Localized Extremity Soft Tissue Sarcoma: Improved Knowledge With Unchanged Survival Over Time

2003 ◽  
Vol 21 (14) ◽  
pp. 2719-2725 ◽  
Author(s):  
Jürgen Weitz ◽  
Christina R. Antonescu ◽  
Murray F. Brennan
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Current Therapy ◽  
Disease Specific Survival ◽  
Actuarial Survival ◽  
Extremity Soft Tissue Sarcoma ◽  
Risk Patients ◽  
Disease Specific

Purpose: The objective of this study was to define whether survival of patients with extremity soft tissue sarcoma (STS), stratified for known risk factors, has improved over the last 20 years. Patients and Methods: From January 1982 to December 2001, 1,706 patients with primary and recurrent STS of the extremities were treated at our institution and were prospectively followed. From this cohort, we selected 1,261 patients who underwent complete macroscopic resection and had one of the following histopathologies: fibrosarcoma, liposarcoma, leiomyosarcoma, malignant fibrous histiocytoma, or synovial sarcoma. Median follow-up was 55 months. Patient, tumor, and treatment factors were analyzed as prognostic factors. Results: The 5-year disease-specific actuarial survival was 79% (78% for patients treated from 1982 to 1986, 79% for patients treated from 1986 to 1991, 79% for patients treated from 1992 to 1996, and 85% for patients treated from 1997 to 2001; P = not significant). For high-risk patients (high-grade, > 10 cm, deep tumors; n = 247), 5-year disease-specific survival was 51% (50% for patients treated from 1982 to 1986, 45% for patients treated from 1986 to 1991, 52% for patients treated from 1992 to 1996, and 61% for patients treated from 1997 to 2001; P = not significant). Tumor depth, size, grade, microscopic margin status, patient age, presentation status (primary tumor versus local recurrence), location (proximal versus distal), and certain histopathologic subtypes were significant prognostic factors for disease-specific survival on multivariate analysis; however, time period of treatment was not. Conclusion: Prognosis of patients with extremity STS, stratified for known risk factors, has not improved over the last 20 years, indicating that current therapy has reached the limits of efficacy.

Association of local recurrence with subsequent survival in extremity soft tissue sarcoma.

1997 ◽  
Vol 15 (2) ◽  
pp. 646-652 ◽  
Author(s):  
J J Lewis ◽  
D Leung ◽  
M Heslin ◽  
J M Woodruff ◽  
M F Brennan
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcoma ◽  
Distant Metastasis ◽  
High Grade ◽  
Disease Specific Survival ◽  
Primary Tumors ◽  
Poor Prognostic Factor ◽  
Extremity Soft Tissue Sarcoma ◽  
Disease Specific

PURPOSE The aim of this study was to analyze local recurrence in a large cohort of prospectively followed patients with primary extremity soft tissue sarcoma. In particular, we analyzed the correlation of local recurrence with subsequent metastasis and disease-specific survival. PATIENTS AND METHODS Patients who underwent treatment for primary extremity soft tissue sarcoma from July 1982 through July 1995 at Memorial Sloan-Kettering Cancer Center were the subject of this study. Local recurrence, distant metastasis, and disease-specific survival were used as end points of the study. The influence of local recurrence on subsequent distant metastasis and disease-specific survival were examined using the Cox proportional hazards model. RESULTS We treated 911 patients, of whom 297 (33%) developed recurrent disease. Local recurrence occurred in 116 patients (13%), metastasis in 167 (18%), and synchronous local recurrence and metastasis in 13 (2%). Of 116 patients who developed local recurrence, 38 subsequently developed metastasis and 34 died of disease. Metastasis after local recurrence was predicted in patients with initial high-grade (P = .005; risk = 3.5) or deep (P = .02; risk = 2.9) tumors. Tumor mortality after local recurrence was predicted in patients with initial high-grade (P = .007; risk = 3.7) or large (> 5 cm; P = .01; risk = 3.2) primary tumors. DISCUSSION These findings suggest that there is a strong association of local recurrence with the development of subsequent metastasis and tumor mortality, and that local recurrence is a poor prognostic factor. It would seem prudent to consider patients who develop local recurrence and have high-grade tumors as being at high risk for systemic disease and therefore eligible for investigational adjuvant systemic therapy.

18F-FLT PET/CT as a prognostic imaging biomarker of disease specific survival in patients with primary soft tissue sarcoma

2021 ◽  
pp. jnumed.121.262502
Author(s):  
Joseph Crompton ◽  
Wesley R. Armstrong ◽  
Mark A. Eckardt ◽  
Ameen Seyedroudbari ◽  
William D. Tap ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Imaging Biomarker ◽  
Disease Specific Survival ◽  
Flt Pet ◽  
Pet Ct ◽  
Disease Specific

scholarly journals Prognostic Factors Predictive of Survival and Local Recurrence for Extremity Soft Tissue Sarcoma

1994 ◽  
Vol 219 (2) ◽  
pp. 165-173 ◽  
Author(s):  
Samuel Singer ◽  
Joseph M. Corson ◽  
Rene Gonin ◽  
Brian Labow ◽  
Timothy J. Eberlein
Keyword(s):  
Prognostic Factors ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcoma ◽  
Extremity Soft Tissue Sarcoma

scholarly journals Prognostic Factors in Extremity Soft Tissue Sarcoma Patients Treated with Preoperative Radiotherapy

2019 ◽  
Vol 4 (03) ◽  
Author(s):  
Berrin Inanc, MD ◽  
Kubilay Inanc, MD
Keyword(s):  
Prognostic Factors ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Preoperative Radiotherapy ◽  
Soft Tissue Sarcomas ◽  
Tumor Grade ◽  
Metastatic Recurrence ◽  
Extremity Soft Tissue Sarcoma ◽  
Metastatic Relapse

Purpose: The purpose of the study was to investigate the prognostic factors and survival after preoperative radiotherapy in Extremity Soft Tissue Sarcomas (ESTS). Materials and Methods: In this retrospective study, all patients treated for an extremity sarcoma with pre-operative radiotherapy followed by surgery. Results: The mean follow-up for all 24 ESTS patients was 15.5 (range: 10-39 months). At last follow-up, 9 patients (37%) were alive, 15 patients (62%) had died of distant disease progression. Among the patients died, there were 15 with metastatic relapse (13 lung and 2 cranial metastasis), 5 with both local and metastatic recurrence. The median OS was 16 month. The 2-years actuarial OS rate and 3-years OS rate were 39% and 26%, respectively. The median RFS was 14(12.5-15.4) month. The 2-years and 3-years RFS rate was 71%.The median MFS was 12 months. The 2-years and 3-years MFS rate were 33%, 17%, respectively. The effects of age, sex, histopathologic type, tumor size, tumor localization, tumor grade, tumor depth, radiation doses and recestion margin on OS, RFS, MFS were not observed. In univariate and multivariate model, it was observed that recurrence decreased OS time significantly (p<0.05). Conclusion: Recurrens and metastasis are strong and negative prognostic factor for survival in extremity soft tissue sarcoma patients.

Prognostic factors of extremity soft tissue sarcoma in adults. A single institutional analysis

2012 ◽  
Vol 16 (8) ◽  
pp. 661-666 ◽  
Author(s):  
I. Atean ◽  
Y. Pointreau ◽  
P. Rosset ◽  
P. Garaud ◽  
G. De-Pinieux ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Institutional Analysis ◽  
Extremity Soft Tissue Sarcoma

Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities.

1996 ◽  
Vol 14 (5) ◽  
pp. 1679-1689 ◽  
Author(s):  
P W Pisters ◽  
D H Leung ◽  
J Woodruff ◽  
W Shi ◽  
M F Brennan
Keyword(s):  
Prognostic Factors ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Tumor Size ◽  
Recurrent Disease ◽  
Soft Tissue Sarcomas ◽  
Distant Recurrence ◽  
Disease Specific Survival ◽  
Positive Surgical Margins ◽  
Disease Specific

PURPOSE To identify specific independent adverse clinicopathologic factors for event-free survival in a cohort of consecutively treated patients with extremity soft tissue sarcomas. PATIENTS AND METHODS Prospectively collected data from a population of 1,041 adult patients with localized (American Joint Committee on Cancer [AJCC] stage IA to IIIB) extremity soft tissue sarcomas were analyzed. Patients were treated at a single institution between 1982 and 1994. Patient, tumor, and pathologic factors were analyzed by univariate and multivariate techniques to identify independent prognostic factors for the end points of local recurrence, distant recurrence, disease-specific survival, and post-metastasis survival. RESULTS The 5-year survival rate for this cohort of patients was 76%, with a median follow-up time of 3.95 years. Significant independent adverse prognostic factors for local recurrence were age greater than 50 years, recurrent disease at presentation, microscopically positive surgical margins, and the histologic subtypes fibrosarcoma and malignant peripheral-nerve tumor. For distant recurrence, intermediate tumor size, high histologic grade, deep location, recurrent disease at presentation, leiomyosarcoma, and nonliposarcoma histology were independent adverse prognostic factors. For disease-specific survival, large tumor size, high grade, deep location, recurrent disease at presentation, the histologic subtypes leiomyosarcoma and malignant peripheral-nerve tumor, microscopically positive surgical margins, and lower extremity site were adverse factors. For post-metastasis survival, only large tumor size ( > 10 cm) was an adverse prognostic factor. CONCLUSION The independent adverse prognostic factors for distant recurrence and disease specific survival differ from those identified for subsequent local recurrence. Patients with microscopically positive surgical margins or patients who present with locally recurrent disease are at increased risk for subsequent local recurrence and tumor-related mortality. Specific histopathologic subtypes are associated with increased risks for local failure and tumor-related mortality.

Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma.

1996 ◽  
Vol 14 (3) ◽  
pp. 859-868 ◽  
Author(s):  
P W Pisters ◽  
L B Harrison ◽  
D H Leung ◽  
J M Woodruff ◽  
E S Casper ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Local Control ◽  
Distant Metastasis ◽  
Soft Tissue Sarcomas ◽  
Complete Resection ◽  
High Grade ◽  
Disease Specific Survival ◽  
Recurrence Rates ◽  
Disease Specific

PURPOSE This trial was performed to evaluate the impact of adjuvant brachytherapy on local and systemic recurrence rates in patients with soft tissue sarcoma. PATIENTS AND METHODS In a single-institution prospective randomized trial, 164 patients were randomized intraoperatively to receive either adjuvant brachytherapy (BRT) or no further therapy (no BRT) after complete resection of soft tissue sarcomas of the extremity or superficial trunk. The adjuvant radiation was administered by iridium-192 implant, which delivered 42 to 45 Gy over 4 to 6 days. The two study groups had comparable distributions of patient and tumor factors, including age, sex, tumor site, tumor size, and histologic type and grade. RESULTS With a median follow-up time of 76 months, the 5-year actuarial local control rates were 82% and 69% in the BRT and no BRT groups (P = .04), respectively. Patients with high-grade lesions had local control rates of 89% (BRT) and 66% (no BRT) (P = .0025). BRT had no impact on local control in patients with low-grade lesions (P = .49). The 5-year freedom-from-distant-recurrence rates were 83% and 76% in the BRT and no BRT groups (P = .60), respectively. Analysis by histologic grade did not demonstrate an impact of BRT on the development of distant metastasis, despite the improvement in local control noted in patients with high-grade lesions. The 5-year disease-specific survival rates for the BRT and no BRT groups were 84% and 81% (P = .65), respectively, with no impact of BRT regardless of tumor grade. CONCLUSION Adjuvant brachytherapy improves local control after complete resection of soft tissue sarcomas. This improvement in local control is limited to patients with high-grade histopathology. The reduction in local recurrence in patients with high-grade lesions is not associated with a significant reduction in distant metastasis or improvement in disease-specific survival.

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