A Retrospective Epidemiological and Histopathological Study of Soft Tissue Sarcomas in Iraqi Patients (2011–2024)

Abstract

Background: Soft tissue refers to the non-epithelial extraskeletal tissue of the body, excluding the reticuloendothelial system, glial tissue, and some supporting tissue of different parenchymal organs. It consists of voluntary muscles, fibrous tissue, and fat, with the vessels serving these tissues. Also, the peripheral nervous system included with them because nerve tumors founded as masses of soft tissue with similar challenges in differentiating and treatment. Objective: Malignant soft tissue sarcomas (MSTS) are rare and heterogeneous group of mesenchymal tumors accounting for more than 1% of adult malignancies. Their low prevalence and histological heterogeneity make their diagnosis a challenging task. This retrospective cross-sectional study analyzed cases with confirmed STS diagnosis, dating back to January 2011 to September 2024. Method: The analyzed variables include: sarcoma subtype, grade, sex distribution, year of diagnosis and anatomical site. Assessments of associations and significance levels were assessed using standard statistical analyses. Results: There were 430 reported cases, male were 239 (55.6%) and 191 (44.4%) were females. The most frequent subtypes were liposarcoma (22.8%), rhabdomyosarcoma (12.6%), and leiomyosarcoma (11.9%). There was a high male preponderance (p = 0.035). There were no significant changes in terms of the year-on-year occurrence of sarcomas (p = 0.948). On grade distribution, the tumors were Grade I in magnitude of 50.9%, Grade II, and Grade III in 32.1 and 17.0, respectively, with statistically significant (p < 0.001). The most prevalent location of the lower limbs (27.2%), the abdomen (16.7%), and pelvis (16.1%) represented a statistically significant (p = 0.0001). Conclusion: The incidence of MSTS was observed to be higher in men. This male dominance could be associated with occupational exposure to environmental mutagens; however, this remains a hypothesis that warrants further investigation in future studies although the incidence appeared stable with time and this work offers insightful descriptive statistics, prospective studies can build on the outcomes of survival and other factors.