The incidence of soft tissue sarcoma in Dakshina Kannada: study in a District Government Hospital.

BACKGROUND: We present a retrospective study depicting the incidence and outcome of soft tissue sarcomas (STSs) in patients admitted in a District Government Hospital situated in coastal belt of Southern India for a period of four and a half years. The hospital is a district referral centre catering to rural and urban poor population of 1,900,000 people.
METHODS: Histologically proven soft tissue STS patients admitted in Department of General Surgery in District Government Wenlock Hospital, Mangalore, from January 2002 to July 2007 were included in the study. The incidence, age distribution, gender distribution, histological subtypes, site of tumour, and clinical outcome were the parameters studied. The above parameters were then compared with Memorial Sloan and Kettering Cancer Centre (MSKCC) study.
RESULTS: Fifty-one cases of STS were reported out of 7674 (0.65%) patients with cancer in the said period. Ninety percent belonged to adolescents and adult age group. Liposarcoma (18%) is the most common subtype followed by leiomyosarcoma, Ewings' sarcoma. 66.6% originated in the extremities and rest being intra-abdominal and retroperitoneal. The age of presentation was a decade less than MSKCC study. The alarming yet expected fact was 35% of patients came with delayed presentation of the disease and refusal for surgery. Thirty-nine percent of patients were treated surgically.
CONCLUSION: Majority of patients presenting to our institution in advanced stage of the disease, indicating ignorance, fear and reluctance for surgery; as well as economic constraints, that delay early detection and initiation of proper treatment. The incidence appears to be increasing, targeting the younger population. There is a definite need to incorporate drug trials in rural set up so that patients can be benefited.