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. 2019 Mar 29;10(25):2462-2474.
doi: 10.18632/oncotarget.26809.

Sarcomas in the United States: Recent trends and a call for improved staging

Michele M Gage  1 , Neeraja Nagarajan  1 , Jessica M Ruck  1 , Joseph K Canner  1 , Salma Khan  2 , Katherine Giuliano  1 , Faiz Gani  1 , Christopher Wolfgang  1 , Fabian M Johnston  1 , Nita Ahuja  1   3
Affiliations

Sarcomas in the United States: Recent trends and a call for improved staging

Michele M Gage et al. Oncotarget. .

Abstract

Background and objectives: Sarcomas represent a heterogeneous group of tumors, and there is lack of data describing contemporary changes in patterns of care. We evaluated the epidemiology of sarcomas over 12 recent years.

Methods: The Surveillance, Epidemiology and End Results (SEER) database was queried for sarcoma cases from 2002-2014. Patient, tumor and treatment factors, and trends over time were studied overall and by subtype. Univariable and multivariable logistic regression models and 5-year survival and cause-specific mortality (CSM) were summarized.

Results: There were 78,527 cases of sarcomas with an overall incidence of 7.1 cases per 100,000 people, increasing from 6.8 in 2002 to 7.7 in 2014. Sarcoma NOS(14.8%) and soft tissue(43.4%) were the most common histology and primary site, respectively. A majority of tumors were high-grade(33.6%) and >5 cm(51.3%). CSM was 28.6% and 5-year survival was 71.4%. Many patients had unknown-grade(42.2%), which associated with 2.6 times increased odds of no surgical intervention.

Conclusions: This comprehensive national study highlights important trends including increasing incidence, changing histologic types, and underestimation of true incidence. A large proportion of sarcomas are inadequately staged (unknown-grade 42.2%) with lack of appropriate surgical treatment. Our study highlights need for standardization of care for sarcomas.

Keywords: SEER; connective tissue tumors; mesenchymal tumors; sarcoma; trends of sarcoma.

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Conflict of interest statement

CONFLICTS OF INTEREST No relevant conflict of interest disclosures. Dr. Nita Ahuja has received grant funding from Cepheid and Astex and has served as consultant to Ethicon. She has licensed methylation biomarkers to Cepheid.

Figures

Figure 1
Figure 1. Trends over time for incidence of sarcomas
Figure 2
Figure 2
(A) Trends over time for sarcoma subtypes that are increasing in incidence. (B) Trends over time for sarcoma subtypes that are decreasing in incidence.
Figure 3
Figure 3. Racial distribution by histological subtype (n=64,645)
Figure 4
Figure 4. Primary anatomical site across histological subtype (n=64,645)
Figure 5
Figure 5. Cause-specific mortality by histological subtype (n=64,645)
See this image and copyright information in PMC

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