Epidemiological trends of dermal sarcoma in Australia

Main Article Content

Dr Edward Gibson https://orcid.org/0000-0002-1629-1557
Dr Roger Woods https://orcid.org/0000-0003-2787-1562
Dr Alexa Potter
Jessica Leigh Reid
Jennie Louise
Dr Gelareh Farshid
Dr Taryn Bessen
Dr Susan Neuhaus https://orcid.org/0000-0001-6520-6892

Keywords

Australia, incidence, skin neoplasms, sarcoma, malignant fibrous histiocytoma

Abstract

Background: Sarcomas comprise a heterogenous group of malignant tumours of mesenchymal origin and can arise in the skin. Definitive management of skin sarcoma usually entails surgical resection with wide margins, often requiring reconstruction. The incidence and demographics of these neoplasms in Australia are poorly understood.
Method: Incidence, gender and age distribution data for skin sarcomas for the period 1982–2009 were obtained from the Australian Cancer Database (ACD). Morphology and topographical region coding via the International Classification of Diseases for Oncology third edition (ICD-O-3)1 were used to identify the data.
Results: A total of 5453 cases of skin sarcoma in the Australian population were identified over the 28-year period. Anatomically, 1610 cases (29%) occurred on the limbs, 1416 (26%) on the head and neck area, 957 (18%) on the trunk and 1470 (27%) had an unspecified skin origin. Overall incidence was 2.09 per 100,000 population. Males were more commonly affected (70%), most commonly in the 30–49 years and 70+ years age groups. The most common pathological subtypes were fibromatous sarcoma (including dermatofibrosarcoma protuberans), Kaposi’s sarcoma and pleomorphic dermal sarcoma.
Conclusion: The Australian Cancer Database data used to describe the pattern and epidemiological trends for skin sarcoma in Australia demonstrated variation from international trends and highlight the need for further research into the aetiology of these tumours.

Metrics

Metrics Loading ...
Abstract 30 | PDF Downloads 26 HTML Downloads 18

References

1. Zahm S, Tucker M, Fraumeni J. Soft tissue sarcomas. Cancer Epidemiol Prev. 1996;2:984–99.
2. Zahm S, Fraumeni J. The epidemiology of soft tissue sarcoma. Semin Oncol. 1997;24(5):504–14.
3. da Silva S, de Oliveira D. HIV, EBV and KSHV: viral cooperation in the pathogenesis of human malignancies. Cancer Lett. 2011;305(2):175–85. https://doi.org/10.1016/j.canlet.2011.02.007 PMid:21402436
4. Lahat G, Lazar A, Lev D. Sarcoma epidemiology and etiology: potential environmental and genetic factors. Surg Clin N Am. 2008;88(3):451–81. https://doi.org/10.1016/j.suc.2008.03.006 PMid:18514694
5. Toguchida J, Yamaguchi T, Dayton SH, Beaughamp RL. Prevalence and spectrum of germline mutations of the p53 gene among patients with sarcoma. N Engl J Med. 1992;326(20):1301–8. https://doi.org/10.1056/NEJM199205143262001 PMid:1565143
6. Amankwah E, Conley A, Reed D. Epidemiology and therapies for metastatic sarcoma. Clin Epidemiol. 2013;5:147–56. https://doi.org/10.2147/CLEP.S28390 PMid:23700373 PMCid:PMC3660127
7. Cheng S, Ke C, Lee C, Wu C, Chen G, Hu S. Rainbow pattern in Kaposi’s sarcoma under polarized dermoscopy: a dermoscopic pathological study. Br J Dermatol. 2009;160:801–9. https://doi.org/10.1111/j.1365-2133.2008.08940.x PMid:19067686
8. Upjohn E, Braue A, Ryan A. Primary cutaneous carcinosarcoma: dermoscopic and immunohistochemical features. Aus J Dermatol. 2010;51:26–28. https://doi.org/10.1111/j.1440-0960.2009.00587.x PMid:20148837
9. Strauss D, Qureshi Y, Hayes A, Thway K, Fisher C, Thomas J. The role of core needle biopsy in the diagnosis of suspected soft tissue tumours. J Surg Oncol. 2010;102(5):523–29. https://doi.org/10.1002/jso.21600 PMid:20872955
10. Costa M, Campman S, Davis R, Howell L. Fine-needle aspiration cytology of sarcoma: retrospective review of diagnostic utility and specificity. Diagn Cytopathol. 1996;15(1):23–32. https://doi.org/10.1002/(SICI)1097-0339(199607)15:1<23::AID-DC6>3.0.CO;2-R
11. Clayer M. Open incisional biopsy is a safe and accurate technique for soft tissue tumours. ANZ J Surg. 2010;80(11):786–88. https://doi.org/10.1111/j.1445-2197.2010.05340.x PMid:20969684
12. Mankin H, Mankin J, Simon M. The hazards of the biopsy, revisited. Members of the Musculoskeletal Tumor Society. J Bone Joint Surg Am. 1996;78(5):656–63. https://doi.org/10.2106/00004623-199605000-00004 PMid:8642021
13. Arbiser Z, Folpe A, Weiss S. Consultative (expert) second opinions in soft tissue pathology. Analysis of problem-prone diagnostic situations. Am J Clin Pathol. 2001;116(4):473–76. https://doi.org/10.1309/425H-NW4W-XC9A-005H PMid:11601130
14. Morel M, Taïeb S, Penel N, Mortier L, Vanseymortier L, Robin YM, Gosset P, Cotton A, Ceugnart L. Imaging of the most frequent superficial soft-tissue sarcomas. Skeletal Radiol. 2011;40;3;271–84. https://doi.org/10.1007/s00256-009-0855-y PMid:20069421
15. American Joint Committee on Cancer. Cancer staging manual, 7th ed. New York: Springer-Verlag.
16. Johannesmeyer D, Smith V, Cole D, Esnaola N, Camp E. The impact of lymph node disease in extremity soft-tissue sarcomas: a population-based analysis. Am J Surg. 2013;206(3):289–95. https://doi.org/10.1016/j.amjsurg.2012.10.043 PMid:23806824
17. Neuhaus SJ, Thomas D, Desai J, Vuletich C, von Dincklage J, Olver I. Wiki-based clinical practice guidelines for the management of adult onset sarcoma: a new paradigm in sarcoma evidence. Sarcoma. 2015, Article ID 614179, 6 pages. https://doi.org/10.1155/2015/614179 PMid:25784832 PMCid:PMC4345266
18. Bhangu A, Beard J, Grimer R. Should soft tissue sarcomas be treated at a specialist centre? Sarcoma. 2004;8(1):1–6. https://doi.org/10.1080/13577140410001679185 PMid:18521386 PMCid:PMC2395603
19. Ruhstaller T, Roe H, Thürlimann B, Nicoll J. The multidisciplinary meeting: an indispensable aid to communication between different specialities. Eur J Cancer. 2006;42(15):2459–62. https://doi.org/10.1016/j.ejca.2006.03.034 PMid:16934974
20. Kawaguchi N, Ahmed A, Matsumoto S, Manabe J, Matsushita Y. The concept of curative margin in surgery for bone and soft tissue sarcoma. Clin Orthop Relat Res. 2004;419:165–72. https://doi.org/10.1097/00003086-200402000-00027 PMid:15021149
21. Hafner J, Schütz K, Morgenthaler W, Steiger E, Meyer V, Burg G. Micrographic surgery (‘slow Mohs’) in cutaneous sarcomas. Dermatology. 1999;198:37–43. https://doi.org/10.1159/000018062 PMid:10026400
22. Yang J, Chang, AE, Barker AR, Sindelar WF, Danforth DN. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol. 1998;16(1);197–203. https://doi.org/10.1200/JCO.1998.16.1.197 PMid:9440743
23. Jebsen N, Trovik CS, Bauer HCF, Rydholm A, Monge OR, Sundby Hall K. Radiotherapy to improve local control regardless of surgical margin and malignancy grade in extremity and trunk wall soft tissue sarcoma: a Scandinavian sarcoma group study. Int J Radiat Oncol Biol Phys. 2008;15;71(4);1196–203. https://doi.org/10.1016/j.ijrobp.2007.11.023 PMid:18207661
24. O’Sullivan B, Davis AM, Turcotte R, Bell R, Catton C, Chabot P. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial. Lancet. 2002;359(9325):2235–41. https://doi.org/10.1016/S0140-6736(02)09292-9
25. Pisters P, Harrison L, Leung D, Woodruff J, Casper E, Brennan M. Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol. 1996;14(3):859–68. https://doi.org/10.1200/JCO.1996.14.3.859 PMid:8622034
26. Pervaiz N, Colterjohn N, Farrokhyar F, Tozer R, Figueredo A, Ghert M. A systematic meta-analysis of randomized controlled trials of adjuvant chemotherapy for localized resectable soft-tissue sarcoma. Cancer. 2008;113(3):573–81. https://doi.org/10.1002/cncr.23592 PMid:18521899
27. Cattelan A, Calabrò ML, De Rossi A, Aversa SM, Barbierato M, Trevenzoli M, Gasperini P, Zanchetta M, Cadrobbi P, Monfardini S, Chieco-Bianchi L. Long-term clinical outcome of AIDS-related Kaposi’s sarcoma during highly active antiretroviral therapy. Int J Oncol. 2005;27(3):779–85.
28. Rouhani P, Fletcher C, Devesa S, Toro J. Cutaneous soft tissue sarcoma incidence patterns in the US. Cancer. 2008;113:616–27. https://doi.org/10.1002/cncr.23571 PMid:18618615
29. Toro J, Travis L, Wu H, Zhu K, Fletcher C, Devesa S. Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978–2001: an analysis of 26,758 cases. Int J Cancer. 2006;119:2922–30. https://doi.org/10.1002/ijc.22239 PMid:17013893
30. Stiller C, Trama A, Serraino D, Rossie S, Navarro C, Chirlaque MD, Casali PG. Descriptive epidemiology of sarcomas in Europe: report from the RARECARE project. Eur J Cancer. 2013;49(3):684–95. https://doi.org/10.1016/j.ejca.2012.09.011 PMid:23079473
31. Holterhues C, de Vries E, Louwman MW, Koljenovic S, Nijste T. Incidence and trends of cutaneous malignancies in the Netherlands, 1989–2005. J Invest Dermatol. 2010;130(7):1807–12. https://doi.org/10.1038/jid.2010.58 PMid:20336085
32. Peng K, Grogan T, Wang M. Head and neck sarcomas: analysis of the SEER database. Otolaryngol Head Neck Surg. 2014:0194599814545747. https://doi.org/10.1177/0194599814545747 PMid:25135525 PMCid:PMC4598178
33. Fletcher C, Unni K, Mertens F. World Health Organization classification of tumours. Pathology and genetics of tumours of soft tissue and bone. Lyon: IARC Press; 2002.
34. Australian Institute of Health and Welfare. Australian Cancer Database [Cited December 2015]. Available from: www.aihw.gov.au/australian-cancer-database.
35. Australian Bureau of Statistics. Australian Demographic Statistics 1982–2011 [web report] [Cited December 2015]. Available from: www.abs.gov.au.
36. Griewank K, Schilling B, Murali R, Bielefeld N, Schwamborn M, Sucker A, Zimmer L, Hillen U. TERT promoter mutations are frequent in atypical fibroxanthomas and pleomorphic dermal sarcomas. Modern Pathol. 2014;27(4):502–8. https://doi.org/10.1038/modpathol.2013.168 PMid:24030750
37. Mayer J, Swetter S, Fu T, Geller A. Screening, early detection, education, and trends for melanoma: current status (2007–2013) and future directions. Part I. Epidemiology, high-risk groups, clinical strategies, and diagnostic technology. J Am Acad Dermatol. 2014;71(4):599. https://doi.org/10.1016/j.jaad.2014.05.046 PMid:25219716
38. Parkin D. The global health burden of infection-associated cancers in the year 2002. Int J Cancer. 2006;118(12):3030–44. https://doi.org/10.1002/ijc.21731 PMid:16404738
39. The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia. Annual Surveillance Report, 2014 HIV Supplement [web report] [Cited March 2016]. Available from: https://kirby.unsw.edu.au/sites/default/files/hiv/.../HIVASRsuppl2014_online.pd.