Clinicopathological, Patterns of Care and Outcome of Soft Tissue Tumors in A Tertiary Center in Oman, A Mixed Cohort Study Over 14 Years

Abstract

Connective tissue tumors are a wide spectrum of disease ranging from benign, to intermediate to malignant and they can affect any part of the body. The diversity in clinical presentational and behaviors makes the diagnosis and management of such diseases challenging. This study presents the unique features of soft tissue tumors in Arab population in a cancer center in Oman over a 20-year period. A retrospective analysis was conducted on a cohort of patients diagnosed with connective tissue tumors between 2010 and 2024 in a tertiary cancer center. Data retrieved from electronic medical records included demographic information, clinical presentation, histopathological findings, treatment modalities and follow-up records until Dec 2024. The study included consecutive patients diagnosed with soft tissue tumors over the study period. Osseous tumors and gastrointestinal stromal tumors were excluded. Statistical analysis, including descriptive statistics and survival analysis were performed. After applying the inclusion criteria, 228 patients were identified and evaluated. The 2020 WHO soft tissue neoplasm classification was used to categorize them. Myo fibroblastic origin tumors were the commonest accounting for 39% of all cases, with Desmoid-Like Fibromatosis as the commonest entity. Followed by tumors of Uncertain differentiation with Synovial sarcoma as its prevalent subcategory. Perivascular tumors were of the least common subtype, accounting for less than 2%. The median age at diagnosis was 41.8 years with a slight female predominance. Limbs were the comments site seen accounting for 34% of cases, followed by trunk (22%) and intra-abdominal and retroperitoneum (10, 8%). Almost half of the patients (48%) presented with a mass, others presented with pain (15.8%) bleeding or were detected incidentally. Surgical resection was done on 84% of the patients including wide local excision, multivesicular resection and even cytoreductive surgery and Heated Intra Peritoneal chemotherapy (HIPEC). Two third of the patients received some form of radiation during their treatment. Details about systemic management and overall outcome were also evaluated and reported. Our study evaluated the presentation soft tissue tumors in Omani individuals and different treatment patterns and outcome. There are very spars information about soft tissue tumors among Arabs overall and Omani’s specifically and this study can help to build a foundation for understanding this disease in the area at a deeper level in parallel to the current information we have about Asian and European population.