Soft-Tissue Sarcoma in Black Africans: Pattern, Distribution and Management Dilemma

Abstract

Background: Soft-tissue sarcomas (STS) are a heterogeneous group of rare tumors that arise predominantly from the embryonic mesoderm. Currently, >70 different histologic types of STS have been identified. There is no identifiable etiology in most cases of STS even though a variety of predisposing or associated factors have been identified. The American Cancer Society estimated that approximately 8,680 new cases were expected to be diagnosed, and 3,660 deaths in the United States were a result of STS in 2004. This study shows the pattern, distribution and problems of STS in a black African population. Methods: We retrospectively reviewed 209 patients that were managed for STS between the periods of January 1985 to December 2004. Materials for the study were obtained from the case notes as well as the histopathology reports of the patients. Results: Two-hundred-nine patients were treated for STS during the 20-year study period. The peak incidence of age occurred between the third and sixth decades of life with a slightly male preponderance. Fibrosarcoma was the commonest STS, followed by malignant fibrous histocytoma, liposarcoma and rhabdomyosarcoma. Fibrosarcoma, malignant fibrous histocytoma and liposarcoma are more common in the extremities while leiomyosarcoma is more common in the intra-abdominal region. Conclusion: The treatment of STS is a multidisciplinary approach, and patients have benefited from multimodality treatment. In the western countries, STS most commonly present as asymptomatic masses with tumors in the distal extremities, often small in size when discovered. In our own environment, delayed and advanced stages of the disease are the rule. Modern imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) are not commonly available-and where they are available, they are usually not affordable for the majority of our patients. We need to establish good interdisciplinary relationships among the managing physicians and educate our patients on early presentation to the hospital.