Gupta Ashish, Rao Harish K, Gupta Soumya
Department of General Surgery, Department of Plastic Surgery, D.M.C. and Hospital, Ludhiana, India.
Indian J Surg. 2009 Feb;71(1):10-4. doi: 10.1007/s12262-009-0003-x. Epub 2009 Mar 13.
We present a retrospective study depicting the incidence and outcome of soft tissue sarcomas (STSs) in patients admitted in a District Government Hospital situated in coastal belt of Southern India for a period of four and a half years. The hospital is a district referral centre catering to rural and urban poor population of 1,900,000 people.
Histologically proven soft tissue STS patients admitted in Department of General Surgery in District Government Wenlock Hospital, Mangalore, from January 2002 to July 2007 were included in the study. The incidence, age distribution, gender distribution, histological subtypes, site of tumour, and clinical outcome were the parameters studied. The above parameters were then compared with Memorial Sloan and Kettering Cancer Centre (MSKCC) study.
Fifty-one cases of STS were reported out of 7674 (0.65%) patients with cancer in the said period. Ninety percent belonged to adolescents and adult age group. Liposarcoma (18%) is the most common subtype followed by leiomyosarcoma, Ewings' sarcoma. 66.6% originated in the extremities and rest being intra-abdominal and retroperitoneal. The age of presentation was a decade less than MSKCC study. The alarming yet expected fact was 35% of patients came with delayed presentation of the disease and refusal for surgery. Thirty-nine percent of patients were treated surgically.
Majority of patients presenting to our institution in advanced stage of the disease, indicating ignorance, fear and reluctance for surgery; as well as economic constraints, that delay early detection and initiation of proper treatment. The incidence appears to be increasing, targeting the younger population. There is a definite need to incorporate drug trials in rural set up so that patients can be benefited.
我们开展了一项回顾性研究,描述了在印度南部沿海地区一家区级政府医院收治的患者中软组织肉瘤(STS)的发病率及治疗结果,研究为期四年半。该医院是一个区级转诊中心,服务于190万农村和城市贫困人口。
纳入2002年1月至2007年7月在芒格洛尔市温洛克区政府医院普通外科收治的经组织学证实的软组织STS患者。研究参数包括发病率、年龄分布、性别分布、组织学亚型、肿瘤部位及临床结果。然后将上述参数与纪念斯隆凯特琳癌症中心(MSKCC)的研究进行比较。
在上述期间的7674例癌症患者中,报告了51例STS(0.65%)。90%属于青少年和成年年龄组。脂肪肉瘤(18%)是最常见的亚型,其次是平滑肌肉瘤、尤因肉瘤。66.6%起源于四肢,其余位于腹腔内和腹膜后。发病年龄比MSKCC研究小十岁。令人担忧但又在意料之中的是,35%的患者因疾病就诊延迟且拒绝手术。39%的患者接受了手术治疗。
大多数到我们机构就诊的患者处于疾病晚期,这表明患者无知、恐惧和不愿接受手术,以及经济限制,这些因素导致早期发现和开始适当治疗的延迟。发病率似乎在上升,且以年轻人群为目标。确实需要在农村地区开展药物试验,以便患者能够受益。