Managing Soft Tissue Sarcomas in a Developing Health System.

BACKGROUND: The gold standard for treatment of soft tissue sarcomas (STS) includes wide local excision and limb salvage surgery. There is currently a lack of reports on the effectiveness of these techniques in a resource-poor setting with a lack of access to imaging and adjuvant therapies. This article reports the experience and outcome of patients presenting with STS to the Children's Surgical Centre (CSC), Phnom Penh, Cambodia.
METHODS: Patients with a diagnosis of STS and the operations they received were retrospectively sourced from the CSC database. Follow-up data were obtained through a telephone questionnaire and home visits.
RESULTS: Forty STS patients were identified. Definitive surgery was performed in 31 cases, the majority receiving initial local excision of the lesion (19/31), some went on to have secondary amputations (5/19), and the rest had primary amputation (12/31). Eight patients suffered perioperative complications: 6 had infections, 1 haemorrhage, and 1 patient suffered from prolonged pain. Follow-up information was available for 25 patients, 8 of whom survived whilst 17 had died. Two of the deceased and 2 of the surviving patients had received adjuvant therapy. Seven survivors reported that they had resumed employment. Estimated average survival for STS in Cambodia was 25 months with a 58 % 1-year survival rate in treated cases.
CONCLUSIONS: Despite the loss to follow-up, some STS patients in Cambodia have been successfully managed by the CSC. An evolving increase in survival will hopefully be seen as access to adjuvant therapies and imaging technology improves.