Clinicopathological characteristics, one-year survival, and predictors among patients with soft tissue sarcoma: A retrospective cohort study at a tertiary referral center in Tanzania.
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ObjectiveSoft tissue sarcomas (STSs) are rare, heterogeneous tumors of mesenchymal origin that arise from muscle, fat, fibrous tissue, blood vessels, nerves, and connective tissue. They pose significant diagnostic and therapeutic challenges, and limited data exist on their epidemiology and outcomes in sub-Saharan Africa. This study assessed the clinicopathological characteristics and one-year survival of patients with STSs managed at a tertiary facility in Tanzania.MethodsA retrospective cohort review was conducted of medical records from January 2019 to April 2023. Data included patient demographics, tumor site, histological subtype, grade, stage at diagnosis, treatment modalities, and follow-up. Survival was estimated using Kaplan-Meier analysis, and Cox proportional hazards regression was applied to identify predictors of one-year survival.ResultsNinety-six cases were analyzed. Males constituted 54.2% of patients, and the majority (70.8%) were aged 15-64 years. Rhabdomyosarcoma was the most frequent histological type (34.4%), followed by sarcoma not otherwise specified (28.1%). Surgery was the predominant treatment modality. The overall one-year survival rate was 63.8% (95% CI: 48.0-71.7). Female sex (adjusted hazard ratio (HR): 3.36; 95% CI: 1.25-9.03; p = 0.016) and absence of surgery (adjusted HR: 5.57; 95% CI: 1.92-16.14; p = 0.002) were independent predictors of increased mortality. The advanced stage (Stage IV: HR = 9.37; unknown stage: HR 10.30) showed a trend toward poorer outcomes, although not statistically significant. Histological subtype was not clearly associated with mortality, though gastrointestinal stromal tumors (GISTs) trended toward improved survival (HR = 0.06; p = 0.057). Adjuvant chemotherapy was associated with increased mortality (HR = 4.39; p = 0.049), likely due to confounding by indication.ConclusionApproximately two-thirds of patients with STSs survive one year post-diagnosis. Prognosis is strongly influenced by sex, stage, and surgical management. These findings highlight the need for early diagnosis, appropriate surgery, and structured multidisciplinary care to improve survival outcomes in Tanzanian tertiary settings.