Upper-extremity sarcomas in the United States: Analysis of the surveillance, epidemiology, and end results database, 1973-1998

Purpose: Upper-extremity soft-tissue sarcomas are a rare disease with unclear epidemiology and evolving treatment strategies. Our purpose is to evaluate the incidence of upper-extremity soft-tissue sarcomas and the use of adjuvant radiotherapy in this patient population. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, a national population-based database, we identified all cases of primary upper-extremity sarcoma reported to the 9 national SEER registries in the Untied States from 1973 to 1998. Results: Of the 1,286 upper-extremity soft-tissue sarcomas the average incidence rate is 2.2 cases/million/y, which has not changed significantly from 1973 to 1998. Caucasians' average incidence rate is significantly higher than African Americans' (incidence rate ratio [IRR] =1.3, p=.02); and men are at a significantly higher risk compared with women ORR = 1.3, p<.01). The use of adjuvant radiotherapy has increased significantly from 17% in 1973 to 47% in 1998 (p<.01). African-Americans, compared with Caucasians, are significantly less likely to receive adjuvant radiotherapy (odds ratio [OR] =.5, p=.01). Conclusions: The incidence of upper-extremity sarcomas has not changed significantly over the past 3 decades; however, the disease differentially affects the population with higher rates in Caucasians and men. Based on the results of this study the use of adjuvant radiotherapy is increasing but African Americans are less likely than Caucasians to receive this treatment for upper-extremity sarcoma. (J Hand Surg 2003;28A:511-518. Copyright (C) 2003 by the American Society for Surgery of the Hand.),