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1.
BMC Womens Health ; 23(1): 10, 2023 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-36624439

RESUMO

BACKGROUND: To estimate the incidence, prevalence and incidence-based mortality in patients with gynecologic sarcoma (GS), and described the trends of survival and initial treatments in the US by using the Surveillance, Epidemiology, and End Results (SEER) database. METHODS: GS cases aged 20 years or older between 1975 and 2015 were identified from SEER 9 registries. Incidence, prevalence, and incidence-based mortality were estimated, all rates were age adjusted to the 2000 US standard population and presented as per 100,000 persons. Annual percentage change (APC) and average APC (AAPC) were calculated to describe the trends. In addition, stage distribution, cancer-specific survival (CSS) and initial treatment pattern over time were also reported. RESULTS: The overall age-adjusted incidence of GS increased from 2.38 to 3.41 per 100,000 persons from 1975 to 2015, with an AAPC of 1.0 (P < 0.05), and the AAPC increased to 1.3 (P < 0.05) in the last decade. The incidence of population aged ≥ 55 years was three or more times than that of population aged 20-54 year from 1975 to 2015. Corpus and uterus GS was the main subtype, and it increased significantly during last three decades (an APC of 1.5). In addition, the prevalence of corpus and uterus GS increased mostly among all GSs. The incidence of GS with regional and distant stages increased pronouncedly, but not for local stage. GS cases showed increasing 3-year and 5-year CSS rates except for other sites GS. Approximately 87.7% GS cases received surgery during the first-course treatment, but the proportion decreased over years. In contrast, the proportion of receiving multiple treatment modalities increased. CONCLUSIONS: The incidence of GS increased significantly with improved survival, which might due to the strategy of combination of multiple treatment. However, no obvious improvement on the early detection of GS was found, which should be facilitated to further improve the prognosis of GS.


Assuntos
Sarcoma , Humanos , Feminino , Estados Unidos/epidemiologia , Incidência , Estudos Retrospectivos , Sarcoma/epidemiologia , Sarcoma/terapia , Sistema de Registros , Prevalência
2.
West Afr J Med ; 39(12): 1229-1237, 2022 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-36580654

RESUMO

BACKGROUND: Published data on childhood and adolescent cancers in northern Ghana is scanty. The aim of this retrospective histopathological study was to identify and describe the relative proportions of childhood and adolescent cancers and the associated clinico-pathological features at the Tamale Teaching Hospital. MATERIALS AND METHODS: The cancers were classified according to the International Classification for Cancer in Children. Data was collected on the demographics and the clinico-pathological characteristics of the various types of cancers, from 1st January 2012 to 31st December, 2021, a 10-year period. The data was analysed using SPSS software (Version 26, Chicago). RESULTS: A total of 196 childhood and adolescent cancers were reviewed, with a mean age of 9.5± 5.5 years. Approximately, 51.5% were female, with a younger mean age (years) of 8.4±5.3, compared to 10.6±5.6 for males. Majority (74.0%), were within the 0-14 years age group, (P<0.0001). All the patients presented with swellings and mostly after 6 months of disease onset. The common cancers for the study population were: soft tissue sarcoma (24.2%), primary bone cancer (21.1%), retinoblastoma (17.5%), lymphoma (13.3%), and germ cell tumours (6.7%). For females these were: soft tissue sarcoma (21.0%), retinoblastoma (20.0%), primary bone cancer (19.0%), nephroblastoma (13.0%), and ovarian tumours (12.0%). For males, these were: soft tissue sarcoma (27.7%), bone cancer (23.4%), lymphoma (19.1%), retinoblastoma (14.9%) and head and neck cancer (6.4%). The common soft tissue cancers were: rhabdomyosarcoma (46.8%), and spindle cell sarcoma (NOS) (17.0%). Osteosarcoma (70.7%), and Ewing's sarcoma 6 (14.6%) were the common primary bone cancers. Many (46.4%) of the retinoblastomas were of a high pathological TNM stage III. The optic nerve was involved in 70.6%, with 26.5% margin involvements. CONCLUSION: Childhood and adolescent cancers were common in pediatric age group with late stage at presentation. The common histological subtypes were: soft tissue sarcoma, primary bone cancer and retinoblastoma. There is the need for detection, diagnosis, and prompt oncology care.


CONTEXTE: Les données publiées sur les cancers de l'enfant et de l'adolescent dans le nord du Ghana sont rares. Le but de cette étude histopathologique rétrospective était d'identifier et de décrire les proportions relatives des cancers de l'enfant et de l'adolescent et les caractéristiques clinico-pathologiques associées à l'hôpital universitaire de Tamale. MATÉRIEL ET MÉTHODES: Les cancers ont été classés selon la Classification internationale du cancer chez l'enfant. Des données ont été recueillies sur les caractéristiques démographiques et clinicopathologiques des différents types de cancers. Les données ont été analysées à l'aide du logiciel SPSS (version 26, Chicago). RÉSULTATS: Un total de 196 cancers d'enfants et d'adolescents ont été examinés, avec un âge moyen de 9,5± 5,5 ans. Environ 51,5 % étaient des femmes, avec un âge moyen plus jeune (ans) de 8,4±5,3, contre 10,6±5,6 pour les hommes. La majorité des patients (74,0 %) étaient âgés de 0 à 14 ans (P<0,0001). Tous les patients présentaient des gonflements, le plus souvent après 6 mois d'apparition de la maladie. Les cancers les plus fréquents dans la population étudiée étaient les suivants : sarcome des tissus mous (24,2%), cancer osseux primaire (21,1%), rétinoblastome (17,5%), lymphome (13,3%) et tumeurs germinales (6,7%). Pour les femmes, il s'agissait de sarcomes des tissus mous (21,0 %), de rétinoblastomes (20,0 %), de cancers osseux primaires (19,0 %), de néphroblastomes (13,0 %) et de tumeurs ovariennes (12,0 %). Chez les hommes, il s'agissait de : sarcome des tissus mous (27,7%), cancer des os (23,4%), lymphome (19,1%), rétinoblastome (14,9%) et cancer de la tête et du cou (6,4%). Les cancers des tissus mous les plus fréquents étaient : le rhabdomyosarcome (46,8%) et le sarcome à cellules fusiformes (NOS) (17,0%). Les cancers osseux primaires les plus fréquents étaient l'ostéosarcome (70,7 %) et le sarcome d'Ewing (14,6 %). Un grand nombre (46,4 %) des rétinoblastomes étaient d'un stade pathologique élevé (TNM III). Le nerf optique était impliqué dans 70,6 % des cas, avec 26,5 % d'implication des marges. CONCLUSION: Les cancers de l'enfant et de l'adolescent étaient fréquents dans le groupe d'âge pédiatrique avec un stade tardif à la présentation. Les sous-types histologiques les plus fréquents étaient : le sarcome des tissus mous, le cancer primaire des os et le rétinoblastome. Il est nécessaire de détecter, de diagnostiquer et de fournir des soins oncologiques rapides. Mots clés: Enfance, Adolescence, Cancer, Ghana du Nord.


Assuntos
Neoplasias Ósseas , Linfoma , Neoplasias da Retina , Retinoblastoma , Sarcoma , Masculino , Humanos , Criança , Adolescente , Feminino , Pré-Escolar , Estudos Retrospectivos , Gana/epidemiologia , Sarcoma/epidemiologia
3.
Surg Oncol ; 45: 101861, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36270157

RESUMO

OBJECTIVES: The optimal frequency and modality of sarcoma surveillance imaging are uncertain, and current practices vary substantially. While efforts to develop evidence-based guidelines are ongoing, patient perspectives regarding surveillance imaging have not been reported. The primary goal of this study was to pilot the novel Sarcoma Surveillance Survey to assess patient concerns regarding sarcoma surveillance. METHODS: In this single-center, cross-sectional study, patients receiving surveillance imaging after surgical sarcoma treatment were administered the 10-item Sarcoma Surveillance Survey, the validated Appraisal Scale, measuring positive and negative emotional reactions to imaging, and the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety Short Form 8a as a measure of anxiety. RESULTS: Patients expressed highest levels of concern about cost and radiation exposure associated with surveillance, and most (87.6%) did not express a preference for more or less frequent imaging. Younger patients and those living further away from the imaging center were more concerned about cost of surveillance. Female patients had higher levels of concern compared to males regarding radiation, IV contrast, and overall levels of concern about surveillance. Higher levels of anxiety were correlated with preference for more frequent imaging (rs = 0.274, p = 0.027) and higher overall level of concern about surveillance (rs = 0.259, p = 0.037). Higher negative appraisal scores were also correlated with higher overall concerns (rs = 0.323; p = 0.012). CONCLUSIONS: Patient perspectives should be considered when developing sarcoma surveillance strategies. Identifying patients with greater anxiety and concerns regarding imaging may create opportunities for improved surveillance practices as well as counseling and survivorship interventions.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Masculino , Humanos , Feminino , Estudos Transversais , Inquéritos e Questionários , Ansiedade/epidemiologia , Sarcoma/epidemiologia
4.
Sci Rep ; 12(1): 17129, 2022 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-36224239

RESUMO

Sarcoma is a rare cancer, and little is known about the etiology, lifestyle epidemiology, and actual circumstances of treatment in hospitals in Japan. Understanding these issues is essential for the effective prevention and treatment of sarcoma. We therefore investigated the incidence of a personal and family cancer history in a total of 1320 sarcoma patients at the National Cancer Center Hospital. In addition, obesity, hypertension, dyslipidemia, diabetes mellitus, drinking, smoking, age and sex were compared in a descriptive study of 1159 of these sarcoma patients who were ≥ 20 years of age, and 7738 controls derived from the National Health and Nutrition Examination Survey in Japan. A total of 8% of sarcoma patients had a personal history of another cancer, and 30% of soft tissue sarcoma patients had a family cancer history in a first-degree relative (malignant peripheral nerve sheath tumor, 52%; leiomyosarcoma, 46%). A smoking habit was associated with the development of sarcoma (odds ratio [OR], 2.05; 95% confidence interval, 1.78-2.37; p < 0.01). According to the histology, the ORs for undifferentiated pleomorphic sarcoma (UPS) of bone, UPS of soft tissue, and liposarcoma were 5.71, 3.04, and 2.92, respectively. A family cancer history may be associated with certain soft tissue sarcomas, and a smoking habit was significantly associated with the development of sarcomas; however, further studies are necessary.


Assuntos
Histiocitoma Fibroso Maligno , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Japão/epidemiologia , Inquéritos Nutricionais , Sarcoma/epidemiologia , Sarcoma/etiologia , Sarcoma/patologia , Fumar/efeitos adversos , Neoplasias de Tecidos Moles/patologia
5.
PLoS One ; 17(10): e0274792, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36201527

RESUMO

BACKGROUND: Variations in cancer occurrence between populations in different places are expected because of many factors. In Ethiopia there is no national cancer registry and here we are reporting the pattern of cancer in Wolaita Sodo University hospital located in Southern region of Ethiopia with catchment area of over ten million peoples. METHODOLOGY: A retrospective record analysis of all pathologically confirmed malignancies from January 2021 up to June 2021. Data was filtered and descriptive analysis was done using IBM SPSS version 22 (Chicago IL USA). RESULT: In the Wolaita Sodo University Teaching Referral Hospital during the first six months of 2021, out of 1,810 histopathologically tested samples 19.5% (354) were confirmed malignant cases. Among 354 patient samples, most of them (62.4%) were in females and the rest (37%) found to be in males. The age pattern shows occurrence of 336 (95%) cases in adults and 18 (5%) cases in children. Breast cancer, soft tissue sarcomas, cancer of uteri cervix, non melanomatous skin cancer, and non hodgkin lymphomas were the five top common cancers of all age groups. In adult population, breast cancer, soft tissue sarcomas, and cancer of uteri cervix are the most common. In children of age less than 14 years non hodgkin lymphomas, soft tissue sarcomas and bone sarcomas were the three top cancers. Breast cancer, cancer of uteri cervix and soft tissue sarcomas are found to be the commonest cancers in females. On the other hand, soft tissue sarcomas, non melanomatous skin cancers and Non Hodgkin lymphomas, are the three top commonest cancers in males. CONCLUSION: Based on our current study cancer is one of the common finding from histopathology samples analyzed at the hospital and the pattern of cancer was similar to those reported in other regions of the country as well as neighboring countries. However, Comprehensive demographic and clinical data using population or facility-based cancer registry is required to get better information. Additionally, our finding of higher proportion of soft tissue sarcomas both in males and females of all age groups in this region is disparate and requires further investigation.


Assuntos
Neoplasias da Mama , Linfoma , Sarcoma , Adolescente , Adulto , Criança , Etiópia/epidemiologia , Feminino , Hospitais de Ensino , Humanos , Masculino , Estudos Retrospectivos , Sarcoma/epidemiologia
6.
Front Public Health ; 10: 942608, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36187680

RESUMO

Background: Renal sarcoma (RS) is rarely seen in clinical practice. The purpose of this study was to develop a prognostic nomogram model, which could predict the probability of overall survival (OS) and cancer-specific survival (CSS) in adult patients with RS. Methods: Patients diagnosed with RS were recruited from the SEER database between 2004 and 2015, and randomized to two cohorts: the training cohort and the validation cohort. Uni- and multivariate Cox regression analyses in the training cohort were used to screen independent prognostic factors for OS and CSS. Prognostic nomograms for OS and CSS were created separately for adult RS patients based on independent risk factors. The area under the receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to validate the nomograms. Results: A total of 232 eligible patients were recruited, including 162 in the training cohort and 70 in the validation cohort. Sex, histological type, SEER stage, and surgery were independent prognostic factors for OS, while histological type, SEER stage, surgery, chemotherapy were independent prognostic factors for CSS. Based on the above independent prognostic factors, prognostic nomograms for OS and CSS were created respectively. In the training cohort, the AUCs of the nomograms for OS and CSS were 0.742 and 0.733, respectively. In the validation cohort, the AUCs of the nomograms for OS and CSS were 0.837 and 0.758, respectively. The calibration curves of the nomograms showed high consistencies between the predicted and actual survival rates. Finally, the DCA demonstrated that the nomograms in the wide high-risk threshold had a higher net benefit than the SEER stage. Conclusion: A prognostic nomogram for renal sarcoma was created and validated for reliability and usefulness in our study, which assisted urologists in accurately assessing the prognosis of adult RS patients.


Assuntos
Nomogramas , Sarcoma , Adulto , Humanos , Estadiamento de Neoplasias , Prognóstico , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Programa de SEER , Sarcoma/diagnóstico , Sarcoma/epidemiologia
7.
Lancet Oncol ; 23(11): 1451-1464, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36240805

RESUMO

BACKGROUND: Soft tissue sarcoma is a rare but serious side-effect of radiotherapy to treat breast cancer, and rates are increasing in the USA. We evaluated potential co-factors in two complimentary cohorts of US breast cancer survivors. METHODS: In this retrospective cohort study, we sourced data from the Kaiser Permanente (KP) cohort and the Surveillance, Epidemiology, and End Results (SEER) 13 registries cohort, both in the USA. The KP cohort included 15 940 women diagnosed with breast cancer from Jan 1, 1990, to Dec 31, 2016, in KP Colorado, KP Northwest (which serves Oregon and Southwest Washington state), or KP Washington, with detailed treatment data and comorbidities (including hypertension and diabetes at or before breast cancer diagnosis) from electronic medical records. The SEER cohort included 457 300 women diagnosed with breast cancer from Jan 1, 1992, to Dec 31, 2016, within the 13 SEER registries across the USA, with initial treatment data (yes vs no or unknown). Eligibility criteria in both cohorts were female breast cancer survivors (stage I-III) aged 20-84 years at diagnosis who had breast cancer surgery, and had survived at least 1 year after breast cancer diagnosis. The outcome of interest was any second thoracic soft tissue sarcoma (angiosarcomas and other subtypes) that developed at least 1 year after breast cancer diagnosis. Risk factors for thoracic soft tissue sarcoma were assessed using multivariable Poisson regression models. FINDINGS: In the KP cohort, median follow-up was 9·3 years (IQR 5·7-13·9) and 19 (0·1%) of 15 940 eligible, evaluable women developed a thoracic soft tissue sarcoma (11 angiosarcomas, eight other subtypes). Most (94·7%; 18 of 19) thoracic soft tissue sarcomas occurred in women treated with radiotherapy; thus, radiotherapy was associated with a significantly increased risk of developing a thoracic soft tissue sarcoma (relative risk [RR] 8·1 [95% CI 1·1-60·4]; p=0·0052), but there was no association with prescribed dose, fractionation, or boost. The RR of angiosarcoma after anthracyclines was 3·6 (95% CI 1·0-13·3; p=0·058). Alkylating agents were associated with an increased risk of developing other sarcomas (RR 7·7 [95% CI 1·2-150·8]; p=0·026). History of hypertension (RR 4·8 [95% CI 1·3-17·6]; p=0·017) and diabetes (5·3 [1·4-20·8]; p=0·036) were each associated with around a five-times increased risk of angiosarcoma. In the SEER cohort, 430 (0·1%) of 457 300 patients had subsequent thoracic soft tissue sarcomas (268 angiosarcomas and 162 other subtypes) after a median follow-up of 8·3 years (IQR 4·3-13·9). Most (77·9%; 335 of 430) cases occurred after radiotherapy; thus, radiotherapy was associated with a significantly increased risk of developing a thoracic soft tissue sarcoma (RR 3·0 [95% CI 2·4-3·8]; p<0·0001) and, for angiosarcomas, the RR for breast-conserving surgery plus radiotherapy versus mastectomy plus radiotherapy was 1·9 (1·1-3·3; p=0·012). By 10 years after radiotherapy, the cumulative incidence of thoracic soft tissue sarcoma was 0·21% (95% CI 0·12-0·34) in the KP cohort and 0·15% (95% CI 0·13-0·17) in SEER. INTERPRETATION: Radiotherapy was the strongest risk factor for thoracic soft tissue sarcoma in both cohorts. This finding, along with the novel findings for diabetes and hypertension as potential risk factors for angiosarcomas, warrant further investigation as potential targets for prevention strategies and increased surveillance. FUNDING: US National Cancer Institute and National Institutes of Health.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Hemangiossarcoma , Hipertensão , Segunda Neoplasia Primária , Sarcoma , Neoplasias de Tecidos Moles , Feminino , Humanos , Masculino , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Neoplasias da Mama/complicações , Hemangiossarcoma/epidemiologia , Hemangiossarcoma/etiologia , Hemangiossarcoma/terapia , Estudos Retrospectivos , Segunda Neoplasia Primária/epidemiologia , Segunda Neoplasia Primária/etiologia , Mastectomia/efeitos adversos , Sarcoma/epidemiologia , Sarcoma/terapia , Neoplasias de Tecidos Moles/cirurgia , Estudos de Coortes , Fatores de Risco , Hipertensão/epidemiologia , Hipertensão/complicações
8.
Niger J Clin Pract ; 25(9): 1584-1592, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36149223

RESUMO

Background: Myxoid soft tissue tumors are rare and diagnostically challenging group of tumors with varied biological behavior ranging from benign, locally aggressive to distantly metastasizing malignant tumors. Aims: The objectives of the study are to identify the relative frequency and distribution of myxoid soft tissue tumors among patients in a tertiary care hospital and to study the clinicopathological features of these tumors. This was a retrospective cross-sectional study conducted in the department of pathology of a tertiary care hospital from January 2008 to December 2013. Materials and Methods: Clinical and pathological details of all the 80 myxoid soft tissue tumors reported during the study period were retrieved from the records of department of pathology. Corresponding Hematoxylin & Eosin (H & E) slides were reviewed, and Immunohistochemistry (IHC) was carried out for confirmation. The relationship among various prognostic variables was analyzed in case of myxoid sarcomas. Results: Myxoid soft tissue tumors accounted for 3.7% among the soft tissue tumors with a predominance of malignant myxoid sarcomas (71.25%) in contrast to the overall picture of sarcomas. Myxoid neurofibroma (34.78%) was the most common benign tumor, while myxofibrosarcoma (33.33%) was the frequent myxoid sarcoma. A statistically significant correlation was seen between tumor size and depth (P-value: 0.038) and also between presence of vascular invasion and histological grade (P-value: 0.012) of sarcomas. Conclusion: Light microscopic morphology, supplemented by ancillary techniques like IHC, remains the cornerstone for diagnosis of myxoid soft tissue tumors.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Adulto , Estudos Transversais , Amarelo de Eosina-(YS) , Hematoxilina , Humanos , Estudos Retrospectivos , Sarcoma/diagnóstico , Sarcoma/epidemiologia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/epidemiologia , Neoplasias de Tecidos Moles/patologia , Centros de Atenção Terciária
10.
Psychooncology ; 31(10): 1700-1710, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35949152

RESUMO

OBJECTIVE: Soft tissue sarcomas (STS) and gastrointestinal stromal tumours (GIST) are a group of rare malignant tumours with a high and heterogenous disease burden. As evidence is scarce, we analysed the prevalence of increased emotional distress and identified distress-associated factors in these patients. METHODS: The PROSa-study (Burden and medical care of sarcoma) was conducted between 2017 and 2020 in 39 study centres. Cross-sectional data from adult STS and GIST patients were analysed. Distress was measured with the Patient Health Questionnaire (PHQ-4). The relation of socioeconomic and clinical factors with distress was explored in adjusted logistic regression models. RESULTS: Among 897 patients, 17% reported elevated anxiety and 19% reported depression. Unemployed patients (odds ratio [OR] 6.6; 95% CI 2.9-15.0), and those with a disability pension (OR 3.1; 95% CI 1.9-5.0) were more likely to experience distress compared to employed patients. Also, patients with a disability pass had higher odds of increased distress than those without (OR 1.8; 95% CI 1.2-2.7). Lowest distress was observed in patients 2 to <5 years and ≥5 years after diagnosis (comparison: <6 months) (OR 0.4; 95% CI 0.2-0.6) and (0.3; 95% CI 0.2-0.6). Patients with thoracic STS (vs. lower limbs) had twice the odds to experience distress (OR 2.0; 95% CI 1.1-3.6). Distress was seen almost twice as often in patients with progressive disease (vs. complete remission) (OR 1.7; 95% CI 1.1-2.8). CONCLUSION: The prevalence of elevated distress in STS and GIST patients is high. In unemployed patients, in those with a disability pension and in newly diagnosed patients a noticeable increase was observed. Clinicians should be aware of these factors and consider the social aspects of the disease.


Assuntos
Tumores do Estroma Gastrointestinal , Sarcoma , Neoplasias de Tecidos Moles , Adulto , Ansiedade/epidemiologia , Estudos Transversais , Tumores do Estroma Gastrointestinal/epidemiologia , Humanos , Sarcoma/epidemiologia , Sarcoma/terapia
11.
J Card Surg ; 37(11): 3961-3963, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35979675

RESUMO

Representing 10%-25% of the primary cardiac neoplasms, primary malignant cardiac tumors (PMCT) have a poor prognosis, yet with rare incidence. Constituting more than 50% of the PMCT, cardiac sarcoma has increased not only in incidence over the past five decades but also in severity. Patients with PMCTs, especially sarcomas, have the worst prognosis when compared with other cardiac or extracardiac tumors. This retrospective study was performed using SEER*stat software, latest version 8.3.9.2(5) by accessing seer 18 registries plus data (excl AK) Nov 2020 Sub (2000-2018) for standard mortality ratio (SMR). A total of 235 patients were identified of whom 49.4% were females. Most of our patients were Stage 4 (n = 81) and distant in location (n = 92). The most common treatment method was tumor-directed surgery (n = 164), chemotherapy (n = 146), and radiotherapy (n = 55). Furthermore, other associated cancers with cardiac sarcoma were rare, with ten cases with lung and bronchus cancer (SMR: 37.95, 95% confidence interval [CI]: 18.2, 69.8), four with bone and joints (SMR: 1726.05, 95% CI: 470.2, 4419.3). During a 5-year follow-up, 235 patients died primarily due to cardiac sarcoma (n = 182, 77.4%), other cancers (n = 34, 14.4%), and other noncancerous causes (n = 19, 8%), while the noncancerous causes were attributed mainly to cardiovascular diseases (n = 4, 21%, SMR: 4.95, 95% CI: 1.35, 12.67), septicemia (n = 2, 10.5%, SMR: 41.23, 95% CI: 4.99, 148.95).


Assuntos
Neoplasias Cardíacas , Neoplasias do Mediastino , Sarcoma , Neoplasias do Timo , Causas de Morte , Feminino , Neoplasias Cardíacas/patologia , Humanos , Masculino , Estudos Retrospectivos , Programa de SEER , Sarcoma/epidemiologia , Estados Unidos/epidemiologia
12.
Eur J Cancer ; 174: 48-56, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35970036

RESUMO

BACKGROUND: Breast sarcomas (BS) are rare cancers originating from mesenchymal breast tissue with a paucity of national population level data detailing their incidence and outcomes. METHODS: We performed an analysis of data collected by National Cancer Registration and Analysis Service (NCRAS) for patients diagnosed with BS between 2013 and 2018. Chi-square test was used to compare groups. Overall survival (OS) was calculated by Kaplan-Meier. Specialist sarcoma centres (SSC) were defined as centres with a sarcoma multidisciplinary team (MDT). RESULTS: There were 684 patients with BS (357 malignant phyllodes tumours [PTs], 238 vascular tumours, 93 other morphology) with a median age of 64 (range 14-96); 187 (27%) had received breast radiotherapy for a prior malignancy; 633 (92%) had resection of the tumour within 12 months of diagnosis. Five-year OS was 82%, 54% and 48% in patients with PT, vascular tumours and other sarcomas, respectively, and 55% for those with radiation-induced BS. Patients managed within SSC more frequently had a biopsy prior to surgery 83% versus 72%, p < 0.05) and were less likely to require multiple operations (26% versus 41%, p < 0.05). Tumour stage and grade data were not available. CONCLUSION: This is the first population series evaluating incidence and outcomes for BS. Patients treated at non-specialist sarcoma centres (NSSCs) are less likely to have a biopsy prior to surgery and more likely to require multiple operations. Based on these observational data, we would recommend all BS are discussed at a sarcoma MDT meeting early in their pathway and surgery to be considered at SSC where possible.


Assuntos
Neoplasias da Mama , Tumor Filoide , Sarcoma , Neoplasias de Tecidos Moles , Neoplasias Vasculares , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Feminino , Humanos , Incidência , Tumor Filoide/complicações , Tumor Filoide/patologia , Estudos Retrospectivos , Sarcoma/epidemiologia , Sarcoma/terapia , Neoplasias Vasculares/complicações
13.
Clin Orthop Relat Res ; 480(11): 2148-2160, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-35901433

RESUMO

BACKGROUND: It is estimated that the 12-month prevalence of depression in the United States is 8.6%, and for anxiety it is 2.9%. Although prior studies have evaluated depression and anxiety in patients with carcinoma, few have specifically evaluated patients with sarcoma, who often have unique treatment considerations such as mobility changes after surgery. QUESTIONS/PURPOSES: We evaluated patients with sarcoma seen in our orthopaedic oncology clinic to determine (1) the proportion of patients with depression symptoms, symptom severity, how many patients triggered a referral to mental health professionals based upon our prespecified cutoff scores on the nine-item Patient Health Questionnaire (PHQ-9), and if their symptoms varied by disease state; (2) the proportion of patients with anxiety symptoms, symptom severity, how many patients triggered a referral to mental health professionals based upon our prespecified cutoff scores on the seven-item Generalized Anxiety Disorder Scale (GAD-7), and if they symptoms varied by disease state; (3) whether other factors were associated with the proportion and severity of symptoms of anxiety or depression, such as tumor location in the body (axial skeleton, upper extremity, or lower extremity), general type of tumor (bone or soft tissue), specific diagnosis, use of chemotherapy, length of follow-up (less than 1 year or greater than 1 year), and gender; and (4) what proportion of patients accepted referrals to mental health professionals, when offered. METHODS: This study was a cross-sectional survey study performed at a single urban National Cancer Institute-designated Comprehensive Cancer Center from April 2021 until July 2021. All patients seen in the orthopaedic clinic 18 years of age and older with a diagnosis/presumed diagnosis of sarcoma were provided the PHQ-9 as well as the GAD-7 in our clinic. We did not track those who elected not to complete the surveys. Surveys were scored per survey protocol (each question was scored from 0 to 3 and summed). Specifically, PHQ-9 scores the symptoms of depression as 5 to 9 (mild), 10 to 14 (moderate), 15 to 19 (moderately severe), and 20 to 27 (severe). The GAD-7 scores symptoms of anxiety as 5 to 9 (mild), 10 to 14 (moderate), and 15 to 21 (severe). Patients with PHQ-9 or GAD-7 scores of 10 to 14 were referred to social work and those with scores 15 or higher were referred to psychiatry. Patients with thoughts of self-harm were referred regardless of score. Patients were divided based on disease state: patients during their initial management; patients with active, locally recurrent disease; patients with active metastatic disease; patients with prior recurrence or metastatic lesions who were subsequently treated and now have no evidence of disease (considered to be patients with discontinuous no evidence of disease); patients with no evidence of disease; and patients with an active, noncancerous complication but otherwise no evidence of disease. We additionally looked at the association of gender, chemotherapy administration, and tumor location on survey responses. Data are summarized using descriptive statistics. Differences across categories of disease state were tested for statistical significance using Kruskal-Wallis tests for continuous variables and Fisher exact tests for categorical variables as well as pairwise Wilcoxon rank sum tests. RESULTS: Overall, symptoms of depression were seen in 35% (67 of 190) of patients, at varying levels of severity: 19% (37 of 190) had mild symptoms, 9% (17 of 190) had moderate symptoms, 6% (12 of 190) had moderately severe symptoms, and 1% (1 of 190) had severe symptoms. Depresssion symptoms severe enough to trigger a referral were seen in 17% (32 of 190) of patients overall. Patients scored higher on the PHQ-9 during their initial treatment or when they had recurrent or metastatic disease, and they were more likely to trigger a referral during those timepoints as well. The mean PHQ-9 was 5.7 ± 5.8 during initial treatment, 6.1 ± 4.9 with metastatic disease, and 7.4 ± 5.2 with recurrent disease as compared with 3.2 ± 4.2 if there was no evidence of disease (p = 0.001). Anxiety symptoms were seen in 33% (61 of 185) of patients: 17% (32 of 185) had mild symptoms, 8% (14 of 185) had moderate symptoms, and 8% (15 of 185) had severe symptoms. Anxiety symptoms severe enough to trigger a referral were seen in 16% (29 of 185) of patients overall. Patients scored higher on the GAD-7 during initial treatment and when they had recurrent disease or an active noncancerous complication. The mean GAD-7 was 6.3 ± 3.2 in patients with active noncancerous complications, 6.8 ± 5.8 in patients during initial treatment, and 8.4 ± 8.3 in patients with recurrent disease as compared with 3.1 ± 4.2 in patients with no evidence of disease (p = 0.002). Patients were more likely to trigger a referral during initial treatment (32% [9 of 28]) and with recurrent disease (43% [6 of 14]) compared with those with no evidence of disease (9% [9 of 97]) and those with discontinuous no evidence of disease (6% [1 of 16]; p = 0.004). There was an increase in both PHQ-9 and GAD-7 scores among patients who had chemotherapy. Other factors that were associated with higher PHQ-9 scores were location of tumor (upper extremity versus lower extremity or axial skeleton) and gender. Another factor that was associated with higher GAD-7 scores included general category of diagnosis (bone versus soft tissue sarcoma). Specific diagnosis and length of follow-up had no association with symptoms of depression or anxiety. Overall, 22% (41 of 190) of patients were offered referrals to mental health professionals; 73% (30 of 41) accepted the referral. CONCLUSION: When treating patients with sarcoma, consideration should be given to potential concomitant psychiatric symptoms. Screening, especially at the highest-risk timepoints such as at the initial diagnosis and the time of recurrence, should be considered. Further work should be done to determine the effect of early psychiatric referral on patient-related outcomes and healthcare costs. LEVEL OF EVIDENCE: Level III, therapeutic study.


Assuntos
Depressão , Sarcoma , Adolescente , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtornos de Ansiedade , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Humanos , Sarcoma/diagnóstico , Sarcoma/epidemiologia , Sarcoma/terapia
14.
Sci Rep ; 12(1): 12824, 2022 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-35896585

RESUMO

This study aimed to analyze burden of STS and GIST in population and survival rate which represented the current situation of treatment in Thailand. The data was collected from five population-based cancer registries around the country for the period 2001 through 2015. The Segi world standard population was used to calculated age-standardized incidence rates (ASR). Standardized rate ratios (SRR) were used to compare populations. Joinpoint Trend Analysis was used to assess changes in incidence. STATA was used to examine patient survival rates. During the study period, 4080 cases of STS and 457 cases of GIST were reported. The ASR of STS and GIST was 2.14/100,000 person-years and 0.22/100,000 person-years, respectively. The most common histological types of STS were unspecified sarcoma (24.8%), leiomyosarcoma (19.0%) and liposarcoma (11.4%). The overall ASR of STS in Thailand was relatively low compared to Western countries. The five-year survival rate was 62.6% for STS and 63.4% for GIST, which was comparable to the rates reported in other countries. This is the first report of STS and GIST from PBCRs in Thailand. Based on current healthcare service, an overall survival rates of STS and GIST are comparable to those reported from others.


Assuntos
Tumores do Estroma Gastrointestinal , Lipossarcoma , Sarcoma , Neoplasias de Tecidos Moles , Tumores do Estroma Gastrointestinal/epidemiologia , Humanos , Incidência , Sarcoma/epidemiologia , Tailândia/epidemiologia
15.
Med Trop Sante Int ; 2(1)2022 03 31.
Artigo em Francês | MEDLINE | ID: mdl-35685844

RESUMO

Aims: To study the epidemiological and histopathological characteristics of sarcomas. Procedure: This was a multi-center, descriptive, retrospective study realized over a 10-year period. We systematically recruited all medical reports of patients with histologically confirmed sarcoma. Results: 159 reports of sarcoma were retained. The average age was 38.9 years. There was a female predominance with a 0.9 estimated sex ratio. Soft tissue sarcomas were the most common (65.4%). The most frequent location was the lower limbs (30.2%). Conclusion: Better access to diagnosis would contribute to a better assessment of the burden of this pathology in Benin.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Adulto , Benin/epidemiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Sarcoma/epidemiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-35727910

RESUMO

INTRODUCTION: The US Military Health System (MHS) provides universal health care to beneficiaries. Few studies have evaluated the potential influence of access to universal care on survival outcomes for sarcoma. This study compared the survival of adult patients with soft-tissue sarcoma in the MHS with the US general population. METHODS: MHS data were obtained from the Department of Defense Automated Central Tumor Registry (ACTUR). US population data were obtained from the National Cancer Institute's Surveillance, Epidemiology, and End Results registry. Patients who were 25 years or older with a histologically confirmed musculoskeletal soft-tissue sarcoma were matched based on age, sex, and race. Kaplan-Meier survival curves and Cox proportional hazards models were used to compare 5-year survival in the two groups. RESULTS: Adult patients in ACTUR had markedly lower 5-year mortality for soft-tissue sarcomas (hazard ratio=0.82; 95% confidence interval, 0.73 to 0.92) after adjustment for potential confounders. Lower 5-year mortality was found in most demographic subgroups for ACTUR patients compared with Surveillance, Epidemiology, and End Results patients. CONCLUSION: Five-year survival in the MHS compared with the US general population may suggest an important role of universal health care in improving the survival of patients with soft-tissue sarcoma.


Assuntos
Serviços de Saúde Militar , Sarcoma , Neoplasias de Tecidos Moles , Adulto , Humanos , Modelos de Riscos Proporcionais , Programa de SEER , Sarcoma/epidemiologia , Sarcoma/terapia , Neoplasias de Tecidos Moles/epidemiologia , Neoplasias de Tecidos Moles/patologia
17.
Surg Oncol Clin N Am ; 31(3): 511-525, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35715147

RESUMO

Skin sarcomas are tumors that are superficial and small in size in comparison with other sarcomas arising in intramuscular or intrabdominal sites. Skin sarcomas are often underrecognized and misdiagnosed. A high level of suspicion is needed, as early recognition and appropriate management including initial surgery is important for oncologic outcomes. Here, the epidemiology, clinical presentation, management, and surveillance of 4 common cutaneous sarcomas are reviewed.


Assuntos
Sarcoma , Neoplasias Cutâneas , Neoplasias de Tecidos Moles , Humanos , Sarcoma/diagnóstico , Sarcoma/epidemiologia , Sarcoma/terapia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/terapia
18.
J Egypt Natl Canc Inst ; 34(1): 27, 2022 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-35754068

RESUMO

BACKGROUND: Sarcoma of unknown primary (SUP) designates an enigmatic entity with histologic confirmation of a metastatic tumor without an identifiable primary after a thorough diagnostic workup. The term "unknown primary" is heavily debatable given that sarcomas can arise from any tissue that harbors its histological structure. In this review, we discuss the validity of SUP as a distinct entity. Medline/PubMed and Google Scholar were searched from 1990 until April 2020 for publications in the English language reporting on SUP. We excluded articles reporting on cases with sarcomas from known organ sites such as lung or uterine sarcomas as well as synovial sarcomas. The Kaplan-Meier method was used to compute the median overall survival. A total of 26 patients with SUP were identified. The median age at diagnosis was 17.5 years with a similar prevalence among men and women. The tumors most commonly reported were alveolar rhabdomyosarcoma and rhabdomyosarcoma not otherwise specified. Almost two-thirds of the patients were reported to have more than one metastatic site. Among the 13 patients with survival data, the median overall survival was 10.0 months. Two patients underwent autopsy and had their primary culprit identified in the chest wall and paravertebral. CONCLUSIONS: This review showed that SUP shares with sarcomas of known primary similar clinical features including an aggressive clinical course, generally poor response to chemotherapy, and dismal patient outcomes. Thus, SUP does not appear to display a different natural history and biological properties that would allude to a distinct entity.


Assuntos
Neoplasias Primárias Desconhecidas , Sarcoma Sinovial , Sarcoma , Neoplasias de Tecidos Moles , Feminino , Humanos , Masculino , Neoplasias Primárias Desconhecidas/epidemiologia , Neoplasias Primárias Desconhecidas/terapia , Estudos Retrospectivos , Sarcoma/diagnóstico , Sarcoma/epidemiologia , Sarcoma/terapia , Neoplasias de Tecidos Moles/patologia
19.
Cir Esp (Engl Ed) ; 100(4): 193-201, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35491323

RESUMO

Surgical units attending sarcomas in Spain are poor studied. The aim is to know the management of this pathology to identify areas of improvement through multicenter study based on a voluntary survey. The survey was completed by 74 surgeons of different hospitals, which 32,4% is exclusively dedicated to sarcomas. Only 24.3% declared to receive specific training in sarcomas. The most frequent type of hospital was the third level (56.8%), where 38,1% of the surgeons belong to societies or working-groups in sarcoma fields vs. 9,4% in first-second levels. The number of surgeons with specific theoretical training and papers published in this field are higher in third level hospitals. 55,4% belonged to a multidisciplinary unit. A multidisciplinary team was available in 57% of third level hospital vs 28% in others. Most services in charge of this patients are characterized by deficient specialization, low workload and the absence of a multidisciplinary team.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Hospitais , Humanos , Sarcoma/epidemiologia , Sarcoma/patologia , Sarcoma/terapia , Espanha/epidemiologia , Inquéritos e Questionários
20.
Cancer ; 128(14): 2777-2785, 2022 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-35599575

RESUMO

BACKGROUND: Adolescents and young adults (AYA) with sarcoma experience both acute and chronic pain related to their disease and treatment. Studies in older adults have reported a high risk of persistent opioid use after cancer therapy among previously opioid-naive patients; however, few studies have evaluated posttreatment opioid use among AYAs. This article describes patterns of new persistent opioid use among AYAs in the year after treatment for sarcoma. METHODS: Opioid-naive patients who were 10 to 26 years old and diagnosed with sarcoma (2008-2016) were identified with the IBM Marketscan Database. Included subjects had an International Classification of Diseases code for sarcoma (ninth or tenth revision), received anticancer therapy (chemotherapy, surgery, and/or radiation) within 30 days of the first diagnosis code, and had continuous insurance coverage (commercial or Medicaid) for more than 12 months both before the diagnosis and after the last therapy. The primary outcome was new persistent opioid use, which was defined as at least 2 opioid prescriptions in the 12 months following treatment completion. Covariates included age, sex, insurance, tumor type, surgical procedure, mental health (MH) or substance use diagnoses before or during therapy, and concomitant lorazepam use. RESULTS: In total, 938 patients met the inclusion criteria; 521 (56%) were male, and 578 (62%) were younger than 18 years. In total, 727 (78%) had commercial insurance, and 273 (29%) had an MH diagnosis either before or during the treatment period. Of the total group, 464 (49%) used opioids during treatment only. Of those who used opioids during treatment, 135 (23%) received at least 2 prescriptions in the year after therapy. In a multivariable analysis, Medicaid versus commercial insurance (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.15-2.64) and non-soft tissue sarcoma (OR for Ewing sarcoma, 3.23; 95% CI, 1.81-5.78; OR for osteosarcoma, 2.05; 95% CI, 1.36-3.09) conferred a higher likelihood of new persistent use. CONCLUSIONS: In this cohort of AYAs treated for sarcoma, 64% of the patients received opioid prescriptions during treatment, and 23% of these patients became new persistent users. Because of the risks associated with persistent opioid use, studies of novel pain management strategies along with age-appropriate education and anticipatory guidance are urgently needed. LAY SUMMARY: Using an insurance claims database, we conducted a study to determine the rate of new persistent opioid use among adolescents and young adults treated for sarcoma. We found that 64% of adolescents and young adults treated for sarcoma received opioid prescriptions during treatment, and 23% of these patients met the criteria for new persistent opioid use. These findings support the need for age-appropriate education and novel pain management strategies in this vulnerable population.


Assuntos
Dor Crônica , Transtornos Relacionados ao Uso de Opioides , Sarcoma , Neoplasias de Tecidos Moles , Adolescente , Adulto , Idoso , Analgésicos Opioides/efeitos adversos , Criança , Dor Crônica/tratamento farmacológico , Feminino , Humanos , Masculino , Medicaid , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Estudos Retrospectivos , Sarcoma/tratamento farmacológico , Sarcoma/epidemiologia , Neoplasias de Tecidos Moles/tratamento farmacológico , Estados Unidos/epidemiologia , Adulto Jovem
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