Multivariate analysis for clinical prognostic factors in 163 patients with soft tissue sarcoma

Abstract

Clinical and histologic findings in 163 patients with localized soft tissue sarcoma (STS) in the extremities and trunk were reviewed. There were 91 male patients and 72 female patients ranging in age from 2 to 84 years (median, 46 years). The histologic status of the tumors was as follows: low grade, 29 cases; intermediate grade, 52 cases; and high grade, 82 cases. The primary tumors were treated by intralesional excision (two cases), marginal (88), wide local (52), or amputation (21). Subsequent adjuvant therapy was given to 61 patients; 17 had radiotherapy (RT), 27 had chemotherapy (CH), and 17 had combined RT and CH. The overall survival (P less than 0.1) and disease-free survival (P less than 0.001) were better in the group that received multimodal treatment (radical surgery and adjuvant chemotherapy with or without radiotherapy) than in the group treated only by surgery. This suggests the favorable role of adjuvant therapy. The univariate and the Cox multivariate analysis for prognosis revealed that sex, tumor-related symptoms, tumor size, tumor depth, and histologic grade were the significant factors. Among the treatment schemes, adjuvant chemotherapy was the only one that affected survival, especially for the intermediate-grade tumors. Initial surgical treatment (marginal versus wide local excision) significantly contributed to the local control of the primary tumors.

Sarcomas in north west England: III Survival

“…overall had a slightly better 5-year survival rate than males (36% vs 32%), the difference was reversed for bone tumour patients (51% vs 32%) but neither difference was statistically significant. Better survival in female soft tissue sarcoma patients has been noted by R66ser et al (1988), Ueda et al (1988) and El-Jabbour et al (1990), but no difference was apparent in other series (Bramwell et al, 1985;Collin et al, 1987). The most consistent finding in these analyses was the better prognosis for younger patients as reported by other investigators (Bramwell et al, 1985;Collin et al, 1987;ElJabbour et al, 1990).…”

“…histological grade, size, depth, degree of necrosis etc. (Trojani et al, 1984;Rooser et al, 1988;Ueda et al, 1988;Mandard et al, 1989) [ion or on various treatment modalities (Markhede et al, 1982;Bramwell et al, 1985;Suit et al, 1985). In addition, most of tl in sarcoma patients is difficult to assess reliably these observations have been made on hospital-based or on of the rarity of such tumours, their differing toposelected sub-sets of population-based series.…”

Prognostic factors for survival in soft tissue sarcoma

“…The prognostic significance of symptoms has been reported by Collin et al (1987) and Ueda et al (1988). Heise et al (1986) found a higher recurrence-free survival in patients presenting with mass as compared with other symptoms.…”

“…Heise et al (1986) found a higher recurrence-free survival in patients presenting with mass as compared with other symptoms. The wide range of duration of symptoms has been shown by others (Bramwell et al, 1985;Ueda et al, 1988) and probably relates to the fact that many patients ignore any swelling not accompanied by pain. In our series there was an association of symptoms with site and they did not prove to be of prognostic significance.…”

“…Since then other authors (Mandard et al, 1989;Rooser et al, 1988;Trojani et al, 1984) have, like us, shown it to be an independent prognostic factor. Assessment of the extent of necrosis is the most subjective and difficult of the criteria used in grading (Costa et al, 1984;Trojani et al, 1984 (Mandard et al, 1989;Ueda et al, 1988) and site (Collin et al, 1987;Markhede et al, 1982) is well documented in the literature. In this study, size was an independent prognostic factor in the superficial STS but not in either the overall group or the deep STS.…”