Prognostic Significance of Histological Subtype in Soft Tissue Sarcoma With Distant Metastasis

Tsuchie, Hiroyuki; Emori, Makoto; Miyakoshi, Naohisa; Nagasawa, Hiroyuki; Okada, Kyoji; Murahashi, Yasutaka; Emi, Mitsuru; Shimizu, Junya; Yamashita, Toshihiko; Shimada, Yasuhiro

doi:10.21873/invivo.11994

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…Although surgery is invasive, removing the BM lesion improves performance status, and a pathological diagnosis is obtained. Moreover, Tsuchie et al reported that removing distant metastatic lesions surgically is important to improve the patient's prognosis (35). However, surgery alone may not be enough to prolong the patient's survival and is likely to cause recurrence of BM lesions.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of the Patients With Brain Metastasis from Soft Tissue Sarcomas

et al. 2021

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Background/Aim: This study aimed to evaluate the association of clinical characteristics with treatment outcomes to ascertain the appropriate treatment options for soft tissue sarcomas (STS) patients with brain metastasis (BM). Patients and Methods: Medical records of STS patients with BM who were treated in our institutions were retrospectively reviewed, and analyzed to identify the factors associated with post-BM survival. Results: Among the 509 STS patients, BM occurred in five patients (0.98%). The median survival after BM was 1.5 months. Histological subtypes of the primary lesions in the five BM patients were: two synovial sarcomas, one myxoid liposarcoma, one alveolar soft part sarcoma, and one rhabdomyosarcoma. Among the five BM patients, the post-BM survival of two patients, who underwent surgery and postoperative radiotherapy, was longer than that of the other patients (p<0.01). Conclusion: Combined surgery and postoperative radiotherapy effectively managed symptoms and prolonged survival in STS patients with BM.Soft tissue sarcomas (STS) are uncommon and heterogeneous cancers of mesenchymal origin, representing approximately 1% of cancers in the adult population (1). Although adequate wide resection is the dominant curative therapy for primary STS (2), a multidisciplinary approach using chemotherapy and/or radiotherapy should be considered as pre-or post-operative adjuvant therapies (3). Half of patients with high-grade STS have been reported to die from metastatic disease, which may present as microscopic foci at the time of primary diagnosis (4). This is especially true in the lung, which is the most common site of distant metastasis (5). Brain metastasis (BM) in STS is rarely encountered, with a reported incidence of 1-8% (6-14). However, its incidence has been increasing due to advances in chemotherapeutic agents and diagnostic imaging technology (15). BM significantly affects the quality of life (QOL) and the prognosis of the patients. The mean overall survival after BM has been reported to be 1.8 to 11.8 months (6,7,9,(11)(12)(13)(15)(16)(17)(18). Therefore, early diagnosis and effective treatment are crucial for BM patients. Valid treatment options for BM are surgery, radiotherapy, chemotherapy, and their combination. Previous reports have demonstrated that surgery and postoperative radiotherapy prolonged survival after BM, and it may be widely accepted as a standard treatment approach for BM from STS (19,20). However, the appropriate treatment for each patient is still controversial due to the limited information available.In the present study, we retrospectively reviewed BM in STS patients to clarify the prognostic factors that may affect post-BM survival in patients. We focused on the appropriate treatment for each patient. Patients and MethodsEthical considerations. This study was approved by the Ethics Review Board of our institutions (#B190213). Informed consent was obtained in the form of an opt-out system. Those who rejected were excluded.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcome of the Patients With Brain Metastasis from Soft Tissue Sarcomas

et al. 2021

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“…The immune-mediated response to autologous vaccinations, as described by Goldberg and colleagues (19), also provides new treatment opportunities. However, we must emphasise that CCS is an aggressive subtype of soft tissue sarcoma and better treatments are urgently needed (21).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Gemcitabine-based Chemotherapy in Clear Cell Sarcoma of Soft Tissue

et al. 2020

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Background/Aim: Clear cell sarcoma (CCS) is an aggressive sarcoma subtype, resistant to conventional anthracycline-based chemotherapy and radiation. The diagnosis is often challenging due to similarities with malignant melanoma. Patients and Methods: We aimed to analyse the activity of gemcitabine-based chemotherapy in a cohort of patients with CCS treated at the Royal Marsden Hospital. Results: Five patients with metastatic CCS received gemcitabine as first-or second-line systemic therapy. The median time-to-progression was 10 weeks. The median number of cycles of gemcitabine-based therapy was 3 (range=2-7 cycles). Median overall survival in our cohort was 66 months from the initial diagnosis but in the metastatic setting, the overall survival was reduced to 28 months. Conclusion: Gemcitabine-based therapy has modest activity in CCS. There remains a significant unmet medical need for novel, effective therapies for this disease.

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Myxoid liposarcoma originating in the retroperitoneum with metastasis to the calcaneus: a rare case report and review of literature

et al. 2022

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Prognostic Significance of Histological Subtype in Soft Tissue Sarcoma With Distant Metastasis

Cited by 5 publications

References 15 publications

Clinical Outcome of the Patients With Brain Metastasis from Soft Tissue Sarcomas

Clinical Outcome of the Patients With Brain Metastasis from Soft Tissue Sarcomas

Efficacy of Gemcitabine-based Chemotherapy in Clear Cell Sarcoma of Soft Tissue

Myxoid liposarcoma originating in the retroperitoneum with metastasis to the calcaneus: a rare case report and review of literature

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