Research Papers:

Sarcomas in the United States: Recent trends and a call for improved staging

Michele M. Gage, Neeraja Nagarajan, Jessica M. Ruck, Joseph K. Canner, Salma Khan, Katherine Giuliano, Faiz Gani, Christopher Wolfgang, Fabian M. Johnston and Nita Ahuja _

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Oncotarget. 2019; 10:2462-2474. https://doi.org/10.18632/oncotarget.26809

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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

Correspondence to:

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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