Late Recurrences in Soft Tissue Sarcomas - A Review

Abstract

Sarcomas are malignant tumors that arise from the connective tissue. Soft tissue is part of connective tissue and includes fat, muscle, nerves, tendons, and blood and lymph vessels. Soft tissue sarcomas (STS) account for 1 percent of all adult cancers in the U.S. Leiomyosarcoma (LMS) is a type of STS that grows in smooth muscles. LMS accounts for 7-11% of all cases of STS. Generally, STS are treated with wide margin surgical resection and some patients are offered radiation and/or chemotherapy to decrease recurrence. Recurrences generally happen in the first two years and late recurrence is defined as appearance of original cancer after 5 years following initial treatment and being disease free. Late recurrences can be in the local area of the initial site or at a distant location. A patient with LMS in the left upper arm was treated with a curative intent with radiation and surgery in Kentucky in 2016. He relocated to Fort Worth, TX recently and was found to have the same LMS in the stomach in 2022, more than 5 years after his initial curative treatment. This prompted us to do literature review of late recurrences in STS. We found that late recurrences happen in 6-15% of patients with STS even if they survived 5 years without cancer following original cancer treatment. LMS accounts for 12% of all late recurrences. Only 27-36% of all STS patients are expected to be alive at 5 years from diagnosis of late distant recurrences.