Clear cell sarcoma (melanoma of soft parts): The Royal Marsden Hospital experience

Abstract Introduction Clear cell sarcoma (CCS) is a rare tumour with a propensity for local recurrence and nodal metastasis. About 300 cases have been reported, thus further clarification regarding the course and outcome of the disease is required. Methods Patients with a histopathologic diagnosis o...

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Bibliographic Details
Published in:European journal of surgical oncology 2008-07, Vol.34 (7), p.800-804
Main Authors: Clark, M.A, Johnson, M.B, Thway, K, Fisher, C, Thomas, J.M, Hayes, A.J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Clear cell sarcoma
Combined Modality Therapy
Female
Hematology, Oncology and Palliative Medicine
Humans
Lower Extremity
Male
Melanoma of soft parts
Middle Aged
Neoplasm Recurrence, Local - epidemiology
Prognosis
Retrospective Studies
Sarcoma, Clear Cell - epidemiology
Sarcoma, Clear Cell - mortality
Sarcoma, Clear Cell - pathology
Sarcoma, Clear Cell - therapy
Soft Tissue Neoplasms - epidemiology
Soft Tissue Neoplasms - mortality
Soft Tissue Neoplasms - pathology
Soft Tissue Neoplasms - therapy
Soft-tissue sarcoma
Surgery
Survival Rate
United Kingdom - epidemiology
Upper Extremity
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Summary:Abstract Introduction Clear cell sarcoma (CCS) is a rare tumour with a propensity for local recurrence and nodal metastasis. About 300 cases have been reported, thus further clarification regarding the course and outcome of the disease is required. Methods Patients with a histopathologic diagnosis of CCS were identified from prospective histopathology and sarcoma databases and supplemented with a retrospective analysis of the patients' hospital records. Results Between 1990 and 2005, a total of 72 patients with a diagnosis of CCS were identified, 35 having been referred for management and 37 having been referred for histopathologic opinion. The median age was 39 years (range 5–90 years). Of the 35 patients referred to the Royal Marsden Hospital for management, 23% developed local recurrence or in-transit metastases at a median of 9 months (2–79 months) after resection of the primary, and nodal or distant metastatic disease was seen in 63% after 14 months (range 0–177 months). Five- and 10-year survival were 52% and 25%, respectively. Conclusions CCS has a number of similarities with melanoma, particularly in its peripheral distribution and propensity for nodal disease. Wide excision with clear margins offers the best chance of cure. Local recurrence and regional metastases are common, and are almost always followed by distant metastases and death.
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2007.10.006