Analysis of Factors for Predicting Survival in Soft-tissue Sarcoma with Metastatic Disease at Initial Presentation

Nakamura, Tomoki; Katagiri, Hirohisa; Shido, Yoji; Hamada, Shunsuke; Yamada, Kenji; Nagano, Akihito; Yamada, Satoshi; Tsukushi, Satoshi; Ishimura, Daisuke; Matsumine, Akihiko; Sudo, Akihiro; Nishida, Yoshihiro

doi:10.21873/anticanres.11671

Cited by 18 publications

(24 citation statements)

References 16 publications

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“…in vivo 34: 1975-1980 (2020) Although age, histological grade, stage, tumor diameter, and resection margins are reportedly associated with a poor prognosis for STS, few reports have evaluated factors influencing the prognosis of patients with STS and distant metastasis (9,(21)(22)(23). Some of these studies have indicated that surgical resection of the distant metastatic lesions can improve the prognosis, similar to what we observed.…”

Section: Discussionsupporting

confidence: 71%

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

Tsuchie¹,

Emori²,

Miyakoshi³

et al. 2020

In Vivo

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Background/Aim: Few studies have examined the prognostic significance of histological subtypes in patients with soft tissue sarcoma (STS) and distant metastasis, and we evaluated the relationship between the histological subtypes and clinical outcomes. Patients and Methods: This retrospective study evaluated the histological subtypes of 105 patients with STS and distant metastasis. The STS histological subtypes were compared based on the clinical information. Results: The Kaplan-Meier curves for overall survival revealed that myxoid liposarcoma had a significantly better prognosis compared to Malignant Peripheral Nerve Sheath Tumor (MPNST) (p=0.0221). In the multivariate logistic regression analyses, the independent predictors of a poor prognosis were: i) large size, ii) advanced stage, and iii) non-surgical treatment for metastasis (p<0.05). The presence or absence of lung metastasis was not significantly associated with prognosis (p=0.4452). Conclusion: Myxoid liposarcoma had a better prognosis compared to MPNST in STS patients with distant metastasis. The surgical removal of distant metastatic lesions may improve the patient's prognosis. Soft tissue sarcoma (STS) is relatively rare, and mainly occurs in middle-aged or older individuals. Despite its low incidence, STS has various histological subtypes, such as liposarcoma and synovial sarcoma, which results in relatively small populations of patients with different histological types. Radical resection with adequate margins is important for treating STS, regardless of the histological subtype, in order to prevent local recurrence. However, recent developments in surgical treatment, radiotherapy, and chemotherapy have improved patient outcomes (1), and various studies have identified factors associated with prognosis among STS patients (2-10). There is consensus that distant metastasis, which mainly involves the lungs, has a strong influence on prognosis. However, the small sample sizes for each subtype typically prevent studies from identifying a clear relationship between subtype and prognosis, despite the fact that several reports have examined the prognostic significance of the STS histological subtypes (2-8, 11, 12). Moreover, only few studies have examined this topic among patients with STS and distant metastases. Therefore, the present study aimed to examine the association of clinical outcomes with the histological subtypes and distant metastasis sites in patients with STS and distant metastasis. 1975 This article is freely accessible online.

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Section: Discussionsupporting

confidence: 71%

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

Tsuchie¹,

Emori²,

Miyakoshi³

et al. 2020

In Vivo

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“…Preoperative anemia has been found as a prognostic factor of poor outcome for patients with soft tissue sarcoma [ 13 , 28 ]. There was a significant relationship between Hb and OS (p = 0.031, HR = 1.99).…”

Section: Discussionmentioning

confidence: 99%

Analysis of prognostic factors in soft tissue sarcoma: Cancer registry from a single tertiary hospital in Indonesia. A retrospective cohort study

Mahyudin

Edward

Basuki

et al. 2020

Annals of Medicine and Surgery

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Background Soft tissue sarcoma is one cause of mortality in adult malignancies. This tumor is rare, persistent, and highly-recurrent. Many patients are came in late stage. It is important to identify a prognostic tool that is reliable, easily obtainable, and widely applicable. The aim of this study is to investigate and analyze the prognostic value of clinicopathological and biomarker factors in patients with soft tissue sarcoma. Methods This retrospective study extracts data from the musculoskeletal tumor registry from January 2012 to December 2018 in a single tertiary hospital. Eighty patients with diagnosis of soft tissue sarcoma were included. Preoperative modified Glasgow Prognostic Score, Neutrophils/Lymphocytes Ratio, Hemoglobin, serum lactate dehydrogenase data were analyzed along with demographic, clinical, radiological and histopathological data. The relationship between variables on overall survival, distant metastasis, and local recurrence were evaluated using univariate and multivariate Cox regression. Results On univariate analysis, there was significant relationship between hemoglobin, Neutrophils/Lymphocytes Ratio and modified Glasgow Prognostic Score with overall survival (p = 0.031, HR = 1.99; p = 0.04, HR = 1.129; and p = 0.044, HR = 3.89). A significant relationship was found between age and soft tissue sarcoma stage with distant metastasis (p = 0.046, HR = 1.95; and p = 0.00, HR = 3.22). In addition, we also found significant relationship between surgical margin with local recurrence (p = 0.018, OR = 3.44). However, on multivariate analysis the independent prognostic factor for overall survival was only modified Glasgow Prognostic Score (HR = 2.138; p = 0.011). Stage IIIA (HR = 5.32; p = 0.005) and IIIB (HR = 13.48; p = 0.00) were independent prognostic for distant metastasis. Surgical margin was independently associated with local recurrence (HR = 14.84; p = 0.001). Conclusion Modified Glasgow Prognostic Score can be used as prognostic tool of overall survival in soft tissue sarcoma patients. Moreover, stage of STS and surgical margin can be used as a prognostic factor for distant metastasis and local recurrence of soft tissue sarcoma respectively.

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“…In a subsequent report, Nakamura et al ., analyzed 142 STS patients and found that elevated CRP and an N/L ratio > 2.3 independently predicted shorter disease-specific survival (87% 5-year OS for normal CRP and low N/L ratio compared to 46% for elevated CRP and high NLR) [3]. More recently, Nakamura explored CRP levels in patients with metastatic STS and also found that CRP was an independent prognostic factor for shorter disease-specific survival [12]. Similarly, Szkandera et al .…”

Section: Discussionmentioning

confidence: 99%

“…Although our data do not address the underlying mechanism for why neoadjuvant RT may decouple the association of elevated CRP and N/L ratio with worse STS outcome, one broad hypothesis is that neoadjuvant RT may impact the inflammatory milieu of the TME in a different manner than upfront surgery and thereby alter the interaction of these bio-markers with outcome [12-15]. For example, pre-clinical studies suggest that complex inflammatory and cell-signaling cascades secondary to RT may mediate a strong immune response which can counteract and in some cases overcome the local immunosuppression of the TME [16].…”

Section: Discussionmentioning

confidence: 99%

Serum C-reactive Protein and Neutrophil/Lymphocyte Ratio After Neoadjuvant Radiotherapy in Soft Tissue Sarcoma

Yanagisawa

Gingrich

Judge

et al. 2018

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Background/Aim The predictive value of serum C-reactive protein (CRP) and neutrophil/lymphocyte (N/L) ratio in soft tissue sarcoma (STS) patients receiving neoadjuvant radiotherapy (RT) has not been analyzed. Patients and Methods From 2007 to 2015, we identified 98 STS patients from a prospective database. Using multivariate analysis, we analyzed CRP and N/L ratios as predictors of overall survival (OS). Results Mean age was 59 years old, 46% were female, and 55% of tumors were located at the extremity. A total of 15 histologies were represented. 50% received preoperative RT. Except for extremity location, characteristics were similar between the preoperative RT and upfront surgery cohorts, including baseline CRP levels and N/L ratios. Multivariate analysis of upfront surgery revealed histologic grade, tumor size, and baseline N/L ratio to be predictors of OS, while for preoperative RT, baseline CRP and N/L ratio were not predictive. Conclusion Baseline CRP and N/L ratio did not predict poor clinical outcome in STS patients receiving neoadjuvant RT.

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Analysis of Factors for Predicting Survival in Soft-tissue Sarcoma with Metastatic Disease at Initial Presentation

Abstract: We suggest that the measurements of CRP and albumin levels are a useful method of identifying STS patients with metastasis at initial presentation that have poor prognosis.

Cited by 18 publications

References 16 publications

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

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

Analysis of prognostic factors in soft tissue sarcoma: Cancer registry from a single tertiary hospital in Indonesia. A retrospective cohort study

Serum C-reactive Protein and Neutrophil/Lymphocyte Ratio After Neoadjuvant Radiotherapy in Soft Tissue Sarcoma

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