No abstract

Background: Undifferentiated pleomorphic sarcoma (UPS) is a rare malignant tumour of mesenchymal origin, which was conceived following re-classification of malignant fibrous histiocytoma (MFH). The objective of this study is to determine prognostic factors for the outcome of UPS, following multi-modal treatment. Methods: Data of UPS tumours from 1996 to 2016 were collected, totalling 266 unique UPS patients. Median follow-up was 7.8 years. All tumours were retrospectively analysed for prognostic factors of the disease, including local recurrence (LR) and metastatic disease (MD) at diagnosis, tumour size, grade, location and depth, patient age, adjuvant therapy and surgical margin. Overall survival (OS), post-treatment LR and metastatic-free survival were assessed as outcomes. Results: The 5-and 10-year OS rates for all ages were 60% and 48%, respectively, with a median survival time of 10.1 years. Multivariate analysis revealed that the adverse prognostic factors associated with decreased OS were older age (P < 0.001; hazard ratio 1.03) and MD at diagnosis (P = 0.001; 2.89), with upper extremity tumours being favourable (P = 0.043; 2.30). Poor prognosis for post-operative LR was associated with older age (P = 0.046; 1.03) and positive surgical margins (P = 0.028; 2.68). Increased post-treatment MD was seen in patients with large tumours (5-9 cm (P < 0.001; 4.42), ≥10 cm (P < 0.001; 6.80)) and MD at diagnosis (P < 0.001; 3.99), adjuvant therapy was favourable, shown to reduce MD (P < 0.001; 0.34). Conclusions: UPS is a high-grade soft tissue sarcoma, for which surgery striving for negative margins, with radiotherapy, is the treatment of choice. Older age, lower extremity location, MD at presentation, large size and positive surgical margins, were unfavourable.

The practice of delaying children's entry into a kindergarten program 1 year beyond the traditional chronolgical age of their classmates is a controversial issue. although this practice has been said to reduce the need for grade retentions and special education services, the research literature has yielded contradictory results about the effects of delayed entry on students. the present study examined the effects of delayed entry in one suburban new york school district on later elementaryschool grade retention and special education service rates. in addition, the influence of gender on the practice of delayed entry was investigated. the sample for this study consisted of all students (n = 3,238) who were enrolled in grades 1 through 12; from this, a subsample of all children (n = 279) who had delayed school entry were identified, and their records were examined for future retentions and use of special education services. it was found that students who delayed school entry were most often male and were placed in special education programs in significantly higher proportions than nondelayed-entry students. no significant effect of delayed entry was noted for retention.