Retrospective analysis of the clinical outcomes of paraspinal soft-tissue sarcoma.

BACKGROUND CONTEXT: Due to the rarity and heterogeneity, paraspinal soft-tissue sarcomas represent a unique and challenging clinical entity for musculoskeletal oncologist. Reports on the treatment of paraspinal soft-tissue sarcoma are limited and the best treatment modality for this rare sarcoma type has not yet been well defined.

PURPOSE: To introduce a modified classification of paraspinal sarcoma, review the outcome of patients treating in our center and determine the effective treatment for paraspinal soft-tissue sarcoma.

STUDY DESIGN/

SETTING

Retrospective review of prospectively collected data.

PATIENT SAMPLE: The study included patients with paraspinal soft-tissue sarcomas in our center.

OUTCOME MEASURES: Clinical outcomes, complications and survival.

METHODS

Twenty-five patients with paraspinal soft-tissue sarcomas treating at our center from April 2017 to December 2023 were retrieved from the hospital database. The treatment of these patients included surgery, chemotherapy, radiation, targeted therapy and immunological therapy according to respective tumor type. Patient demographics, tumor characteristics, treatment history, clinical outcomes and survival were collected from electronical medical records.

RESULTS

According to the modified classification of paraspinal sarcoma, Type 1 tumors were diagnosed in 15 cases, Type 2 in 4, Type 3 in 5 and Type 4 in 1. All the patients received surgery. No patients in the study received intralesional resection, wide or marginal margins were achieved. Eleven patients received postoperative radiotherapy. The median follow-up duration in this study was 27 months (range 8-67 months). Three patients suffered from wound infection postoperatively and were successfully treated by debridement and antibiotics. Three patients had muscular weakness after surgery and gained improved muscular strength with rehabilitation. There was no implant failure complication. Three recurrence cases were recorded. Four patients died of brain or lung metastasis. Five patients survived with the disease and the remaining 16 patients were alive with disease free.

CONCLUSION

Correct pathological diagnosis before treatment is vital, and the modified classification can guide the surgical strategy for paraspinal soft-tissue sarcoma. Paraspinal soft-tissue sarcoma is best treated by comprehensive treatment approach with surgery as the main method, which can yield good outcomes.