Managing Soft Tissue Sarcomas in a Developing Health System

Abstract

Background

The gold standard for treatment of soft tissue sarcomas (STS) includes wide local excision and limb salvage surgery. There is currently a lack of reports on the effectiveness of these techniques in a resource-poor setting with a lack of access to imaging and adjuvant therapies. This article reports the experience and outcome of patients presenting with STS to the Children’s Surgical Centre (CSC), Phnom Penh, Cambodia.

Methods

Patients with a diagnosis of STS and the operations they received were retrospectively sourced from the CSC database. Follow-up data were obtained through a telephone questionnaire and home visits.

Results

Forty STS patients were identified. Definitive surgery was performed in 31 cases, the majority receiving initial local excision of the lesion (19/31), some went on to have secondary amputations (5/19), and the rest had primary amputation (12/31). Eight patients suffered perioperative complications: 6 had infections, 1 haemorrhage, and 1 patient suffered from prolonged pain. Follow-up information was available for 25 patients, 8 of whom survived whilst 17 had died. Two of the deceased and 2 of the surviving patients had received adjuvant therapy. Seven survivors reported that they had resumed employment. Estimated average survival for STS in Cambodia was 25 months with a 58 % 1-year survival rate in treated cases.

Conclusions

Despite the loss to follow-up, some STS patients in Cambodia have been successfully managed by the CSC. An evolving increase in survival will hopefully be seen as access to adjuvant therapies and imaging technology improves.