Sarcomas in the United States: Recent trends and a call for improved staging
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Michele M. Gage1, Neeraja Nagarajan1, Jessica M. Ruck1, Joseph K. Canner1, Salma Khan2, Katherine Giuliano1, Faiz Gani1, Christopher Wolfgang1, Fabian M. Johnston1, and Nita Ahuja1,3
1Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA
2Rehman Medical Institute, Hayatabad, Pakistan
3Department of Surgery, Yale University, New Haven, Connecticut, USA
Nita Ahuja, email: [email protected]
Keywords: sarcoma; mesenchymal tumors; connective tissue tumors; SEER; trends of sarcoma
Received: November 06, 2018 Accepted: February 19, 2019 Published: March 29, 2019
Background and objectives: Sarcomas represent a heterogeneous group of tumors, and there is lack of data describing contemporary changes in patterns of care. We evaluated the epidemiology of sarcomas over 12 recent years
Methods: The Surveillance, Epidemiology and End Results (SEER) database was queried for sarcoma cases from 2002-2014. Patient, tumor and treatment factors, and trends over time were studied overall and by subtype. Univariable and multivariable logistic regression models and 5-year survival and cause-specific mortality (CSM) were summarized.
Results: There were 78,527 cases of sarcomas with an overall incidence of 7.1 cases per 100,000 people, increasing from 6.8 in 2002 to 7.7 in 2014. Sarcoma NOS(14.8%) and soft tissue(43.4%) were the most common histology and primary site, respectively. A majority of tumors were high-grade(33.6%) and >5 cm(51.3%). CSM was 28.6% and 5-year survival was 71.4%. Many patients had unknown-grade(42.2%), which associated with 2.6 times increased odds of no surgical intervention.
Conclusions: This comprehensive national study highlights important trends including increasing incidence, changing histologic types, and underestimation of true incidence. A large proportion of sarcomas are inadequately staged (unknown-grade 42.2%) with lack of appropriate surgical treatment. Our study highlights need for standardization of care for sarcomas.
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