Soft tissue sarcoma at the turn of the millennium:aspects of epidemiology, cytogenetics, diagnosis and treatment

Soft tissue sarcomas (STS) comprise a relatively heterogenic group of malignant tumors arising in mesenchymal tissues. In 1997, 523 new primary STS were diagnosed in the Netherlands, whereas 219 patients died from this disease in that year. In the United States, approximately 8100 new STS are diagnosed annually, whereas 4600 patients die annually from their disease. These figures are relatively disappointing when compared to testicular cancer, a malignancy with a similar incidence, but a much lower cancer death rate. In 1997, 415 new primary testicular cancers were diagnosed in the Netherlands, whereas ‘only’ 31 patients died from that disease. In the U.S. these numbers are 6900 patients and 300 patients, respectively. The unfavourable prognosis of STS is caused mainly by the propensity for metastasis. Moreover, local recurrence rates are relatively high (up to 20%), causing a substantial morbidity. Although STS have been studied quite extensively, several aspects remain unclear. The goal of the present thesis was to get more insight into some of the unsolved aspects of this uncommon malignancy