Intra-abdominal metastases from soft tissue sarcoma.
OBJECTIVE
To define the clinical features and prognosis of patients with abdominal metastasis from primary soft tissue sarcoma (STS) at other sites.


METHODS
All patients with abdominal metastasis from STS were identified from the Royal Marsden Hospital Sarcoma Unit prospective database from January 1990 to July 2001.


RESULTS
Nineteen patients developed abdominal metastasis out of a cohort of 2127 patients (0.9%) evaluated during the study interval. The median age was 49 (19-71) years. The median time to abdominal metastasis from diagnosis of the primary was 27 (8-91) months. The presenting complaints were incomplete intestinal obstruction (n = 5), abdominal pain (n = 4), mass (n = 2), gastrointestinal bleed (n = 2), urinary obstruction (n = 2), anorexia (n = 1), and abdominal distension (n = 1). Emergency laparotomy was done for perforative peritonitis (n = 2), intussusception (n = 2), and bleed in spleen (n = 1). Two patients were asymptomatic. The common histologies were myxoid liposarcoma (n = 6) and leiomyosarcoma (n = 4). The median follow-up of survivors post metastasis was 12 months. Abdominal metastatectomy was performed in 16 patients, 3 of these patients had abdominal recurrences. The 1- and 2-year overall disease specific survival for the 19 patients was 66% (SE = 11%) and 43% (SE = 13%) with a median survival of 13 months (95% CI = 11.8-14.7). Metastasectomy was associated with slight improved median post-metastasis survival (33 months vs. 8 months for unresected patients).


CONCLUSIONS
Although abdominal metastasis is rare, vigilance is warranted. Symptomatic patients should be examined and investigated thoroughly for metastases. Surgery is the treatment of choice for patients with an acute presentation; however, survival is dismal.
Behranwala
Kasim A
KA
Sarcoma and Melanoma Unit, Royal Marsden NHS Trust, United Kingdom.
Roy
Pratik
P
Giblin
Victoria
V
A'hern
Roger
R
Fisher
Cyril
C
Thomas
J Meirion
JM
D000008:Abdominal Neoplasms / Q000401:mortality / Q000556:secondary*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D018219:Histiocytoma, Benign Fibrous / Q000401:mortality / Q000556:secondary; D006801:Humans; D007890:Leiomyosarcoma / Q000401:mortality / Q000556:secondary; D018208:Liposarcoma, Myxoid / Q000401:mortality / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012509:Sarcoma / Q000401:mortality / Q000556:secondary*; D012983:Soft Tissue Neoplasms / Q000473:pathology*; D015996:Survival Rate