Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Schaffler, A.
Diagnosis and therapy of intra-abdominal and retroperitoneal metastases in patients with soft tissue sarcoma
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2015. pp. 85
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Leithner Andreas
- Szkandera Joanna
- Altmetrics:
- Abstract:
- Background: Intra-abdominal metastases are rare in patients with soft tissue sarcomas (STS). The aim of this study was to define the incidence of these metastases, identify the histological subtypes, which most frequently develop such metastases and determine the optimal diagnostic approach. Methods: The files of 558 consecutive patients with an extra-abdominal STS treated with curative intent between 2000 and 2009 were retrospectively analyzed. The mean age at presentation was 57 years (range, 18-96 years). In the study patients with an event-free follow-up of 24 months and those who had an event before were included. The mean follow-up amounted to 58 (4-148) months for all patients. Fisher’s exact test was used to compare unrelated samples. Non-parametric analyses were performed with the Mann-Whitney U test. Survival curves were calculated with the Kaplan-Meier method and compared with the log-rank test. Results: 28 patients (5.0%) developed intra-abdominal metastases after a mean follow-up of 32 (1-100) months. 12.5% of patients with myxoid liposarcoma developed intra-abdominal metastases, compared to 4.6% of patients with other histologies, a difference which was statistically significant (p = 0.044). There were no significant differences in mean tumor size between patients who developed intra-abdominal metastases and patients who did not (9.5 vs. 8.9 cm, p = 0.124). 90% of all STS patients with such metastases showed a primary tumor diameter of > 5cm.Six out of 28 patients presented symptoms like abdominal pain or ileus. There were no statistically significant differences in post-metastasis survival between patients who developed intra-abdominal metastases and patients who developed metastases in other localizations (estimated survival by Kaplan-Meier: 25.5 months vs. 55.8months, p = 0.092). Conclusion: Patients with myxoid liposarcoma appear to have a significantly higher risk for intra-abdominal metastases, compared to patients with other histologies. Metastases in these locations appear to be generally diagnosed in routine tests prior to specific symptoms. Therefore routine imaging of the abdominal cavity in patients at a higher risk for intra-abdominal metastases appears to be justified.