Journal de chirurgie et de pratique clinique

Surgery of Soft Tissue Limb Sarcomas in An African Cancer Center

Sidy KA, Zakarie Saye, Jaafar Thiam, Ollo Roland Some, Adja Coumba Diallo, Doudou Diouf, Mamadou Moustapha Dieng, Macoumba Gaye and Ahmadou Dem

Objective: To study the results of soft tissue sarcoma surgery at the Joliot Curie Cancer Institute in Dakar.

Methods: This was a 3-year retrospective study of all patients undergoing surgery for soft tissue tumors in the upper and lower limbs at Joliot Curie Cancer Institute.
Results: We operated on 16 patients. The average age of patients was 35 years. Female patients were predominant, as they represented 56% of the cases. Sarcoma risk factors was found in 1 patient with type 1 neurofibromatosis. The most frequent localization was the thigh (n = 8). The mean size of the tumor lesion was 11.3 cm. Macroscopic lymph node involvement was found in 5 cases in the groin area, and 1 case in the axilla. Two cases of bone and vascular involvement were found (12.5%). The most common histological type was Dermatofibrosarcoma protuberans (7 cases) followed by spindle cell sarcoma (2 cases). The histological classification found 50% of grade 2 (8 cases). Half of the patients were classified as T2bN0M0. Surgery was conservative in 14 cases. Margins were clear (R0) in 7 cases (44%). Radiotherapy and chemotherapy were given respectively to 2 and 4 patients (12.5 and 25%). After a 10-month follow-up, 4 patients recurred at the tumor site, 4 patients had metachronous metastasis and 5 died.

Conclusion: Soft tissue limb sarcomas are characterized by large sizes at diagnosis. Surgery is the main treatment. Radiotherapy is preferentially adjuvant. Chemotherapy is non-consensual. The quality of surgery is an important prognostic factor.