Malignant fibrous neoplasms of long bones: analysis of the surveillance, epidemiology, and end results database from 1973 to 2015

Abstract

Background: Malignant fibrous neoplasms (MFN) of long bones are rare lesions. Moreover, the prognostic determinants of MFN of long bones have not been reported. This study aimed to present epidemiological data and analyse the prognostic factors for survival in patients with MFN. Materials and methods: The Surveillance, Epidemiology, and End Results (SEER) programme database was used to screen patients with malignant fibrous neoplasms (MFN) of long bones from 1973 to 2015, with attention to fibrosarcoma, fibromyxosarcoma, periosteal fibrosarcoma and malignant fibrous histiocytoma. The prognostic values of overall survival (OS) and cancer-specific survival (CSS) were assessed using the Cox proportional hazards regression model with univariate and multivariate analyses. The Kaplan-Meier method was used to obtain OS and CSS curves. Results: A total of 237 cases were selected from the SEER database. Malignant fibrous histiocytoma was the most common form of lesion in long bones. Multivariate analysis revealed that independent predictors of OS included age, stage, tumour size and surgery. Age, stage, tumour size and surgery were also independent predictors of CSS. Additionally, the most significant prognostic factor was whether metastasis had occurred at the time of initial diagnosis. Conclusion: Among patients with MFN of long bones, age (> 60 years), tumour size (> 10 cm), distant stage, and non-surgical treatment are factors for poor survival.

Score for the Overall Survival Probability Scores of Fibrosarcoma Patients after Surgery: A Novel Nomogram-Based Risk Assessment System

“…Through univariate and multivariate analyses, we determined that age, race, tumor grade, and historic stage were closely associated with prognosis ( Table 2 ). We did not find that chemotherapy was an independent prognostic factor for OS, and the results were consistent with a recent study [ 26 ]. Based on this, a nomogram was created to facilitate clinical work ( Figure 2 ).…”

“…Adult fibrosarcoma occurs most frequently in the trunk and limbs, followed by the head and neck, consistent with our results [ 25 ]. Tumor size of malignant fibrous neoplasms (MFN) of long bones >10 cm is a poor prognostic factor for OS and cancer-specific survival [ 26 ]. A report on primary intracranial fibrosarcoma suggested that large tumor volume (≥5 cm) and high Ki-67 index (≥30%) were independent risk factors for OS [ 27 , 28 ].…”

Is the Number of National Database Research Studies in Musculoskeletal Sarcoma Increasing, and Are These Studies Reliable?

“…Of the 94 studies that shared a major study question with at least one other study, 35% (33 of 94) reported discordant key findings concerning 10 study questions [1, 6, 8, 11‐13, 18, 23, 26, 29, 36, 39‐41, 44, 49, 53, 59, 63, 67, 68, 72, 79, 83, 93, 95, 98‐100, 106, 109‐111] (Table 2), 29% (27 of 94) reported mixed key findings concerning six study questions [3, 7, 15, 19, 22, 25, 27, 28, 30, 35‐37, 43, 45, 47, 50, 56, 75, 76, 82, 88‐91, 103, 104, 107] (Table 3), and 44% (41 of 94) reported concordant key findings concerning 12 study questions [2, 4, 5, 14, 16‐18, 20, 24, 31, 33, 38, 42, 46, 48, 52, 57, 58, 61, 71, 74, 75, 77, 78, 81, 84‐87, 91, 92, 96, 97, 101, 102, 105, 106, 108, 110‐112] (Table 4). Of the 299 studies in total, 20% (59 of 299) reported discordant or mixed findings [1, 3, 6‐8, 11‐13, 15, 18, 19, 22, 23, 25‐30, 35‐37, 39‐41, 43‐45, 47, 49, 50, 53, 56, 59, 63, 67, 68, 72, 75, 76, 79, 82, 83, 88‐91, 93, 95, 98‐100, 103, 104, 106, 107, 109‐111] and 14% (41 of 299) reported concordant findings [2, 4, 5, 14, 16‐18, 20, 24, 31, 33, 38, 42, 46, 48, 52, 57, 58, 61, 71, 74, 75, 77, 78, 81, 84‐87, 91, 92, 96, 97, 101, 102, 105, 106, 108, 110‐112]. Examples of topics with discordant or mixed findings include the effect of radiation on survival in several sarcoma types and the influence of race on treatment and survival.…”