Impact of infiltrative growth on the outcome of patients with undifferentiated pleomorphic sarcoma and myxofibrosarcoma

Iwata, Shintaro; Yonemoto, Tsukasa; Araki, Atsuko; Ikebe, Dai; Kamoda, Hiroto; Hagiwara, Yoko; Ishii, Takeshi

doi:10.1002/jso.23708

Cited by 62 publications

(52 citation statements)

References 15 publications

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“…Therefore, the exclusion of low-grade sarcomas might account for the contrasting results to some previous studies. Furthermore, previous studies have demonstrated that tumor depth and histological grade were predictive factors for metastasis and survival, which could explain our findings that growth patterns were associated with inferior disease-specific and metastasis-free survivals [10,16–18]. It should be interesting whether adjuvant therapy, such as chemotherapy and radiotherapy, is effective for tumor control in patients with infiltrative growth pattern.…”

Section: Discussionmentioning

confidence: 54%

“…Low-grade MFS is unusual among low-grade sarcomas because it often recurs relentlessly and multiplies after surgical resection, despite gross negative margins and wide surgical resection [12,15]. On the other hand, Iwata et al excluded patients with low-grade MFS, and reported that an infiltrative growth pattern was significantly correlated with poor disease-specific and metastasis-free survival rates, but was not associated with poor local control [10]. Therefore, the exclusion of low-grade sarcomas might account for the contrasting results to some previous studies.…”

Section: Discussionmentioning

confidence: 99%

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Infiltrative tumor growth patterns on magnetic resonance imaging associated with systemic inflammation and oncological outcome in patients with high-grade soft-tissue sarcoma

et al. 2017

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ObjectiveThe aim of this study was to determine whether the tumor infiltrative growth pattern on magnetic resonance imaging (MRI) was associated with blood inflammatory markers (C-reactive protein; CRP and Neutrophil-lymphocyte ratio; NLR) and survival in patients with high-grade soft-tissue sarcoma (STS).MethodsThe cohort for this retrospective study included 81 patients with a mean age of 63 years. The tumor depth was superficial or deep in 15 and 66 patients, respectively. The mean CRP and NLR were 1.31 mg/dL and 2.81, respectively. The assessment of a peripheral growth pattern which divided into three patterns on MRI was based on the largest midsection of the tumor.ResultsOn MRI scans, diffuse-type, focal-type, and pushing-type growth patterns were observed in 18, 33, and 30 patients, respectively. Superficial high-grade STS were prone to show a focal-type pattern on MRI. There were no correlations between growth pattern type and clinicopathological factors such as age, sex, tumor size, and histological grade. However, the incidence of infiltrative growth was significantly higher in patients with elevated CRP (p = 0.0002). In multivariate analysis, growth pattern and CRP were independent prognostic factors for disease-specific survival, metastasis-free survival. Growth pattern was also related to local tumor control.ConclusionsThere were significant associations between the tumor growth pattern and CRP levels in patients with high-grade soft-tissue sarcoma. An infiltrative growth pattern and elevated CRP may be associated with inferior disease-specific and metastasis-free survival rates in these patients. Therefore, careful post-treatment follow-up should be conducted in such patients.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Infiltrative tumor growth patterns on magnetic resonance imaging associated with systemic inflammation and oncological outcome in patients with high-grade soft-tissue sarcoma

et al. 2017

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“…[3,9,13,14] Intralesional or marginal excision is associated with a high local recurrence rate and metastasis. [9] Although adjuvant chemotherapy has been shown to improve the survival rate and reduce the incidence of metastasis, [9] chemotherapy alone is not successful without adequate resection.…”

Section: Discussionmentioning

confidence: 99%

Primary malignant fibrous histiocytoma of long bones: long-term follow-up

Özkurt

Başarır

Yıldız

et al. 2016

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu çalışmada malign fibröz histiyositoma tanılı hastalar değerlendirildi ve sağkalım süresi ile ilişkili muhtemel prognostik faktörler araştırıldı. Hastalar ve yöntemler: Mayıs 1994 -Eylül 2013 tarihleri arasında yapılan çalışmaya malign fibröz histiyositoma tanılı 14 hasta (12 erkek, 2 kadın; ortanca 48 yıl; dağılım 17-64 yıl) dahil edildi. Hastaların demografik özellikleri, patolojinin yeri, histolojik bulgular, cerrahi sınırlar ve tedavi yöntemleri değerlendirildi ve bu parametrelerin sağkalım üzerindeki etkileri araştırıldı.Bulgular: En sık tutulan kemik femur idi, bunu tibia ve humerus izledi. Hastaların takip süresi ortanca 129 ay idi. On üç hastada ekstremite koruyucu cerrahi ve bir hastada amputasyon uygulandı. Üç hastada cerrahi sınırlar marjinal idi ve hastalığın lokal kontrolü için ameliyat sonrası radyoterapi uygulandı. Bu hastalarda hiç lokal nüks olmasa da iki hastada uzak metastaz gelişti, bu da cerrahi sınırın sağkalım üzerinde etkili önemli bir faktör olduğunu ortaya çıkardı. Beş yıllık sağkalım oranı geniş cerrahi sınırları olan hastalarda %81.9, marjinal sınırları olan hastalarda %33.3 idi. Sonuç: Geniş sınırlarla cerrahi eksizyon ve adjuvan kemoterapi yeterli hastalık kontrolü ve daha uzun sağkalım sağladı. Sağkalım süresi ile istatistiksel olarak anlamlı şekilde ilişkili tek prognostik faktör cerrahi sınırlar idi. Damar ve sinir yapılarıyla yakın ilişki nedeniyle cerrahi sırasında yeterli geniş cerrahi sınır elde edilememe şüphesi olduğunda, neoadjuvan kemoterapi kullanılabilir.

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“…A recent study described the frequent presence of curvilinear signal extensions from the main mass of MFS, so‐called “tail sign”, using magnetic resonance imaging (MRI), and some other studies also showed that this tail sign was frequently found in both UPS and MFS . This infiltrative pattern of MFS and UPS via MRI correlates well with macroscopic or microscopic tumor extension along the fascia or fibrous septa of subcutaneous fat .…”

mentioning

confidence: 94%

Prognostic significance of microscopic tumor extension in local recurrence of myxofibrosarcoma and undifferentiated pleomorphic sarcoma

Song

Lee

et al. 2018

Pathology International

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Myxofibrosarcoma (MFS) and undifferentiated pleomorphic sarcoma (UPS) frequently display infiltrative growth into the adjacent normal soft tissue. In this study, we aimed to determine whether the microscopic extension into surrounding normal tissue can influence the local recurrence of MFS and UPS. A total of 42 cases (22 MFS and 20 UPS) were examined. The length of the microscopic extension was measured from the edge of the main tumor mass to the end of infiltration. The length of 5.5 mm was selected as the optimal cut-off value that could predict local recurrence using the receiver operating characteristic (ROC) curve and Youden index. Longer length of microscopic extension was significantly correlated with the status of resection margin (P = 0.032). The group with longer length of microscopic extension (>5.5 mm) had significantly worse recurrence-free survival than the group with shorter length of microscopic extension (≤5.5 mm) (P = 0.000). Multivariate analysis revealed that the length of microscopic extension was independent predictors of recurrence-free survival (P = 0.018). In conclusion, microscopic extensions at the edge of the main mass into the surrounding normal tissue were observed in most MFS and UPS patients, and the length of microscopic extension was associated with local recurrence.

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Impact of infiltrative growth on the outcome of patients with undifferentiated pleomorphic sarcoma and myxofibrosarcoma

Abstract: Infiltrative growth was an adverse prognostic factor for not only local control, but also disease-specific and metastasis-free survival in patients with UPS and MFS. Radiotherapy could not salvage inadequately resected infiltrative tumors.

Cited by 62 publications

References 15 publications

Infiltrative tumor growth patterns on magnetic resonance imaging associated with systemic inflammation and oncological outcome in patients with high-grade soft-tissue sarcoma

Infiltrative tumor growth patterns on magnetic resonance imaging associated with systemic inflammation and oncological outcome in patients with high-grade soft-tissue sarcoma

Primary malignant fibrous histiocytoma of long bones: long-term follow-up

Prognostic significance of microscopic tumor extension in local recurrence of myxofibrosarcoma and undifferentiated pleomorphic sarcoma

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