Background: Primary buttock soft tissue sarcomas in adults are common entities that have been infrequently reported (three clinical series and isolated case reports). We present our experience of buttock sarcomas to better characterize and define the natural history of this condition.
Methods: Buttock tumors occurring in adults (>16 years) between January 1990 and January 2002 were identified from the Royal Marsden Hospital’s Sarcoma Unit prospective database.
Results: Seventy-three buttock sarcomas were evaluated and treated at the Royal Marsden Hospital during this period. Liposarcoma (n = 19), leiomyosarcoma (n = 13), and synovial sarcoma (n = 9) were the most frequent histological types. There were 8 T1 and 61 T2 tumors, and size was not available in 4 patients. Most tumors (n = 64) were located deep to the deep fascia. There were 15 grade 1, 20 grade 2, and 37 grade 3 tumors, and grade was not available in 1 patient. There were 29 tumors contained within the gluteus maximus. Wide excision was performed in 50 patients. Local recurrence and distant metastasis occurred in 15 and 35 patients with a median time of 18 and 8 months, respectively. The rate of local recurrence at 2 years was 20.9% (SE, 6.8%). The 2-year overall and disease-free survival rates were 64.1% (SE, 6.7%) and 48.5% (SE, 6.4%), respectively.
Conclusions: Buttock sarcomas present special surgical difficulties because of proximity of the sciatic nerve and the ability of tumors at this site to extend into the pelvis and perineum. Size and grade of the tumor were independent predictors for disease-free and overall survival.
Buttock Gluteus maximus Sarcoma Prognosis
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Cheng EY, Springfield DS, Mankin HJ. Frequent incidence of extrapulmonary sites of initial metastasis in patients with liposarcoma. Cancer 1995;75:1120–7.CrossRefPubMedGoogle Scholar
Smith TA, Easley JA, Goldblum JR. Myxoid/round cell liposarcoma of the extremities: a clinicopathologic study of 29 cases with particular attention to extent of round cell liposarcoma. Am J Surg Pathol 1996;20:171–80.CrossRefPubMedGoogle Scholar
Spillane AJ, Fisher C, Thomas JM. Myxoid liposarcoma—the frequency and the natural history of nonpulmonary soft tissue metastases. Ann Surg Oncol 1999;6:389–94.CrossRefPubMedGoogle Scholar
Ruka W, Sikorowa L, Iwanowska J, Romeyko M. Induced soft tissue sarcomas following radiation treatment for uterine carcinomas. Eur J Surg Oncol 1991;17:585–93.PubMedGoogle Scholar
Sugarbaker PH, Chretien PA. A surgical technique for buttockectomy. Surgery 1982;91:104–7.PubMedGoogle Scholar
Pitcher ME, Thomas JM. Functional compartmental resection for soft tissue sarcomas. Eur J Surg Oncol 1994;20:441–5.PubMedGoogle Scholar
Sugarbaker PH, Chretien PA. Hemipelvectomy for buttock tumours utilizing an anterior myocutaneous flap of quadriceps femoris muscle. Ann Surg 1983;197:106–15.PubMedPubMedCentralGoogle Scholar
Pitcher ME, Ramanathan RC, Fish S, A’Hern R, Thomas JM. Outcome of treatment for limb and limb girdle sarcomas at the Royal Marsden Hospital. Eur J Surg Oncol 2000;26:548–51.CrossRefPubMedGoogle Scholar