Surgery of Soft Tissue Limb Sarcomas in An African Cancer Center

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.