Clinicopathologic characteristics, treatment outcomes, and prognostic factors of primary thoracic soft tissue sarcoma: A multicenter study of the Anatolian Society of Medical Oncology (ASMO)

Abstract

BackgroundSoft tissue sarcomas (STSs) are rare malignant tumors of embryogenic mesoderm origin. Primary thoracic STSs account for a small percentage of all STSs and limited published information is available. This study aimed to identify the prognostic factors for thoracic STSs and evaluate the disease's clinical outcomes.MethodsThe medical records of 109 patients with thoracic STSs who were treated between 2003 and 2013 were retrospectively reviewed. Patients' survival rates were analyzed and potential prognostic factors evaluated.ResultsThe median follow-up period was 29 months (range: 1–121 months). STSs were most frequently localized on the chest wall (n = 42; 38.5%) and lungs (n = 42; 38.5%). The most common histological types were malignant fibrous histiocytoma (n = 23; 21.1%), liposarcoma (n = 17; 15.6%), and leiomyosarcoma (n = 16; 14.7%). The median survival time of all patients was 40.3 months (95% confidence interval, 14.22–66.37 months), with one and five-year survival rates of 93.4% and 63.5%, respectively. Univariate analysis of all groups revealed that metastatic stage, unresectability, tumor diameter of >10 cm, tumor location other than the chest wall, and grade 3 diseases were predictable of poor survival. However, only grade 3 diseases and tumor location other than the chest wall were confirmed by multivariate analysis as poor prognostic factors.ConclusionsPrimary thoracic STSs are rarely seen malignant tumors. Our results indicated that patients with low-grade tumors and those localized on the chest wall often experienced better survival outcomes.

Clinical Outcomes of Surgical Treatment for Primary Chest Wall Soft Tissue Sarcoma

“…Only a few studies of prognostic factors for CW-STS patient survival have been conducted, and those studies have produced inconsistent results because of the rarity of the disease. A multicenter study of the Anatolian Society of Medical Oncology suggested that patients with resectable and low-grade tumors might have better prognostic outcomes [13]. McMillan et al [14] reported that tumor grade was a significant factor influencing the survival rate and recurrence patterns in patients with CW-STS.…”

“…Duranti et al [16] evaluated 337 patients with resected thoracic STS and found that those with high-grade tumors, with pulmonary and mediastinal STS, and who had undergone R1 resection were more likely to experience poor outcomes than those with low-grade tumors, with CW-STS, and who had undergone R0 resection. Unal et al [13] reported that adjuvant chemotherapy increased the survival rate. In the present study, complete resection and stage were prognostic factors for predicting recurrence.…”

Primary intrathoracic liposarcoma: a clinical analysis of 31 cases

“…Of the 24 patients with mediastinal liposarcomas, 8 (33.3%) had tumors located in the posterior mediastinum, and 16 (66.7%) in the anterior mediastinum. However, Gladish et al [7] reported that intrathoracic soft tissue sarcomas were often found in the lungs, mediastinum, pleura, pericardium, heart, and chest wall, whereas Unal et al [8] found that they were most frequently localized on the chest wall and lungs.…”

11-year experience with Chest Wall resection and reconstruction for primary Chest Wall sarcomas

“…Once this evaluation is complete considerations regarding the resectability of the tumor and the need for neoadjuvant therapy are made. Important factors influencing the design of the treatment plan include tumor histology, grade and size, the potential to achieve clear surgical margins and the general health status of the patient [10][11][12][13][14]. Overall, we performed 28 surgeries on 25 patient.…”

“…Keeping in mind that achieving clear resection margins remains the key goal of surgery for chest wall sarcomas, we argue that it is important in the preoperative planning to thoroughly consider the desired extent of resection, and also to prepare for the appropriate reconstructive steps [2,[4][5][6][7][10][11][12][13][14]. Overall, in the current series, we have applied an aggressive surgical resection approach.…”