Recurrence-free survival time for surgically treated soft tissue sarcoma patients. Multivariate analysis of five prognostic factors

Uniform conclusions about therapeutic concepts and survival time of bone and soft tissue sarcoma patients are difficult due to the heterogeneity of histological subtypes as well as the different responses to neoadjuvant therapy. The subject of this retrospective study was the analysis of tumour free survival, risk and prognostic factors of sarcoma patients treated by limb sparing techniques or amputation. We included 118 patients with soft tissue sarcoma of the extremities treated primarily or secondarily at our institution between 1990 and 2008 with a minimum follow-up of 12 months. Data about the tumour free survival time, operative techniques and potential prognostic factors were analysed. The tumour-specific and overall survival were significantly influenced by two factors: the grading and distant metastases present at time of diagnosis. Optimal multimodal therapeutic concepts at a specialized Cancer Center decreased the risk of local recurrence. The importance of optimal preoperative and surgical course concerning the oncological long term outcome was investigated. The decrease in local recurrence as a result of multimodal therapeutic concepts at a specialized Cancer Center was confirmed. To evaluate the individual prognosis of a patient, multiple factors have to be considered. Factors for a poor prognosis are primary metastasis, high-grade tumours and several histological entities (<em>e.g</em>. synovial sarcoma, not other specified).

Download Full-text

Multivariate analysis for clinical prognostic factors in 163 patients with soft tissue sarcoma

Cancer ◽

10.1002/1097-0142(19881001)62:7<1444::aid-cncr2820620733>3.0.co;2-l ◽

1988 ◽

Vol 62 (7) ◽

pp. 1444-1450 ◽

Cited By ~ 67

Author(s):

Takafumi Ueda ◽

Katsuyuki Aozasa ◽

Masahiko Tsujimoto ◽

Hideki Hamada ◽

Hideki Hayashi ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Soft Tissue ◽

Soft Tissue Sarcoma

Download Full-text

Histologic Response Following Pre-Operative Radiotherapy for Soft Tissue Sarcoma (STS) in a French Reference Center and Review

Clinical Oncology and Research ◽

10.31487/j.cor.2020.08.24 ◽

2020 ◽

pp. 1-8

Author(s):

Sunyach Marie ◽

Severine Prapan ◽

Aurelie Bertaut ◽

Marie Karanian ◽

Gualter Vaz ◽

...

Keyword(s):

Soft Tissue ◽

Local Recurrence ◽

Soft Tissue Sarcoma ◽

Tumor Cells ◽

Distant Recurrence ◽

Recurrence Free Survival ◽

Histologic Response ◽

Free Survival ◽

Viable Cells ◽

Viable Tumor

Background and Purpose: Limb sparing surgery and radiotherapy is the main treatment of patients harboring soft tissue sarcoma of the extremity. There is limited data regarding the prognostic impact of histologic response after pre-operative radiotherapy. Patients and Methods: Between 2010 and 2018, 123 patients were treated with a pre-operative radiotherapy for soft tissue sarcoma at Leon Berard Centre (Lyon, France) and were retrospectively reviewed. All patients received a dose of 50 Gy in 25 fractions. The histologic response has been analysed by considering the following factors: necrosis ≥ 90%, percentage of viable tumor cells ≤ 10% and fibrosis ≥ 10%. Overall survival (OS), local recurrence-free survival (LRFS), distant recurrence-free survival (DRFS) and event-free survival (EFS) were evaluated. Results: Median follow up was 33.2 months (range 2.3-128.1 months). Local recurrence occurred in 9 patients (7.5%) and 40 patients (33%) presented a distant recurrence. The 2 and 5-year OS was 84% and 63%. Histologic response factors (necrosis ≥ 90%, viable tumor cells ≤ 10% and fibrosis ≥ 10%) were not predictive in DRFS and EFS. In multivariate analysis, grade was the only significant prognostic factor for EFS P=0.0087. Among the 14 patients with ≤ 10% viable cells after irradiation 13 presented a metastatic evolution within 6 months. Conclusion: This study showed that current histological response evaluation based on necrosis, fibrosis and viable cells could not predict clinical outcomes after radiotherapy for extremity soft tissue sarcoma. A significant proportion of patients with a good response after pre-operative radiotherapy present a metastatic recurrence.

Download Full-text

Impact of Smoking History on Pulmonary Metastasis-free Survival in Patients With Soft-tissue Sarcoma

Cancer Diagnosis & Prognosis ◽

10.21873/cdp.10013 ◽

2021 ◽

Vol 1 (2) ◽

pp. 89-94

Author(s):

MASATAKE MATSUOKA ◽

MASANORI OKAMOTO ◽

TAMOTSU SOMA ◽

ISAO YOKOTA ◽

RYUTA ARAI ◽

...

Keyword(s):

Overall Survival ◽

Multivariate Analysis ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Confidence Interval ◽

Pulmonary Metastasis ◽

Hazard Ratio ◽

Smoking History ◽

Free Survival ◽

The Impact

Background/Aim: Although smoking history is predictive of poor pulmonary metastasis-free survival (PMFS) in patients with epithelial tumors, the impact of smoking history on PMFS in those with soft-tissue sarcoma (STS) is not known. Patients and Methods: Patients undergoing treatment for STS at our institutes between 2008 and 2017 were enrolled. Patients were excluded if they had metastatic lesion, or had a histopathological classification demonstrating small round-cell sarcoma. The impact of smoking history on PMFS and overall survival was examined with multivariate analysis using a Cox proportional hazards model. Results: A total of 250 patients were retrospectively reviewed. Patients with smoking history had worse PMFS on multivariate analysis (hazard ratio=2.00, 95% confidence interval=1.12-3.60). On the other hand, smoking history did not significantly affect overall survival (hazard ratio=1.26, 95% confidence interval=0.61-2.58). Conclusion: Patients with STS need to be followed-up by frequent clinical assessments if they have a smoking history.

Download Full-text

Multivariate Analysis for Histological Prognostic Factors in Soft Tissue Sarcoma of Extremities and Trunk

Recent Advances in Musculoskeletal Oncology ◽

10.1007/978-4-431-68364-3_29 ◽

1992 ◽

pp. 248-253 ◽

Cited By ~ 1

Author(s):

Takafumi Ueda ◽

Katsuyuki Aozasa ◽

Masahiko Tsujimoto ◽

Akira Myoui ◽

Shigeyuki Kuratsu ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Soft Tissue ◽

Soft Tissue Sarcoma

Download Full-text

Factors Influencing Prognosis After Initial Inadequate Excision (IIE) for Soft Tissue Sarcoma

Sarcoma ◽

10.1080/13577140310001650321 ◽

2003 ◽

Vol 7 (3-4) ◽

pp. 159-165 ◽

Cited By ~ 8

Author(s):

Albert N. Van Geel ◽

Alexander M. M. Eggermont ◽

Patrick E. J. Hanssens ◽

Paul I. M. Schmitz

Keyword(s):

Overall Survival ◽

Soft Tissue ◽

Local Recurrence ◽

Soft Tissue Sarcoma ◽

Tumor Grade ◽

Residual Tumor ◽

Radical Resection ◽

Recurrence Free Survival ◽

Free Survival ◽

Local Recurrence Free Survival

Purpose. The influence of initial inadequate excision (IIE) of soft tissue sarcoma (STS) on local control and overall survival is not well established. It is generally believed that an IIE may have a negative impact on both, despite subsequent treatment by radical surgery and radiotherapy. However, data on local recurrence-free survival/overall survival are conflicting and there are no data on the effect of IIE on overall survival.Patients and methods. A retrospective analysis was made of 86 patients with soft tissue sarcoma of the extremities and trunk after an IIE had been performed due to inappropriate work-up. The minimal follow-up was 7 years. Specimens of the subsequent radical resection were evaluated for residual tumor, grade of tumor and complications of IIE. Endpoints were recurrence-free survival and overall survival.Results. Specimens of the subsequent radical resection showed residual tumor in 66 patients (77%). The most common complication after IIE was hematoma. In both univariate and multivariate analyses, grade II/III tumors and complications after IIE are significant negative prognostic factors for local recurrence-free survival (P= 0.008 andP= 0.002, respectively, in the Cox model). For this survival, three prognostic groups could be formed based on grade, or presence or absence of complications. Adjuvant radiotherapy did not change the rate of local recurrence-free survival. For overall survival, only tumor grade is a significant factor (log-rank test).Conclusion. This retrospective study shows that complications associated with an IIE have a significant negative effect on local control, but not on overall survival, because IIE is often the result of inappropriate work-up before surgery. For better diagnosis and therapy STS should be treated in specialized centers.

Download Full-text

Efficacy of hyperthermic isolated limb perfusion in the treatment of locally recurrent high-grade soft tissue sarcoma of the extremities

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02110-4 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Farhad Farzaliyev ◽

Alexander Touma ◽

Georg Taeger ◽

Hans-Ulrich Steinau ◽

Jendrik Hardes ◽

...

Keyword(s):

Soft Tissue ◽

Local Recurrence ◽

Soft Tissue Sarcoma ◽

Isolated Limb Perfusion ◽

High Grade ◽

Recurrence Free Survival ◽

Free Survival ◽

Limb Perfusion ◽

Locally Recurrent ◽

Local Recurrence Free Survival

Abstract Background This novel study compared the use of tumor necrosis factor (TNF)-alpha and melphalan-based isolated limb perfusion (TM-ILP) to the standard treatment of locally recurrent soft tissue extremity sarcoma. The aim was to assess whether TM-ILP positively influences the recurrence-free survival of locally recurrent high-grade soft tissue sarcoma (STS) of the extremities. Methods We retrospectively analyzed our clinical database for patients with STS. Variables were analyzed using chi-square test or Mann-Whitney rank-sum test. Furthermore, Kaplan-Meier survival plots were calculated and a proportional hazard regression model was developed. Results Out of 448 patients with extraabdominal STS treated between August 2012 and December 2015, 52 cases involving 47 patients had locally recurrent STS. Twenty-eight of these patients were treated with TM-ILP prior to surgical resection (TM-ILP-group), and 24 were treated with standard therapy (without TM-ILP). The 3-year recurrence-free survival for the TM-ILP-group was estimated at 75% (95% confidence interval (CI), 71.5–78.5). Local recurrence-free survival in the standard group was significantly lower (LRFS: 43.4%, 95% CI 38.7–48.1, p = 0.026). Multivariable analysis revealed resection with negative margins, lower number of previous recurrences, and TM-ILP as positive predictors for recurrence-free survival. Conclusions TM-ILP and consecutive resection of residual tumor with negative resection margins significantly improves local recurrence-free survival for patients with a first local recurrence of high-grade STS in the extremities.

Download Full-text