{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T11:04:23Z","timestamp":1779966263830,"version":"3.53.1"},"reference-count":43,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine Pharmacy \u201cCarol Davila\u201d"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Objectives: Sarcomas are rare malignancies of mesenchymal origin comprising less than 1% of all adult solid tumors, exhibiting marked histological heterogeneity and variable clinical behavior. Data from Eastern European tertiary oncology centers remain scarce. This study characterized the clinicopathological features, treatment modalities, and survival outcomes of patients with sarcomas of the extremities and trunk treated at the \u201cProf. Dr. Alexandru Trestioreanu\u201d Institute of Oncology from Bucharest over a ten-year period. Materials and Methods: We conducted a retrospective analysis of 164 patients diagnosed with sarcomas of the extremities and trunk between 2010 and 2020 at \u201cProf. Dr. Alexandru Trestioreanu\u201d Institute of Oncology. Variables included age, sex, tumor localization, histological subtype, immunohistochemical profile, treatment modalities, recurrence, metastatic spread, and overall survival (OS). Kaplan\u2013Meier curves estimated survival; log-rank tests were applied for subgroup comparisons. Results: The cohort comprised 82 males and 82 females (50.0% each), with a mean age of 48.8 \u00b1 18.3 years. The lower limb was the most frequent site (n = 96, 58.5%), particularly the thigh\/femur (34.1%). The most common subtypes were undifferentiated pleomorphic sarcoma (14.6%), osteosarcoma (12.2%), and fibrosarcoma (11.0%). Surgery was performed in 75.6%, chemotherapy in 80.5%, and radiotherapy in 59.8%. Local recurrence occurred in 35.4% and distant metastases in 41.5%. The median OS was 96.0 months (vital status known for 160\/164 patients; 90 deceased, 70 alive; OS duration available in 126 patients). Metastatic disease was associated with shorter observed survival in descriptive Kaplan\u2013Meier analysis (log-rank p &lt; 0.001); this comparison is exploratory given the time-dependent nature of the variable. Survival ranged from 11.5 months (leiomyosarcoma) to 162.5 months (dermatofibrosarcoma protuberans) by histotype. Conclusions: This study provides clinically relevant epidemiological and survival data from Romania. The findings illustrate real-world heterogeneity of sarcoma presentations and outcomes at an Eastern European tertiary center and highlight the need for improved diagnostic standardization, prospective data collection, and integration within specialized sarcoma networks.<\/jats:p>","DOI":"10.3390\/diagnostics16111659","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T09:57:43Z","timestamp":1779962263000},"page":"1659","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinicopathological Characteristics and Treatment Patterns of Extremity, Trunk, and Axial Sarcomas: A Descriptive Real-World Cohort Study from a Romanian Tertiary Oncology Center"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1601-0580","authenticated-orcid":false,"given":"Mihai-Teodor","family":"Georgescu","sequence":"first","affiliation":[{"name":"Oncology 2 Discipline, Department 8\u2014Radiology, Oncology, Hematology, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3589-799X","authenticated-orcid":false,"given":"Adelina Silvana","family":"Gheorghe","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology I, \u201cProf. Dr. Alexandru Trestioreanu\u201d, Institute of Oncology, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9541-3347","authenticated-orcid":false,"given":"Romina-Marina","family":"Sima","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashar Haj","family":"Hamoud","sequence":"additional","affiliation":[{"name":"Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, 66421 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7859-7391","authenticated-orcid":false,"given":"Georgia Luiza","family":"Serbanescu","sequence":"additional","affiliation":[{"name":"Oncology 2 Discipline, Department 8\u2014Radiology, Oncology, Hematology, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea Veronica","family":"Lazescu","sequence":"additional","affiliation":[{"name":"Oncology 2 Discipline, Department 8\u2014Radiology, Oncology, Hematology, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9566-7067","authenticated-orcid":false,"given":"Oana Gabriela","family":"Trifanescu","sequence":"additional","affiliation":[{"name":"Oncology 2 Discipline, Department 8\u2014Radiology, Oncology, Hematology, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0454-0453","authenticated-orcid":false,"given":"Radu Iulian","family":"Mitrica","sequence":"additional","affiliation":[{"name":"Oncology 2 Discipline, Department 8\u2014Radiology, Oncology, Hematology, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0414-1607","authenticated-orcid":false,"given":"Laurentia Nicoleta","family":"Gales","sequence":"additional","affiliation":[{"name":"Oncology 2 Discipline, Department 8\u2014Radiology, Oncology, Hematology, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Rahnea-Nita","sequence":"additional","affiliation":[{"name":"Oncology 1 Discipline, Department 8\u2014Radiology, Oncology, Hematology, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andra-Elena","family":"Balcangiu-Stroescu","sequence":"additional","affiliation":[{"name":"Discipline of Physiology, Department 3, Faculty of Stomatology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","first-page":"394","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.ejca.2012.09.011","article-title":"Descriptive epidemiology of sarcomas in Europe: Report from the RARECARE project","volume":"49","author":"Stiller","year":"2013","journal-title":"Eur. J. Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1016\/j.annonc.2021.07.006","article-title":"Soft tissue and visceral sarcomas: ESMO-EURACAN-GENTURIS Clinical Practice Guidelines","volume":"32","author":"Gronchi","year":"2021","journal-title":"Ann. Oncol."},{"key":"ref_5","unstructured":"Fletcher, C.D.M., Bridge, J.A., Hogendoorn, P.C.W., and Mertens, F. (2020). WHO Classification of Tumours of Soft Tissue and Bone, IARC Press. [5th ed.]."},{"key":"ref_6","first-page":"506182","article-title":"Guidelines for the management of soft tissue sarcomas","volume":"2010","author":"Grimer","year":"2010","journal-title":"Sarcoma"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1002\/1097-0142(20010515)91:10<1914::AID-CNCR1214>3.0.CO;2-3","article-title":"Predictive value of grade for metastasis development in adult soft tissue sarcomas","volume":"91","author":"Coindre","year":"2001","journal-title":"Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1200\/JCO.1996.14.5.1679","article-title":"Analysis of prognostic factors in 1041 patients with localized soft tissue sarcomas of the extremities","volume":"14","author":"Pisters","year":"1996","journal-title":"J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"iv51","DOI":"10.1093\/annonc\/mdy096","article-title":"Soft tissue and visceral sarcomas: ESMO-EURACAN Clinical Practice Guidelines","volume":"29","author":"Casali","year":"2018","journal-title":"Ann. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"iv79","DOI":"10.1093\/annonc\/mdy310","article-title":"Bone sarcomas: ESMO-PaedCan-EURACAN Clinical Practice Guidelines","volume":"29","author":"Casali","year":"2018","journal-title":"Ann. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1200\/JCO.2015.62.4734","article-title":"Efficacy and Safety of Trabectedin or Dacarbazine for Metastatic Liposarcoma or Leiomyosarcoma","volume":"34","author":"Demetri","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1016\/S0140-6736(12)60651-5","article-title":"Pazopanib for metastatic soft-tissue sarcoma (PALETTE)","volume":"379","author":"Blay","year":"2012","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1200\/JCO.1997.15.1.350","article-title":"Comparative study of the NCI and FNCLCC grading systems in 410 adult patients with soft tissue sarcoma","volume":"15","author":"Guillou","year":"1997","journal-title":"J. Clin. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1002\/cncr.28657","article-title":"Sarcoma classification: An update based on the 2013 WHO Classification","volume":"120","author":"Doyle","year":"2014","journal-title":"Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1002\/cncr.25538","article-title":"Trends in survival for patients with metastatic soft-tissue sarcoma","volume":"117","author":"Italiano","year":"2011","journal-title":"Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1200\/JCO.2005.04.160","article-title":"Status of surgical margins and prognosis in adult soft tissue sarcomas of the extremities","volume":"23","author":"Gronchi","year":"2005","journal-title":"J. Clin. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1097\/00000658-200203000-00015","article-title":"Analysis of the prognostic significance of microscopic margins in 2,084 localized primary adult soft tissue sarcomas","volume":"235","author":"Stojadinovic","year":"2002","journal-title":"Ann. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1016\/S1470-2045(16)30214-5","article-title":"Comparison of MAPIE versus MAP in patients with a poor response to preoperative chemotherapy for newly diagnosed high-grade osteosarcoma (EURAMOS-1)","volume":"17","author":"Marina","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1200\/JCO.2002.20.3.776","article-title":"Prognostic factors in high-grade osteosarcoma of the extremities or trunk","volume":"20","author":"Bielack","year":"2002","journal-title":"J. Clin. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.ejca.2015.09.021","article-title":"Evaluation of response after neoadjuvant treatment in soft tissue sarcomas; the EORTC-STBSG recommendations","volume":"53","author":"Wardelmann","year":"2016","journal-title":"Eur. J. Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2442","DOI":"10.1093\/annonc\/mdr610","article-title":"Sarcoma: Concordance between initial diagnosis and centralized expert review","volume":"23","author":"Montesco","year":"2012","journal-title":"Ann. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/2045-3329-2-14","article-title":"The epidemiology of sarcoma","volume":"2","author":"Burningham","year":"2012","journal-title":"Clin. Sarcoma Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1200\/JCO.1996.14.3.869","article-title":"Prognostic factors in adult patients with locally controlled soft tissue sarcoma","volume":"14","author":"Coindre","year":"1996","journal-title":"J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ducimeti\u00e8re, F., Lurkin, A., Ranch\u00e8re-Vince, D., Decouvelaere, A.-V., P\u00e9oc\u2019H, M., Istier, L., Chalabreysse, P., Muller, C., Alberti, L., and Bringuier, P.-P. (2011). Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0020294"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s13569-016-0060-4","article-title":"UK guidelines for the management of soft tissue sarcomas","volume":"6","author":"Dangoor","year":"2016","journal-title":"Clin. Sarcoma Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.anndiagpath.2018.10.006","article-title":"Subclassification of pleomorphic sarcomas: How and why should we care?","volume":"37","author":"Hornick","year":"2018","journal-title":"Ann. Diagn. Pathol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ejca.2009.09.022","article-title":"Prognostic and predictive factors for outcome to first-line ifosfamide-containing chemotherapy for adult patients with advanced soft tissue sarcomas","volume":"46","author":"Sleijfer","year":"2010","journal-title":"Eur. J. Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/S1470-2045(14)70063-4","article-title":"Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft-tissue sarcoma","volume":"15","author":"Judson","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3036","DOI":"10.1200\/JCO.2014.59.5256","article-title":"Ewing Sarcoma: Current Management and Future Approaches","volume":"33","author":"Gaspar","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1016\/S0140-6736(02)09292-9","article-title":"Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: A randomised trial","volume":"359","author":"Davis","year":"2002","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0022-5223(97)70397-0","article-title":"Long-term results of lung metastasectomy: Prognostic analyses based on 5206 cases","volume":"113","author":"Pastorino","year":"1997","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.1200\/JCO.2003.08.132","article-title":"Primary metastatic osteosarcoma: Presentation and outcome","volume":"21","author":"Kager","year":"2003","journal-title":"J. Clin. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/01.blo.0000141660.05125.46","article-title":"Lymph node metastasis in soft tissue sarcoma in an extremity","volume":"426","author":"Riad","year":"2004","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/S1470-2045(17)30334-0","article-title":"Histotype-tailored neoadjuvant chemotherapy versus standard chemotherapy in patients with high-risk soft-tissue sarcomas (ISG-STS 1001)","volume":"18","author":"Gronchi","year":"2017","journal-title":"Lancet Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.1200\/JCO.2009.25.7899","article-title":"Imatinib mesylate in advanced dermatofibrosarcoma protuberans: Pooled analysis of two phase II clinical trials","volume":"28","author":"Rutkowski","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2824","DOI":"10.1200\/JCO.2002.11.050","article-title":"Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma","volume":"20","author":"Hensley","year":"2002","journal-title":"J. Clin. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"623746","DOI":"10.1155\/2015\/623746","article-title":"The identification of prognostic factors and survival statistics of conventional central chondrosarcoma","volume":"2015","author":"Nota","year":"2015","journal-title":"Sarcoma"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/S0959-8049(99)00287-7","article-title":"Surgical margins, local recurrence and metastasis in soft tissue sarcomas: 559 surgically-treated patients from the Scandinavian Sarcoma Group Register","volume":"36","author":"Trovik","year":"2000","journal-title":"Eur. J. Cancer."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2852","DOI":"10.1093\/annonc\/mdx484","article-title":"Improved survival using specialized multidisciplinary board in sarcoma patients","volume":"28","author":"Blay","year":"2017","journal-title":"Ann. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e000666","DOI":"10.1136\/esmoopen-2019-000666","article-title":"Rationale of the rare cancer list: A consensus paper from the Joint Action on Rare Cancers (JARC)","volume":"5","author":"Casali","year":"2020","journal-title":"ESMO Open"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/S0140-6736(19)30764-0","article-title":"Pexidartinib versus placebo for advanced tenosynovial giant cell tumour (ENLIVEN)","volume":"394","author":"Tap","year":"2019","journal-title":"Lancet"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1038\/s41571-018-0012-4","article-title":"Using biology to guide the treatment of sarcomas and aggressive connective-tissue tumours","volume":"15","author":"Dufresne","year":"2018","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1016\/j.ejca.2011.08.008","article-title":"Rare cancers are not so rare: The rare cancer burden in Europe","volume":"47","author":"Gatta","year":"2011","journal-title":"Eur. J. Cancer"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/11\/1659\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T10:12:48Z","timestamp":1779963168000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/11\/1659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,28]]},"references-count":43,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["diagnostics16111659"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16111659","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,28]]}}}