Prognostic factors of patients with extremity myxoid liposarcomas after surgery

Abstract

Background Extremity myxoid liposarcoma (MLS) is a rare soft tissue sarcoma in adults. We performed this study to define distinctive clinical features of extremity MLS by assessing prognostic factors. Methods Between 1973 and 2015, 1756 patients with extremity MLS who underwent surgical resection were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database of the US National Cancer Institute. Both overall survival (OS) and cancer-specific survival (CSS) were assessed using the Kaplan–Meier method (to obtain OS and CSS curves) and a Cox proportional hazards regression model. Results Of the 1756 patients with extremity MLS, the mean and median patient age at diagnosis were 47 and 45 years, respectively. More than half ( n = 1027, 58.5%) of the patients were male. In terms of location, 10.5% tumors were located in the upper limbs and 89.5% in lower limbs. All patients received local surgery, and about half of the patients (57.2%) received radiation treatment. The 5- and 10-year OS rates of the entire cohort were 86.4% and 75.9%, respectively. The 5- and 10-year CSS rates were 90.5% and 85.2%, respectively. On multivariate analysis, older age, male gender, high tumor grade, and tumor size > 10 cm were found to be independent risk factors of both decreased OS and CSS. Year of diagnosis ≥ year 2000 was significantly associated with an increased CSS. In addition, radiation treatment failed to become an independent risk factor for either OS or CSS. Conclusion We identified age, gender, tumor grade, year of diagnosis, and tumor size as independent prognostic factors for OS and CSS in patients with extremity MLS.

Nomogram for predicting the overall survival and cancer-specific survival of patients with extremity liposarcoma: a population-based study

“…Previous studies have identified large tumor size as an indicator of poor prognosis for extremity STS patients [3,10,13,14,22], consistent with the present research. This is probably because a large tumor size is related to higher biologic malignancy, including regional invasiveness and metastatic potential.…”

“…Currently, the American Joint Committee on Cancer (AJCC) system, known as the TNM staging system, remains the gold standard for prognostic prediction for tumor patients. However, other elements that have been reported to be prognostic factors for extremity STS patients are not taken into consideration in the TNM staging system, such as patient factors (including age and sex), tumor characteristics (including tumor grade, histologic subtype, and tumor location), and treatment strategies (including surgery, radiotherapy, and chemotherapy) [7,[9][10][11][12][13][14][15]. More importantly, the TNM staging system is unable to meet the increasing need for precision medicine and cannot provide individual predictions of prognosis at specific times [16,17].…”

Individualizing Follow-Up Strategies in High-Grade Soft Tissue Sarcoma with Flexible Parametric Competing Risk Regression Models

“…Potentially due to the application of the present statistical model, interesting results emerged: Female gender was independently associated with a significantly lower risk of LR and DM. An association between gender and overall survival (OS) has been observed by Maretty-Nielsen et al and Wu et al [2,23]. However, an association between gender and LR-free as well as DM-free survival has not been described thus far [24].…”

Increasing Incidence of Liposarcoma: A Population-Based Study of National Surveillance Databases, 2001–2016

“…Smith et al showed no sex differences among well-differentiated liposarcoma in the overall and disease-specific survival [11]. However, another study that examined survival among patients with extremity myxoid liposarcomas, showed males as being a negative survival predictor [9]. For all cancer types overall, the increased cancer risk and poor survival among males has been established by population-based data [27][28][29].…”