scholarly journals Individualizing Follow-Up Strategies in High-Grade Soft Tissue Sarcoma with Flexible Parametric Competing Risk Regression Models

Cancers ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 47 ◽  
Author(s):  
Maria Anna Smolle ◽  
Michiel van de Sande ◽  
Dario Callegaro ◽  
Jay Wunder ◽  
Andrew Hayes ◽  
...  

Currently, patients with extremity soft tissue sarcoma (eSTS) who have undergone curative resection are followed up by a heuristic approach, not covering individual patient risks. The aim of this study was to develop two flexible parametric competing risk regression models (FPCRRMs) for local recurrence (LR) and distant metastasis (DM), aiming at providing guidance on how to individually follow-up patients. Three thousand sixteen patients (1931 test, 1085 validation cohort) with high-grade eSTS were included in this retrospective, multicenter study. Histology (9 categories), grading (time-varying covariate), gender, age, tumor size, margins, (neo)adjuvant radiotherapy (RTX), and neoadjuvant chemotherapy (CTX) were used in the FPCRRMs and performance tested with Harrell-C-index. Median follow-up was 50 months (interquartile range: 23.3–95 months). Two hundred forty-two (12.5%) and 603 (31.2%) of test cohort patients developed LR and DM. Factors significantly associated with LR were gender, size, histology, neo- and adjuvant RTX, and margins. Parameters associated with DM were margins, grading, gender, size, histology, and neoadjuvant RTX. C-statistics was computed for internal (C-index for LR: 0.705, for DM: 0.723) and external cohort (C-index for LR: 0.683, for DM: 0.772). Depending on clinical, pathological, and patient-related parameters, LR- and DM-risks vary. With the present model, implemented in the updated Personalised Sarcoma Care (PERSARC)-app, more individualized prediction of LR/DM-risks is made possible.

1999 ◽  
Vol 8 (4) ◽  
pp. 215-218 ◽  
Author(s):  
Martin R. Weiser ◽  
Jonathan J. Lewis ◽  
Denis H.Y. Leung ◽  
Murray F. Brennan

2004 ◽  
Vol 15 (11) ◽  
pp. 1667-1672 ◽  
Author(s):  
S.R. Grobmyer ◽  
R.G. Maki ◽  
G.D. Demetri ◽  
M. Mazumdar ◽  
E. Riedel ◽  
...  

In Vivo ◽  
2020 ◽  
Vol 34 (6) ◽  
pp. 3057-3068 ◽  
Author(s):  
DIETMAR DAMMERER ◽  
ANNELIES VAN BEECK ◽  
VIKTORIA SCHNEEWEISS ◽  
ANTON SCHWABEGGER

Author(s):  
Berrin Inanc, MD ◽  
Kubilay Inanc, MD

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.


2018 ◽  
Vol 7 (9) ◽  
pp. 4228-4239 ◽  
Author(s):  
Stephen J. Ramey ◽  
Raphael Yechieli ◽  
Wei Zhao ◽  
Joyson Kodiyan ◽  
David Asher ◽  
...  

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