Reimplantation of extracorporeal irradiated bone segments in musculoskeletal tumor surgery: clinical experience in eight patients and review of the literature. Langenbecks Arch Surg 2003; 387: 355-65.
- Trautmanna F, Schulerb M, Schmitta J. Burden of soft-tissue and bone sarcoma in routine care Estimation of incidence, prevalence and survival for health services research. Cancer Epidemiology 2015; 39: 440-6.
- Stiller CA, Trama A, Serraino D, Rossi S, Navarro C, Chirlaque MD, et al. Descriptive epidemiology of sarcomas in Europe: report from the RARECARE project. Eur J Cancer 2013; 49 (3): 684–95.
- C.D.M. Fletcher. WHO Classification of Tumours of Soft Tissue and Bone. IARC. 4th Ed. 2013: 240-2.
- Wibmer C, Leithner A, Zielonke N, Sperl M, Windhager R. Increasing incidence rates of soft tissue sarcomas? A population-based epidemiologic study and literature review. Annals of Oncology 2010; 21: 1106–11. 12.Murphey MD, Walker EA, Wilson AJ, Kransdorf MJ, Temple HT, Gannon FH. From the archives of the AFIP: imagining of primary chondrosarcoma: radiologic-pathologic correlation. Radiographics. 2003; 23 (5): 1245-78. 13.Weis SW, Goldblum JR. Soft Tissue Tumors. 5th. Ed. Mosby, 2008. 14.Cotterill SJ, Ahrens S, Paulussen M, Jurgens HF, Voute PA, et al. Prognostic factors in Ewing’s tumor of bone: Analysis of 975 patients from the European İntergroup Cooperative Ewing’s sarcoma Study Group. J of Clinical Oncology 2000; 18 (3): 108-14.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Ek |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2019 |
| Gönderilme Tarihi | 15 Şubat 2019 |
| Yayımlandığı Sayı | Yıl 2019 |