Can Multistate Modeling of Local Recurrence, Distant Metastasis, and Death Improve the Prediction of Outcome in Patients With Soft Tissue Sarcomas?

Posch, Florian; Leitner, Lukas; Bergovec, Marko; Bezan, Angelika; Stotz, Michael; Gerger, Armin; Pichler, Martin; Stöger, Herbert; Liegl‐Atzwanger, Bernadette; Leithner, Andreas; Szkandera, Joanna

doi:10.1007/s11999-017-5232-x

“…A composite of either local or distant recurrence and death from any cause, that is, recurrence‐free survival (RFS), was specified as a secondary endpoint. Overall survival and recurrence‐free survival were estimated using Kaplan–Meier product limit estimator, whereas the cumulative risk of death from sarcoma was calculated using a competing risk approach, incorporating death from other causes as a competing event . In detail, we applied cumulative incidence estimators with confidence intervals according to Marubini and Valsecchi (Stata program stcompet) .…”

Section: Methodsmentioning

confidence: 99%

“…According to the latest WHO classification for soft tissue tumors, including new insights on molecular genetic and cytogenetic characterization of STS, myofibroblastic and fibroblastic tumors have been subclassified as a separate STS category . Although the prognosis for these type of soft tissue sarcomas is relatively favorable compared to other STS after surgical resection, a proportion of patients will develop local recurrence and/or distant metastasis with a reported 5‐year overall survival ranging from 57% to 84% …”

mentioning

confidence: 99%

Serum creatinine and albumin predict sarcoma‐specific survival in patients with myofibroblastic and fibroblastic sarcomas

Willegger

¹

,

Posch

²

,

Schieder

³

et al. 2017

Journal Orthopaedic Research

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Recent evidence suggests that common prognostic factors predicting disease progression and survival in soft tissue sarcomas (STS) are not applicable to all STS entities, indicating the need for histotype specific evaluation of new prognosticators. This study aimed at evaluating preoperative serum creatinine, albumin, and the albumin-creatinine ratio (ACR) as markers for survival in patients with malignant fibroblastic and myofibroblastic sarcomas. One hundred and thirty-two patients who underwent sarcoma resection have been included. Statistical analysis comprised uni- and multivariable Cox proportional hazard models, competing risk analysis and Kaplan-Meier estimates. The 5-year overall survival (OS) was estimated at 64.1% (95%CI: 53.7-72.8) and the 5-year sarcoma-specific mortality was 19.9% (95%CI: 12.8-28.1). Elevated serum creatinine levels were significantly associated with an impaired sarcoma-specific survival (SSS) adjusted for tumor stage (subdistribution hazard ratio (SHR) per 1 mg/dl increase: 3.27; 95%CI: 1.87-5.73; p < 0.0001). Low serum albumin levels were associated with a shorter recurrence-free survival (RFS) experience (HR per 10 g/L increase: 0.62; 95%CI: 0.41-0.94; p = 0.024). The ACR emerged as an AJCC-stage-independent prognosticator of SSS (SHR per 1 unit increase: 0.94; 95%CI: 0.90-0.98; p = 0.003). In conclusion, serum albumin and creatinine have been confirmed as predictive biomarkers for disease-specific outcomes in myofibroblastic and fibroblastic sarcomas. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2815-2824, 2017.

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“…[5,7,8,9] Surgery accompanied by adjuvant radiotherapy as needed is the gold standard for achieving local control of STS. [3,5,7,[9][10][11][12] The role of chemotherapy in the cure of STS is underrecognized, but it is currently improving. [5,13] The aim of surgery and radiotherapy is local control of the STS, whereas the aim of chemotherapy is systemic control as curative, supportive, or palliative therapy.…”

Section: Introductionmentioning

confidence: 99%

Using Different Parts Of Surgical Gloves For Non-Absorptive Drainage Of Fingers In Hand Surgery

Akgun¹

2016

Kartal TR

0

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Objective: Soft tissue sarcoma (STS) is a very rare, heterogeneous, solid tumor of mesenchymal origin that accounts for about 1% of adult malignancies and 15% of pediatric malignancies. The aim of this study was to analyze the data of STS patients who were treated with surgery and preoperative radiotherapy, postoperative radiotherapy, or chemotherapy between 2010 and 2017 for prognostic factors. Methods:The study included 22 patients with a diagnosis of any type of STS who were treated at a training and research hospital between 2010 and 2017. Data regarding patient age and sex, histological type of the tumor, tumor size, tumor localization, tumor grade, time of radiotherapy (preoperative or postoperative), prescribed radiation dose, chemotherapy treatment regime, length of follow-up, survival, and recurrence of the tumor were analyzed.Results: A total of 22 patients with a mean age of 60.5±16.2 years (range: 34-86 years) were included in the study. In all, 54.5% of the group had a high-grade sarcoma. The mean follow-up for all 22 patients was 34.1±22.4 months (range: 5-98 months), with a median of 28.0 months. The mean overall survival (OS) was 82.3±8.3 months (range: 66.0-98.6). The 3-year OS rate was 78.4%. The mean recurrence-free survival (RFS) was 72.5±8.8 months (range: 55.0-89.5 months) and the 3-year RFS rate was 69.3%. Conclusion:The OS was lower in the group that received chemotherapy and in cases of larger tumors. Preoperative or postoperative administration of radiotherapy did not have any significant effect on OS or RFS. Studies with larger samples are needed to further define the effects of radiotherapy and chemotherapy on OS and complications.

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“…[2,3,5,6] Recent studies have indicated that grade, tumor size, surgical margins, histology, location, radiotherapy, age, and sex are important prognostic factors for STS. [5,7,8,9] Surgery accompanied by adjuvant radiotherapy as needed is the gold standard for achieving local control of STS. [3,5,7,[9][10][11][12] The role of chemotherapy in the cure of STS is underrecognized, but it is currently improving.…”

Section: Introductionmentioning

confidence: 99%

“…[5,7,8,9] Surgery accompanied by adjuvant radiotherapy as needed is the gold standard for achieving local control of STS. [3,5,7,[9][10][11][12] The role of chemotherapy in the cure of STS is underrecognized, but it is currently improving. [5,13] The aim of surgery and radiotherapy is local control of the STS, whereas the aim of chemotherapy is systemic control as curative, supportive, or palliative therapy.…”

Section: Introductionmentioning

confidence: 99%

Retrospective evaluation of the geriatric oncology cases hospitalized in our clinic

Erdem¹

2015

Kartal TR

1

0

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Objective: Soft tissue sarcoma (STS) is a very rare, heterogeneous, solid tumor of mesenchymal origin that accounts for about 1% of adult malignancies and 15% of pediatric malignancies. The aim of this study was to analyze the data of STS patients who were treated with surgery and preoperative radiotherapy, postoperative radiotherapy, or chemotherapy between 2010 and 2017 for prognostic factors. Methods:The study included 22 patients with a diagnosis of any type of STS who were treated at a training and research hospital between 2010 and 2017. Data regarding patient age and sex, histological type of the tumor, tumor size, tumor localization, tumor grade, time of radiotherapy (preoperative or postoperative), prescribed radiation dose, chemotherapy treatment regime, length of follow-up, survival, and recurrence of the tumor were analyzed.Results: A total of 22 patients with a mean age of 60.5±16.2 years (range: 34-86 years) were included in the study. In all, 54.5% of the group had a high-grade sarcoma. The mean follow-up for all 22 patients was 34.1±22.4 months (range: 5-98 months), with a median of 28.0 months. The mean overall survival (OS) was 82.3±8.3 months (range: 66.0-98.6). The 3-year OS rate was 78.4%. The mean recurrence-free survival (RFS) was 72.5±8.8 months (range: 55.0-89.5 months) and the 3-year RFS rate was 69.3%. Conclusion:The OS was lower in the group that received chemotherapy and in cases of larger tumors. Preoperative or postoperative administration of radiotherapy did not have any significant effect on OS or RFS. Studies with larger samples are needed to further define the effects of radiotherapy and chemotherapy on OS and complications.

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Can Multistate Modeling of Local Recurrence, Distant Metastasis, and Death Improve the Prediction of Outcome in Patients With Soft Tissue Sarcomas?

Abstract: Level III, therapeutic study.

Cited by 31 publications

References 14 publications

Serum creatinine and albumin predict sarcoma‐specific survival in patients with myofibroblastic and fibroblastic sarcomas

Serum creatinine and albumin predict sarcoma‐specific survival in patients with myofibroblastic and fibroblastic sarcomas

Using Different Parts Of Surgical Gloves For Non-Absorptive Drainage Of Fingers In Hand Surgery

Retrospective evaluation of the geriatric oncology cases hospitalized in our clinic

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