Characteristics, Treatment Patterns, and Clinical Outcomes of Patients Diagnosed with Fungating Soft Tissue Sarcomas

Abstract

Objectives. A fungating soft tissue sarcoma of the extremities (F-ESTS) is a rare clinical presentation with limited literature. This study aims to describe the important clinical characteristics, treatment patterns, and outcomes of twenty patients diagnosed with F-ESTS and treated by a single surgeon at a sarcoma unit.
Methodology. We conducted a retrospective clinical study on twenty F-ESTS patients treated by a single surgeon at a sarcoma unit over 25 years (1993–2018).
Results. The local incidence of F-ESTS was 10.9%. The mean age of patients was 49.2 years old. The most common site of occurrence was the thigh (50%) with an average size of 11.8 cm. Most tumors were deep (65%) and high grade (85%). Liposarcomas were the most common histologic diagnosis (35%). Limb salvage was done in 60% of the patients with 50% requiring reconstructive procedures. Fifteen percent of patients developed complications, 25% had local recurrence, and 65% developed distant metastases. The mean survival for this cohort was 49.2 months. Sixty percent of patients died of disease.
Conclusion. The majority of F-ESTS patients were younger than 65 years old, had deep and high-grade tumors, predominantly liposarcomas, most commonly found in the thigh, and had a history of surgery or biopsy. In the last 10 years, limb salvage surgery has become the treatment of choice even for patients with fungating sarcomas.

Most F-ESTS patients in our study were still able to undergo limb salvage surgery. Local recurrence was seen in five (25%) patients, while thirteen (65%) patients had distant metastases. Twelve (60%) patients had died of disease.