Analysis of Factors for Predicting Survival in Soft-tissue Sarcoma with Metastatic Disease at Initial Presentation

e23550 Background: Sarcoma is a rare heterogeneous group malignancy and most commonly arises from soft tissue. The primary treatment modality is surgery. However, in metastatic disease, treatment options are limited. Cytotoxic chemotherapy is preferred for palliative treatment. This study aimed to assess the efficacy of temozolomide in heavily pretreated soft tissue sarcoma. Methods: We evaluated the patients with a metastatic various types of soft tissue sarcoma retrospectively. The patients with gastrointestinal stromal tumors and bone sarcomas were excluded from the study. We recorded the clinical, pathological, and treatment data of the patients. SPSS 25v was used for statistical analysis. Survival analysis was performed with the Kaplan-Meier method. Results: Sixteen patients were included in this study. The median age was 48 (range, 21-73) years. Six (37.5%) patients were de-novo metastatic. Tumor localizations were intra-abdominal (43.8%), extremity (31.2%), intrathoracic (12.5%), and head-and-neck (12.5%). The most common metastatic sites were lung (75%), bone (31.8%), liver (18.8%), respectively. For metastatic disease, the patients received at least two different chemotherapy regimens (75%), pazopanib (50%) and palliative radiotherapy (31.3%). Metastasectomy was also performed on five (31.3%) patients. Median progression-free survival was 3.5 (95% CI, 2.6-4.3) months. Partial response was observed in one (6.3%) patients, stable disease in four (25 %) patients. Eleven (68.8%) patients had progressive disease. Grade 1-2 adverse events were observed in nine (56.3%) patients, grade 3-4 in one (6.3%) patients. Conclusions: We showed that temozolomide was well-tolerated but had a limited efficacy for the treatment of patients with metastatic sarcoma. Treatment options for metastatic sarcomas are limited. Temozolomide may be considered a treatment option in patients with heavily pretreated soft tissue sarcoma.

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Prediction of treatment response and metastatic disease in soft tissue sarcoma

10.1117/12.2043792 ◽

2014 ◽

Cited By ~ 2

Author(s):

Hamidreza Farhidzadeh ◽

Mu Zhou ◽

Dmitry B. Goldgof ◽

Lawrence O. Hall ◽

Meera. Raghavan ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Treatment Response ◽

Metastatic Disease

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Soft tissue sarcoma presenting with metastatic disease

Cancer ◽

10.1002/cncr.25418 ◽

2010 ◽

Vol 117 (2) ◽

pp. 372-379 ◽

Cited By ~ 37

Author(s):

Peter C. Ferguson ◽

Benjamin M. Deheshi ◽

Peter Chung ◽

Charles N. Catton ◽

Brian O'Sullivan ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Metastatic Disease

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Soft-tissue sarcoma: Initial characteristics and prognostic factors in patients with and without metastatic disease

Seminars in Surgical Oncology ◽

10.1002/ssu.2980040105 ◽

1988 ◽

Vol 4 (1) ◽

pp. 13-19 ◽

Cited By ~ 55

Author(s):

Michael H. Torosian ◽

Mdclaudia Friedrich ◽

James Godbold ◽

Steven I. Hajdu ◽

Murray F. Brennan

Keyword(s):

Prognostic Factors ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Metastatic Disease

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Radiation Therapy in Metastatic Soft Tissue Sarcoma: From Palliation to Ablation

Cancers ◽

10.3390/cancers13194775 ◽

2021 ◽

Vol 13 (19) ◽

pp. 4775

Author(s):

Nishant K. Shah ◽

Nikhil Yegya-Raman ◽

Joshua A. Jones ◽

Jacob E. Shabason

Keyword(s):

Radiation Therapy ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Metastatic Disease ◽

Local Control ◽

Metastatic Cancer ◽

Local Therapy ◽

Primary Site ◽

Metastatic Soft Tissue Sarcoma ◽

Low Volume

The management of patients with metastatic cancer is rapidly changing. Historically, radiotherapy was utilized for the treatment of localized disease or for palliation. While systemic therapy remains the mainstay of management for patients with metastatic cancer, radiotherapy is becoming increasingly important not only to palliate symptoms, but also to ablate oligometastatic or oligoprogressive disease and improve local control in the primary site. There is emerging evidence in multiple solid malignancies that patients with low volume metastatic disease that undergo local ablative therapy to metastatic sites may have improved progression free survival and potentially overall survival. In addition, there is increasing evidence that select patients with metastatic disease may benefit from aggressive treatment of the primary site. Patients with metastatic soft tissue sarcoma have a poor overall prognosis. However, there may be opportunities in patients with low volume metastatic soft tissue sarcoma to improve outcomes with local therapy including surgery, ablation, embolization, and radiation therapy. Stereotactic body radiation therapy (SBRT) offers a safe, convenient, precise, and non-invasive option for ablation of sites of metastases. In this review article, we explore the limited yet evolving role of radiotherapy to metastatic and primary sites for local control and palliation, particularly in the oligometastatic setting.

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Soft-Tissue Sarcoma: Initial Characteristics and Prognostic Factors in Patients With and Without Metastatic Disease

The Journal of Urology ◽

10.1016/s0022-5347(17)41868-4 ◽

1988 ◽

Vol 140 (4) ◽

pp. 902-902

Author(s):

Robert C. Newman

Keyword(s):

Prognostic Factors ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Metastatic Disease

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Utility of total body FDG PET/CT imaging in the initial staging of soft-tissue sarcoma

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.10531 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 10531-10531 ◽

Cited By ~ 1

Author(s):

D. Roberge ◽

M. Hickeson ◽

M. Charest ◽

R. E. Turcotte

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Metastatic Disease ◽

Fdg Pet ◽

Chest Ct ◽

Pet Ct ◽

Total Body ◽

Fdg Pet Ct ◽

Pet Scans ◽

Initial Staging

10531 Background: Soft-tissue sarcoma spreads predominantly to the lung. It is currently unclear how often PET scan will detect metastases not already obvious by chest imaging or clinical examination. Methods: Soft-tissue sarcoma cases were identified retrospectively. Ewing's sarcoma, rhabdomyosarcoma and GIST tumors were excluded as were patients imaged for follow-up, response assessment or recurrence. Patients all had had a diagnostic chest CT scan as part of their staging. Directed studies were requested to follow-up on abnormal findings in the clinical history or physical examination. All charts and pre-treatment imaging were reviewed retrospectively. Results: From 2004 to 2008, 75 patients met the criteria for this review. These 75 patients had total body FDG-PET/CT imaging on routine initial staging of their sarcoma. The median age was 51. In 21% of cases, the primary tumor had been removed by excisional biopsy or unplanned excision prior to staging. 97% of the previously unresected primary tumors were FDG avid (SUV ≥ 2). 81% of tumors were high-grade (FNCLCC Grade 2–3). The primary tumor was stage T2b in 68% of cases. The most common primary site was the lower extremity (55%). The most common pathological diagnoses were: leiomyosarcoma (21%), liposarcoma (19%) and synovial sarcoma (17%). At the end of staging, 17% of patients were considered to have metastatic disease. PET scans were negative for distant disease in 64/75 cases. Seven of these 64 cases had metastatic disease on chest CT (negative predictive value 89%). 8 PET scans were positive - of these, 4 patients were already known to have metastases, 2 were pathologically proven false positives and 1 was a new finding of a pulmonary metastasis (sensitivity 46%). Three patients had indeterminate PET scans (subsequently none developed metastatic disease). Two incidental benign parotid tumors were found. In total, only 1 patient was upstaged by the PET imaging (1.3%). In addition, PET did not alter management of patients already know to have M1 disease (no new organ sites identified). Conclusions: Although PET scans may be of use in specific circumstances, routine use of FDG PET imaging for detection of metastatic disease as part of the initial staging of soft-tissue sarcoma adds little to chest CT scanning and is unlikely to alter management. No significant financial relationships to disclose.

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Alveolar Soft Part Sarcoma: Progress Toward Improvement in Survival? A Population-Based Study

10.21203/rs.3.rs-948320/v1 ◽

2021 ◽

Author(s):

Tomohiro Fujiwara ◽

Eiji Nakata ◽

Toshiyuki Kunisada ◽

Toshifumi Ozaki ◽

Akira Kawai

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Metastatic Disease ◽

Soft Part ◽

Oncological Outcome ◽

Cytotoxic Chemotherapy ◽

Prolonged Survival ◽

Alveolar Soft Part Sarcoma ◽

National Study ◽

Study Cohort

Abstract Background: Alveolar soft part sarcoma (ASPS) is a rare histological subtype of soft-tissue sarcoma, which remains refractory to conventional cytotoxic chemotherapy. We aimed to characterize ASPS and investigate whether the oncological outcome has improved over the past decade.Methods: One hundred and twenty patients with newly diagnosed ASPS from 2006 to 2017 were identified from the Bone and Soft-Tissue Tumor Registry in Japan. The Kaplan–Meier estimate and Cox proportional hazard model were used to investigate the survival outcomes and factors affecting prognosis.Results: The study cohort comprised 34 (28%) patients with localized ASPS and 86 (72%) with metastatic disease at presentation. The 5-year disease-specific survival (DSS) was 68% for all patients and 86% and 62% for localized and metastatic disease, respectively (p = 0.019). Metastasis at presentation was the only adverse prognostic factor for DSS (hazard ratio [HR]: 7.65; p = 0.048). Patients who were >25 years (80%; p = 0.023), had deep-seated tumors (75%; p = 0.002), and tumors >5 cm (5–10 cm, 81%; >10 cm, 81%; p < 0.001) were more likely to have metastases at presentation. In patients with localized ASPS, adjuvant chemotherapy or radiotherapy did not affect survival, and 13 patients (45%) developed distant metastases in the lung (n = 12, 92%) and brain (n = 2, 15%). In patients with metastatic ASPS (lung, n = 85 [99%]; bone, n = 12 [14%]; and brain n = 9 [11%]), surgery for the primary or metastatic site did not affect survival. The use of pazopanib significantly prolonged survival in patients who received systemic treatment (p = 0.045), whereas doxorubicin-based cytotoxic chemotherapy did not. Overall, a trend toward improved DSS for metastatic ASPS has been observed since 2012 (5-year, 58%–65%; p = 0.117), when pazopanib was approved for use in advanced disease.Conclusion: The national study confirmed a unique feature of ASPS with frequent metastasis to the lung and brain but an indolent clinical course. An overall trend toward prolonged survival after the introduction of targeted drugs encourages continuous efforts to develop novel therapeutic options for this therapeutically resistant soft-tissue sarcoma.

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