myuauaisb sususujw wuwisijsihs sarcoma.pptx

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1. Management of soft tissue sarcoma, our experience Dr.Zubair Ahmed Professor Dr Mahmood Ayaz Surgical Unit I Services Hospital,Lahore

2. Introduction R are tumors, International incidence rates range from 1.8 to 5 per 100,000 per year. 5 year survival rate is 50-60% Can arise in any of the mesodermal tissues of extremities (50%), trunk and retroperitoneum (40%), or head and neck (10%) Wibmer C, Leithner A, Zielonke N, et al.: Increasing incidence rates of soft tissue sarcomas? A population-based epidemiologic study and literature review. Ann Oncol 21 (5): 1106-11, 2010.

3. Introduction Sarcomas have been associated with earlier radiation therapy, toxic exposure and genetic conditions but no clearly defined aetiology has been identified. Singer S, Nielsen T, Antonescu CR: Molecular biology of soft tissue sarcoma. In: DeVita VT Jr, Lawrence TS, Rosenberg SA: Cancer: Principles and Practice of Oncology. 9th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2011, pp 1522-32. Singer S, Maki RG, O'Sullivan B: Soft tissue sarcoma. In: DeVita VT Jr, Lawrence TS, Rosenberg SA: Cancer: Principles and Practice of Oncology. 9th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2011, pp 1533-77.

4. Objective W e planned to under take a study to report our two year experience of dealing with sarcoma patients at a tertiary care hospital as data is limited from our country.

5. Methodology: population and setting : Study duration: From 2016-2018 Setting : Surgical Unit-I /Services Hospital,Lahore. Study Design: Observational Study Sample size: 16

6. PRE-OPERATIVE WORKUP Core biopsy was performed in each patient to get tissue diagnosis before resection. Assessment of operability of the tumor done with baseline blood tests and radiological workup were done .

7. Results The age of observed population varies from 14 to 65 years,with median of 43 year

8. Gender:

9. Location:

10. Upper extremity Sarcoma T otal patients 2 Patients Resection Margins adjuvant chemo/ Radiation therapy Recurrance Surgery Stage IIa 1 Free No No Wide local excision Stage IIb 1 Involved Yes No

11. Lower extremity sarcoma T otal patients 6 Patients Margins adjuvant chemo/ Radiation therapy Recurrance surgery Stage1 1 Free No No Wide local excision StageII 3 Free No No StageIII 2 (node negative stageIII) Free Given to one Pt Both recurret

12. Retroperitoneal sarcoma Total patients 4 Patients Margins adjuvant chemo/ Radiation therapy Recurrance surgery StageI 2 (Ib) Involved given 1 remain tumor free 1 recurrance Debulking done StageII 1 Involved given no StageIII 1 Involved lost to follow -

13. Histopathalogical Results Type Percentage Malignant fibrous histiocytoma 57% Dermatofibrosarcoma 18% Liposarcoma 11% Myxoid sarcoma 4% Pleomorhic sarcoma 5% Splindle cell sarcoma 3% Rabdomyosarcoma 2%

14. Operative procedures For soft tissue sarcoma present in thigh ,upper extremity and back wide local excision was done. For 3 cases of retroperitoneal sarcoma, debulking was done. For soft tissue sarcoma in front of neck , modified radical neck dissection was done.

15. Results Characters Percentage Curative resection 7(43.7%) Debulking surgery 3 (18.75%) Recurrence 4 (25%) Margins involved 1 (0.6%)

16. Case: Zafar Iqbal,27years Lump in front of neck 1.5 years 8*8 cm ,non tender lump Multiple enlarged Lymph nodes in level III,IV and V.

17. Case: 15 years old ,female Recurrent lump in posteromedial aspect of left calf True cut biopsy showed, synovial sarcoma

18. Grade II Dermatofibrosarcoma All margins were free of tumor