Impact of surgical margins on survival in cutaneous sarcomas: A nationwide study of French Sarcoma Group (FSG) from NETSARC Database.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23537-e23537
Author(s):  
Mélanie Saint-Jean ◽  
Audrey Michot ◽  
Andrea Cavalcanti ◽  
Gauthier Decanter ◽  
Thomas Meresse ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Median Time ◽  
Tumor Size ◽  
Multivariate Analyses ◽  
Local Relapse ◽  
Young Age ◽  
Margin Status ◽  
Undifferentiated Sarcoma ◽  
Small Tumor ◽  
Small Tumor Size

e23537 Background: R0 surgery in reference centers is the cornerstone for sarcomas treatment with better local control and survival and is mandatory for ESMO-EURACAN and NCCN guidelines. The medical community is out on this issue for cutaneous sarcomas, if they have to follow suit. This retrospective descriptive study focused on margin status and local relapse-free survival (LRFS) and overall survival (OS) of patients (pts) with cutaneous sarcomas. Methods: Between 01/01/10 and 30/12/17, surgery was performed on 2044 pts with cutaneous sarcomas from 20 centers. Data were collected from the NETSARC national network database ( http://netsarc.sarcomabcb.org ). Diagnosis of cutaneous sarcoma was reviewed and histologically confirmed by a local expert pathologist of RRePS (“Network for expert pathology diagnosis in sarcoma”). Dermatofibrosarcoma, Kaposi sarcoma and rare subtypes (< 20 cases in the database) were excluded. Univariate analyses were conducted using log rank test or Cox test. Multivariate analyses were conducted using Cox test. Age and tumor size were analyzed as continuous values. Two-sided significant p level was set at < 0.05. Results: Mean age was 66 years. Primary tumor was localized in lower limb, trunk wall, head and neck and upper limb for 30%, 26%, 26% and 18% pts respectively. Main subtypes were leiomyosarcoma, undifferentiated sarcoma, and myxofibrosarcoma for 29%, 29%, and 14% pts respectively. Angiosarcoma was the subtype of 9% of the patients (n = 193). Mean size was 45 mm. FNCLCC grade was 1, 2, and 3 for 14%, 29.5%, and 24% tumors respectively. Before surgery, imaging and biopsy were performed for 21% and 51% pts respectively. Surgery was carried out in a NETSARC center for 26% of the pts. Margin status after initial surgery was R0, R1, and R2 for 35% (n = 724), 34% (n = 696), and 12% pts (n = 246) respectively. Re-excision was performed for 34% (703/2044 pts), leading to a subsequent R0 margin for 74% of them (523/703 pts, equivalent to 26% of the overall population). Local relapse occurred for 21% of pts after a median time of 10 months. Metastatic relapse occurred for 13% of pts after a median time of 11 months. One hundred and ninety-three pts (9%) died. Median follow-up was 12 months. In multivariate analyses, statistically significant favorable prognostic factors for LRFS were: young age, small tumor size and non-angiosarcoma subtype. Significant prognostic factors associated with longer OS were: young age, small tumor size, non-angiosarcoma subtype, FNCLCC grade (1 vs 2 and 1 vs 3) and initial R0 surgery. Conclusions: Cutaneous sarcomas share same favorable clinical prognostic factors than non-cutaneous sarcomas. Quality of surgery remains the mainstay for OS.

Prognostic factors in adolescents and young adults (AYA) with high-risk soft tissue sarcoma (STS) treated by adjuvant chemotherapy: A study based on two pooled European Organisation for Research and Treatment of Cancer (EORTC) clinical trials

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10573-10573
Author(s):  
B. Kasper ◽  
M. Ouali ◽  
M. Van Glabbeke ◽  
J. Blay ◽  
V. H. Bramwell ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Tumor Size ◽  
Age Groups ◽  
Radical Resection ◽  
Low Grade ◽  
Small Tumor ◽  
Favorable Prognosis ◽  
Small Tumor Size

10573 Background: We conducted a retrospective study pooling data from two clinical trials in high risk STS patients with the objective to compare two different age groups: 15 - 29 years (AYA population) and ≥ 30 years. The aim was to determine prognostic factors for the AYA population. Methods: Patients selected for analysis were treated in two randomized trials of adjuvant chemotherapy in STS (EORTC 62771 and 62931). A total of 793 patients were included with a median follow-up (FU) of 8.74 years (AYA population: n = 161, median FU 9.46 years; patients ≥ 30 years: n = 632, median FU 8.62 years). Study endpoints were overall survival (OS) and relapse-free survival (RFS). The variables of the multivariate analysis were gender, subtype and grade, tumor size and localization (limb vs. other), absence or presence of local recurrence and treatment (control arm vs. adjuvant chemotherapy). Results: Patients’ characteristics were globally similar with two exceptions, histological subtype (p = 0.0043) and tumor size (p < .0001). The commonest sarcoma subtype in the AYA population was synovial sarcoma (29 %), whereas leiomyosarcoma (18 %), malignant fibrous histiocytoma (MFH, 16 %) and liposarcoma (15 %) were more frequent in patients ≥ 30 years. For OS, independent favorable prognostic factors were low grade and small tumor size for both groups; radical resection and MFH or liposarcoma subtype were factors of favorable prognosis for patients ≥ 30 years only. For RFS, favorable prognostic factors were small tumor size and low grade for both groups; tumor location in the extremities was a factor of favorable prognosis for the AYA population only, whereas radical resection and adjuvant chemotherapy treatment were favorable factors for patients ≥ 30 years only. Conclusions: On the basis of these data, significant differences could be found concerning prognostic factors between the AYA population and older patients. Interestingly, adjuvant chemotherapy was associated with improved RFS only in patients ≥ 30 years. The results may have further implications on the treatment of STS patients in different age groups as well as the design of future clinical trials. No significant financial relationships to disclose.

scholarly journals Impact of Primary Tumor Size on Prognosis in Patients With Metastatic Renal Cell Carcinoma Receiving Cytoreductive Nephrectomy: A Population Study of a Chinese Center and the US SEER Database

2021 ◽  
Vol 20 ◽  
pp. 153303382110195
Author(s):  
Weixing Jiang ◽  
Jianzhong Shou ◽  
Hongzhe Shi ◽  
Li Wen ◽  
Huijuan Zhang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Tumor Size ◽  
Primary Tumor ◽  
Protective Factor ◽  
Seer Database ◽  
Cytoreductive Nephrectomy ◽  
Small Tumor ◽  
Chinese Cohort ◽  
Small Tumor Size

Background: The relationship between the size of the primary tumor and the prognosis of patients with metastatic renal cell carcinoma (mRCC) is unclear. In this study, we aimed to investigate the significance of the size of the primary tumor in mRCC. Methods: We retrospectively reviewed the data of patients with mRCC who underwent cytoreductive nephrectomy (CN) from 2006 to 2013 in a Chinese center (n = 96) and those in the Surveillance, Epidemiology, and End Results (SEER) database (from 2004 to 2015, n = 4403). Tumors less than 4 cm in size were defined as small. Prognostic factors were analyzed using univariate and multivariate Cox proportional hazards regression analyses. Results: Patients with small tumors had a longer overall survival than other patients, both in the Chinese cohort (median, 30.0 vs 24.0 months, P = 0.026) and the SEER cohort (median, 43.0 vs 23.0 months, P < 0.001). After adjusting for other significant prognostic factors, small tumor size was still an independent protective factor in the Chinese cohort (adjusted hazard ratio [HR], 0.793; 95% confidence interval [CI]: 0.587–0.998, P = 0.043). In the SEER cohort, multivariate analysis showed that small tumor size was also an independent protective factor (HR, 0.880; 95% CI: 0.654–0.987, P = 0.008). In addition, as a continuous variable, a 1 cm elevation in tumor size translated into a 3.8% higher risk of death (HR, 1.038; 95% CI, 1.029–1.046; P < 0.001). Conclusion: Patients with small tumors may have a favorable prognosis after CN for mRCC. Although CN is not a standard protocol in mRCC, small tumor size may be a candidate when we are deciding to perform CN because of the potential benefit for OS.

scholarly journals Outcome of multidisciplinary treatment of peripheral primitive neuroectodermal tumor

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yidi Liu ◽  
Yan Yuan ◽  
Fuquan Zhang ◽  
Ke Hu ◽  
Jie Qiu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Size ◽  
Therapeutic Approach ◽  
Univariate Analysis ◽  
Multidisciplinary Treatment ◽  
College Hospital ◽  
Small Tumor ◽  
Medical College ◽  
Treatment Plans ◽  
Small Tumor Size

Abstract Peripheral primitive neuroectodermal tumors (PNETs) constitute very rare and aggressive malignancies. To date, there are no standard guidelines for management of peripheral PNETs due to the paucity of cases arising in various body sites. Therapeutic approach is derived from Ewing sarcoma family, which currently remains multimodal. Our study retrospectively analyzed 86 PNET patients from February 1, 1998 to February 1, 2018 at Peking Union Medical College Hospital with an additional 75 patients from review of literature. The clinicopathologic and treatment plans associated with survival was investigated. Surgery, chemotherapy, female sex, small tumor size, no lymph node metastasis, R0 surgical resection, (vincristine + doxorubicin + cyclophosphamide)/(isophosphamide + etoposide) regimen, and more than 10 cycles of chemotherapy were associated with improved overall survival in univariate analysis. Surgery, more than 10 cycles of chemotherapy, and small tumor size were independent prognostic factors for higher overall survival. Our data indicates that multimodal therapy is the mainstay therapeutic approach for peripheral PNET.

P31 Prognostic significance of vascular tumor emboli in 1518 breast carcinoma patients with small tumor size (≤3 cm)

1998 ◽  
Vol 34 ◽  
pp. S21
Author(s):  
J.-Y. Pierga ◽  
A. Vincent-Salomon ◽  
M. Cousineau ◽  
B. Zafrani ◽  
B. Asselain ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Tumor Size ◽  
Prognostic Significance ◽  
Vascular Tumor ◽  
Small Tumor ◽  
Tumor Emboli ◽  
Small Tumor Size

scholarly journals Hypopharyngeal cancer treatment based on definitive radiotherapy: who is suitable for laryngeal preservation?

2007 ◽  
Vol 122 (5) ◽  
pp. 506-512 ◽  
Author(s):  
S-W Chen ◽  
M-H Tsai ◽  
S-N Yang ◽  
J-A Liang ◽  
A-C Shiau ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Proportional Hazards Model ◽  
Multivariate Analyses ◽  
Local Relapse ◽  
Hypopharyngeal Cancer ◽  
Stage I ◽  
Stage Iii ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Laryngeal Preservation

AbstractAims:To investigate prognostic factors for survival and locoregional control in patients with stage I–IVA hypopharyngeal cancer treated with laryngeal preservation radiotherapy.Methods:This study was a retrospective analysis of 108 patients with stage I–IVA squamous cell carcinoma of the hypopharynx, treated with laryngeal preservation radiotherapy. Actuarial survival, disease-specific survival and local relapse-free survival were calculated, and multivariate analyses were performed using Cox's proportional hazards model.Results:After a median follow-up duration of 39 months, the five-year local relapse-free survival rate was 35 per cent for all patients, 66 per cent for those with stage I–II disease, 46 per cent for those with stage III disease and 20 per cent for those with stage IVA disease (p = 0.004). Multivariate analyses showed that tumour and node stages were independent prognostic factors.Conclusions:Patients with stage I–II disease were suitable for laryngeal preservation radiotherapy. For most patients with stage III–IVA disease, other than those who were T1 N1 or T2 N1, the treatment results were poor.

scholarly journals Improvement of the primary efficacy of microwave ablation of malignant liver tumors by using a robotic navigation system

2020 ◽  
Vol 54 (3) ◽  
pp. 295-300
Author(s):  
Jan Schaible ◽  
Benedikt Pregler ◽  
Niklas Verloh ◽  
Ingo Einspieler ◽  
Wolf Bäumler ◽  
...  
Keyword(s):  
Tumor Size ◽  
Microwave Ablation ◽  
Liver Tumors ◽  
Multiple Logistic Regression Analysis ◽  
Percutaneous Ablation ◽  
Primary Efficacy ◽  
Robotic Navigation ◽  
Liver Malignancies ◽  
Small Tumor ◽  
Small Tumor Size

AbstractBackgroundThe aim of the study was to assess the primary efficacy of robot-assisted microwave ablation and compare it to manually guided microwave ablation for percutaneous ablation of liver malignancies.Patients and methodsWe performed a retrospective single center evaluation of microwave ablations of 368 liver tumors in 192 patients (36 female, 156 male, mean age 63 years). One hundred and nineteen ablations were performed between 08/2011 and 03/2014 with manual guidance, whereas 249 ablations were performed between 04/2014 and 11/2018 using robotic guidance. A 6-week follow-up (ultrasound, computed tomography and magnetic resonance imaging) was performed on all patients.ResultsThe primary technique efficacy outcome of the group treated by robotic guidance was significantly higher than that of the manually guided group (88% vs. 76%; p = 0.013). Multiple logistic regression analysis indicated that a small tumor size (≤ 3 cm) and robotic guidance were significant favorable prognostic factors for complete ablation.ConclusionsIn addition to a small tumor size, robotic navigation was a major positive prognostic factor for primary technique efficacy.

scholarly journals Gastrointestinal Stromal Tumors: Alexandria University Experience

2021 ◽  
Author(s):  
Maher Soliman
Keyword(s):  
Risk Score ◽  
Tumor Size ◽  
Gastrointestinal Stromal Tumors ◽  
Multivariate Analyses ◽  
Disease Free Survival ◽  
Margin Status ◽  
High Power Field ◽  
Mesenchymal Tumors ◽  
Male Predominance ◽  
Stromal Tumors

Abstract Introduction Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract (GIT) that can arise in any parts of the GIT. The clinical behavior and prognosis of GISTs remain unpredictable. The purpose of this study was to evaluate the clinicopathological features and prognostic factors of GISTs. Methods The medical files of 93 patients with nonmetastatic GIST presented to our hospital were reviewed. The clinical and pathological parameters, treatment, and follow-up data were collected and correlated to survival outcome using univariate and multivariate analyses. Results The median age of patients was 48.9 years with a slight male predominance. Abdominal pain (39.8%) was the commonly presenting symptom. About 60% of GISTs originated from the stomach and 22% from the small intestine. Tumors stained positive for CD117 in 95.7%. The median diameter of the tumors was 7 cm. Mitotic counts were < 5/50 high power field in 55.9% of tumors. About 44% of patients had high risk tumors. All patients underwent surgery and about 60.2% of patients received adjuvant imatinib mesylate.The 5-year disease-free survival (DFS) and overall survival (OS) were 74.5 and 80%, respectively. Margin status, tumor site, tumor size, mitotic counts, and risk score were significantly associated with DFS and OS in both univariate and multivariate analyses. Conclusion Surgery is the mainstay treatment for nonmetastatic GISTs. Tumor size, tumor location, margin status, mitotic count, and risk score were predictive factors for DFS and OS of GISTs.

A nomogram for predicting overall survival in patients with uterine leiomyosarcoma: a SEER population-based study

2020 ◽  
Vol 16 (10) ◽  
pp. 573-584
Author(s):  
Yu-Jie Lu ◽  
Han Wang ◽  
Lin-Yan Fang ◽  
Wen-Jie Wang ◽  
Wei Song ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Marital Status ◽  
Tumor Size ◽  
Multivariate Analyses ◽  
Predictive Accuracy ◽  
Population Based ◽  
Uterine Leiomyosarcoma ◽  
Population Based Study ◽  
End Results

Aim: To establish and validate a nomogram for the estimation of overall survival of patients with uterine leiomyosarcoma (uLMS). Methods: Information on patients diagnosed as uLMS was retrospectively retrieved from the Surveillance, Epidemiology, and End Results database. The patients were randomly assigned into the training and the validation cohorts. Univariate and multivariate analyses were used to determine the independent prognostic factors for building a nomogram for predicting overall survival. The predictive accuracy was evaluated based on the concordance indices and the calibration plots. Results: A nomogram that combined age, marital status, tumor size, Surveillance, Epidemiology, and End Result stage, surgery and radiation was established. The internal and external concordance indices were 0.748 and 0.745, respectively. The calibration plots approached 45 degrees. Conclusion: The nomogram might be an effective tool for predicting the survival of patients with uLMS.

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