Faculty Opinions recommendation of The prognostic impact of unplanned excisions in a cohort of 728 soft tissue sarcoma patients: A multicentre study.

Abstract Introduction Advanced or metastatic soft tissue sarcoma (a/mSTS) is associated with a dismal prognosis. Patient counseling on treatment aggressiveness is pivotal to avoid over- or undertreatment. Recently, evaluation of body composition markers like the skeletal muscle index (SMI) became focus of interest in a variety of cancers. This study focuses on the prognostic impact of SMI in a/mSTS, retrospectively. Methods 181 a/mSTS patients were identified, 89 were eligible due to prespecified criteria for SMI assessment. Baseline CT-Scans were analyzed using an institutional software solution. Sarcopenia defining cut-off values for the SMI were established by optimal fitting method. Primary end point was overall survival (OS) and secondary endpoints were progression free survival (PFS), disease control rate (DCR), overall response rate (ORR). Descriptive statistics as well as Kaplan Meier- and Cox regression analyses were administered. Results 28/89 a/mSTS patients showed sarcopenia. Sarcopenic patients were significantly older, generally tended to receive less multimodal therapies (62 vs. 57 years, P = 0.025; respectively median 2.5 vs. 4, P = 0.132) and showed a significantly lower median OS (4 months [95%CI 1.9–6.0] vs. 16 months [95%CI 8.8–23.2], Log-rank P = 0.002). Sarcopenia was identified as independent prognostic parameter of impaired OS (HR 2.40 [95%-CI 1.4–4.0], P < 0.001). Moreover, DCR of first palliative medical treatment was superior in non-sarcopenic patients (49.2% vs. 25%, P = 0.032). Conclusion This study identifies sarcopenia as a prognostic parameter in a/mSTS. Further on, the data suggest that sarcopenia shows a trend of being associated with first line therapy response. SMI is a promising prognostic parameter, which needs further validation.

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PV-0048: Prognostic impact of tumor size and response in neoadjuvant radiotherapy of soft tissue sarcoma

Radiotherapy and Oncology ◽

10.1016/s0167-8140(17)30492-9 ◽

2017 ◽

Vol 123 ◽

pp. S21

Author(s):

A. Cortesi ◽

A. Arcelli ◽

R. Frakulli ◽

L. Giaccherini ◽

S. Bisello ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Tumor Size ◽

Prognostic Impact ◽

Neoadjuvant Radiotherapy

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Prevalence and prognostic impact of comorbidity in soft tissue sarcoma: A population-based cohort study

Acta Oncologica ◽

10.3109/0284186x.2014.888494 ◽

2014 ◽

Vol 53 (9) ◽

pp. 1188-1196 ◽

Cited By ~ 14

Author(s):

Katja Maretty-Nielsen ◽

Ninna Aggerholm-Pedersen ◽

Akmal Safwat ◽

Steen Baerentzen ◽

Alma B. Pedersen ◽

...

Keyword(s):

Cohort Study ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Population Based ◽

Prognostic Impact

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Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft-tissue sarcoma: a randomised phase 3 multicentre study

The Lancet Oncology ◽

10.1016/s1470-2045(10)70071-1 ◽

2010 ◽

Vol 11 (6) ◽

pp. 561-570 ◽

Cited By ~ 417

Author(s):

Rolf D Issels ◽

Lars H Lindner ◽

Jaap Verweij ◽

Peter Wust ◽

Peter Reichardt ◽

...

Keyword(s):

High Risk ◽

Adjuvant Chemotherapy ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Multicentre Study ◽

Phase 3 ◽

Regional Hyperthermia ◽

Neo Adjuvant Chemotherapy

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A phase IIb multicentre study comparing the efficacy of trabectedin to doxorubicin in patients with advanced or metastatic untreated soft tissue sarcoma: The TRUSTS trial

European Journal of Cancer ◽

10.1016/j.ejca.2015.03.023 ◽

2015 ◽

Vol 51 (10) ◽

pp. 1312-1320 ◽

Cited By ~ 38

Author(s):

B. Bui-Nguyen ◽

J.E. Butrynski ◽

N. Penel ◽

J.Y. Blay ◽

N. Isambert ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Multicentre Study

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Aminopeptidase N (CD13): Expression, Prognostic Impact, and Use as Therapeutic Target for Tissue Factor Induced Tumor Vascular Infarction in Soft Tissue Sarcoma

Translational Oncology ◽

10.1016/j.tranon.2018.08.004 ◽

2018 ◽

Vol 11 (6) ◽

pp. 1271-1282 ◽

Cited By ~ 8

Author(s):

Torsten Kessler ◽

Ariane Baumeier ◽

Caroline Brand ◽

Michael Grau ◽

Linus Angenendt ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Tissue Factor ◽

Therapeutic Target ◽

Aminopeptidase N ◽

Prognostic Impact

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Clinical, radiological and genetic features, associated with the histopathologic response to neoadjuvant chemotherapy (NAC) and outcomes in locally advanced soft tissue sarcoma (STS) patients (pts).

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.11014 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 11014-11014 ◽

Cited By ~ 7

Author(s):

Sophie Cousin ◽

Amandine Crombe ◽

Eberhard Stoeckle ◽

Véronique Brouste ◽

Francois Le Loarer ◽

...

Keyword(s):

Soft Tissue ◽

Neoadjuvant Chemotherapy ◽

Soft Tissue Sarcoma ◽

Performance Status ◽

Locally Advanced ◽

Phase Iii ◽

Prognostic Impact ◽

Histological Response ◽

Dce Mri ◽

Genetic Features

11014 Background: Two large phase III studies have shown an improved overall survival in soft-tissue sarcoma (STS) pts treated with neoadjuvant chemotherapy. The prognostic impact of pathologic response is not known neither the clinical, radiological and genetic features associated with response. Methods: Data from pts with localized STS of the extremities or trunk wall and treated with anthracyline-based NAC at Institut Bergonie (Bordeaux, France) were reviewed. Central pathology (diagnosis, histological response) and radiology (MRI, DCE-MRI) reviews were performed for all the cases. A good histological response (GR) was defined as <10% residual viable tumor. Exome and RNA sequencing of pre-treatment tumor samples was performed in order to identify genetic aberrations predictive of response. Results: 150 patients (88 male) were included in the study. Median age was 60 years (17-84). 40 pts (26.7%) were good responders. GR was associated with undifferentiated pleomorphic sarcomas and very large tumors (> 20 cm). Median OSwas 10.3 year [IC95 : 5.8 ; 14.9]. On multivariate analysis, only GR (HR= 0.36, 95%CI 0.184-0.703, p=0.0028) and performance status (PS) (HR= 3.799, 95%CI 1.72-8.387, p=0.001 for PS=2-3) were prognostic factors for OS. Early DCE- MRI parameters (after 2 cycles of treatment) such as, area under the contrast concentration vs. time curve for 90 seconds after contrast injection ( IAUC90) were strongly associated with histological response (p=0.027) whereas RECIST 1.1 was not. Conclusions: As for bone sarcomas, histological response to NAC is a crucial prognostic factor in STS. Multiparametric MRI parameters obtained post-2nd cycle of NAC are predictive of histological response and should be considered to adjust the therapeutic strategy. Genetic features (including the CINSARC signature) associated with response to NAC will be presented at the meeting.

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Low HIF-1α and low EGFR mRNA Expression Significantly Associate with Poor Survival in Soft Tissue Sarcoma Patients; the Proteins React Differently

International Journal of Molecular Sciences ◽

10.3390/ijms19123842 ◽

2018 ◽

Vol 19 (12) ◽

pp. 3842 ◽

Cited By ~ 4

Author(s):

Swetlana Rot ◽

Helge Taubert ◽

Matthias Bache ◽

Thomas Greither ◽

Peter Würl ◽

...

Keyword(s):

Regression Analysis ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Protein Level ◽

Poor Prognosis ◽

Prognostic Impact ◽

Mrna Levels ◽

Increased Risk ◽

Cox's Regression ◽

Low Levels

In various tumors, the hypoxia inducible factor-1α (HIF-1α) and the epidermal growth factor-receptor (EGFR) have an impact on survival. Nevertheless, the prognostic impact of both markers for soft tissue sarcoma (STS) is not well studied. We examined 114 frozen tumor samples from adult soft tissue sarcoma patients and 19 frozen normal tissue samples. The mRNA levels of HIF-1α, EGFR, and the reference gene hypoxanthine phosphoribosyltransferase (HPRT) were quantified using a multiplex qPCR technique. In addition, levels of EGFR or HIF-1α protein were determined from 74 corresponding protein samples using ELISA techniques. Our analysis showed that a low level of HIF-1α or EGFR mRNA (respectively, relative risk (RR) = 2.8; p = 0.001 and RR = 1.9; p = 0.04; multivariate Cox´s regression analysis) is significantly associated with a poor prognosis in STS patients. The combination of both mRNAs in a multivariate Cox’s regression analysis resulted in an increased risk of early tumor-specific death of patients (RR = 3.1, p = 0.003) when both mRNA levels in the tumors were low. The EGFR protein level had no association with the survival of the patient’s cohort studied, and a higher level of HIF-1α protein associated only with a trend to significance (multivariate Cox’s regression analysis) to a poor prognosis in STS patients (RR = 1.9, p = 0.09). However, patients with low levels of HIF-1α protein and a high content of EGFR protein in the tumor had a three-fold better survival compared to patients without such constellation regarding the protein level of HIF-1α and EGFR. In a bivariate two-sided Spearman’s rank correlation, a significant correlation between the expression of HIF-1α mRNA and expression of EGFR mRNA (p < 0.001) or EGFR protein (p = 0.001) was found, additionally, EGFR mRNA correlated with EGFR protein level (p < 0.001). Our results show that low levels of HIF-1α mRNA or EGFR mRNA are negative independent prognostic markers for STS patients, especially after combination of both parameters. The protein levels showed a different effect on the prognosis. In addition, our analysis suggests a possible association between HIF-1α and EGFR expression in STS.

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Uric acid levels in blood are associated with clinical outcome in soft-tissue sarcoma patients

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2014-0486 ◽

2015 ◽

Vol 53 (3) ◽

Cited By ~ 3

Author(s):

Joanna Szkandera ◽

Armin Gerger ◽

Bernadette Liegl-Atzwanger ◽

Michael Stotz ◽

Hellmut Samonigg ◽

...

Keyword(s):

Uric Acid ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Clinical Outcome ◽

Colorimetric Assay ◽

Univariate Analysis ◽

Cost Effective ◽

Prognostic Impact ◽

Cancer Specific Survival ◽

Kaplan Meier

AbstractRecent evidence indicates toward a role of uric acid (UA) as a potential antioxidant. Elevated UA levels were shown to be associated with better survival in various malignancies. The aim of the present study was to evaluate the prognostic relevance of pre-operative UA levels on cancer-specific survival (CSS) in soft-tissue sarcoma (STS) patients who underwent curative surgical resection.Three hundred and fifty-seven patients with STS were included in the study. Pre-operative serum UA level was measured using an enzymatic colorimetric assay. The effect of UA levels on CSS was analyzed using Kaplan-Meier curves. To further evaluate the prognostic impact of UA levels, univariate and multivariate Cox proportional models were calculated.Among the 357 STS patients, cancer-related deaths occurred in 20 (24.7%) of 81 patients with a serum UA level <279.6 µmol/L and in 36 (13%) of 276 patients with a UA level ≥279.6 µmol/L. In univariate analysis, elevated UA levels were significantly associated with increased CSS in STS patients [hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.26–0.77, p=0.004]. Furthermore, elevated UA levels remain a significant factor for better CCS in multivariate analysis (HR 0.42, 95% CI 0.23–0.75, p=0.003).Our study is the first one to demonstrate that higher UA levels are associated with positive clinical outcome in STS patients. UA levels are a simple and cost-effective test for the assessment of the prognosis of STS patients.

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