Bone metastasis in extremity soft tissue sarcomas: risk factors and survival analysis using the SEER registry

Younis, Manaf H; Summers, Spencer; Pretell-Mazzini, Juan

doi:10.1007/s12306-020-00673-9

Cited by 7 publications

(16 citation statements)

References 21 publications

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“…Interestingly, we found that tumor size was indeed significantly correlated with lung and liver metastasis of soft tissue sarcoma, but no similar correlation was found for bone metastasis. Similar results were reported by Younis et al 15 Moreover, the nomogram of bone metastasis shows that these predictive factors, histology grade, N stage and primary site, were related to the development of bone metastasis, which is in line with their conclusions. Patients with lymph node metastasis but not synchronized distant metastases are rare, accounting for only approximately 2% of all STS patients.…”

Section: Discussionsupporting

confidence: 91%

Development and Validation of Novel Nomograms for Predicting Specific Distant Metastatic Sites and Overall Survival of Patients With Soft Tissue Sarcoma

Zhang

et al. 2021

Technol Cancer Res Treat

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Purpose: The goal of this study is to construct nomograms to effectively predict the distant metastatic sites and overall survival (OS) of soft tissue sarcoma (STS) patients. Methods: STS case data between 2010 and 2015 for retrospective study were gathered from public databases. According to the chi-square and multivariate logistic regression analysis determined independent predictive factors of specific metastatic sites, the nomograms based on these factors were consturced. Subsequently, combined metastatic information a nomogram to predict 1-, 2-, and 3-year OS of STS patients was developed. The performance of models was validated by the area under the curve (AUC), calibration plots, and decision curve analyses (DCA). Results: A total of 7001 STS patients were included in this retrospective study, including 4901 cases in the training group and the remaining 2,100 patients in the validation group. Three nomograms were established to predict lung, liver and bone metastasis, and satisfactory results have been obtained by internal and external validation. The AUCs for predicting lung, liver, and bone metastases in the training cohort were 0.796, 0.799, and 0.766, respectively, and in the validation cohort were 0.807, 0.787, and 0.775, respectively, which means that the nomograms have good discrimination. The calibration curves showed that the models have high precision, and the DCA manifested that the nomograms have great clinical application prospects. Through univariate and multivariate COX regression analyses, 8 independent prognosis factors of age, grade, histological type, tumor size, surgery, chemotherapy, radiatiotherapy and lung metastasis were determined. A nomogram was then constructed to predict the 1-, 2-, and 3-years OS, which has a good performance in both internal and external validations. Conclusion: The nomograms for predicting specific metastatic sites and OS have good discrimination, accuracy and clinical applicability. The models could accurately predict the metastatic risk and survival information, and help clinical decision-making.

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Section: Discussionsupporting

confidence: 91%

Development and Validation of Novel Nomograms for Predicting Specific Distant Metastatic Sites and Overall Survival of Patients With Soft Tissue Sarcoma

Zhang

et al. 2021

Technol Cancer Res Treat

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“…Alveolar rhabdomyosarcoma (11.2%), followed by spindle cell sarcoma (9%) and extraskeletal Ewing sarcoma (7.8%), showed a higher incidence of isolated bone metastasis at diagnosis, with leiomyosarcoma (16.48%) presenting combined lung and bone metastasis. 1 In other series including bone metastasis at any point, alveolar soft part sarcomas (ASPS; 62.5%), dedifferentiated liposarcomas (50%), angiosarcomas (50%), and rhabdomyosarcomas (31.3%) showed a higher bone metastasis incidence. 5 Of all types of STS, two are particularly interesting because of their unique characteristics:…”

Section: Histology Typementioning

confidence: 89%

“…A slight predominance of men (52% to 62%) 1,5 in their mid-forties has been reported. 5 Younis et al 1 also described a predominance of White (77.5%), insured (71.9%), and single (44.9%) patients.…”

Section: Epidemiologymentioning

confidence: 99%

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Musculoskeletal Metastasis From Soft-tissue Sarcomas: A Review of the Literature

Pretell-Mazzini

Seldon

D’Amato

et al. 2022

J Am Acad Orthop Surg

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Soft-tissue sarcomas are a rare and extremely heterogeneous group of cancers, representing ,1% of all human malignancies. The lungs are the most common site of distant metastasis, followed by the bone, lymph nodes, liver, brain, and subcutaneous tissue. Clinical experience suggests that skeletal metastasis is part of the natural history affecting the prognosis and quality of life in these patients. Approximately 2.2% of patients have skeletal metastasis at diagnosis. However, up to 10% will develop skeletal metastasis after a mean interval of 21.3 months. Although systemic therapy with conventional chemotherapy remains the primary treatment modality for those with metastatic sarcoma, increased survival has been achieved in selected patients who receive multimodality therapy, including surgery, for their metastatic disease. The 5-year overall survival of patients with isolated bone metastases was 41.2% (26.9% to 54.9%), which decreased to 32.9% (21.2% to 45.1%) in the setting of combined bone and lung metastases. Moreover, the resection of the primary soft-tissue sarcoma is a predictor of survival, resulting in a 58% decrease in mortality after surgery (hazard ratio, 0.42, P = 0.013). Understanding the effect of these metastases on patient survival may influence imaging, surveillance, and treatment decisions. Soft-tissue sarcomas (STSs) are a rare, extremely heterogeneous group of cancers, representing ,1% of human malignancies, 1,2 with an estimated 13,460 new cases in the United States in 2020. 3 At initial diagnosis, most patients with STS have no detectable distant disease 2 ; however, almost 50% of patients can potentially develop metastases to other organs, especially within 3 years of diagnosis. 4 Generally, these tumors have a propensity for hematogenous dissemination, 5 and the lungs are the most common site of distant metastasis, followed by the bone, lymph nodes, liver, brain, and subcutaneous tissue. 5 Musculoskeletal metastasis from STS and its clinical implications have received little attention, although clinical experience suggests that they are a late part of the natural history, representing a terminal stage of disease. 1,5

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“…However, retroperitoneal STSs also tend to metastasize to the liver [14,15]. Other metastatic sites commonly include the bones and the brain [16,17]. Patients with STSs are managed according to the generally accepted guidelines and those with localized and resectable diseases are treated by surgery [18].…”

Section: Introductionmentioning

confidence: 99%

Novel Insights into the Immunotherapy of Soft Tissue Sarcomas: Do We Need a Change of Perspective?

et al. 2021

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Soft tissue sarcomas (STSs) are rare mesenchymal tumors. With more than 80 histological subtypes of STSs, data regarding novel biomarkers of strong prognostic and therapeutic value are very limited. To date, the most important prognostic factor is the tumor grade, and approximately 50% of patients that are diagnosed with high-grade STSs die of metastatic disease within five years. Systemic chemotherapy represents the mainstay of metastatic STSs treatment for decades but induces response in only 15–35% of the patients, irrespective of the histological subtype. In the era of immunotherapy, deciphering the immune cell signatures within the STSs tumors may discriminate immunotherapy responders from non-responders and different immunotherapeutic approaches could be combined based on the predominant cell subpopulations infiltrating the STS tumors. Furthermore, understanding the immune diversity of the STS tumor microenvironment (TME) in different histological subtypes may provide a rationale for stratifying patients according to the TME immune parameters. In this review, we introduce the most important immune cell types infiltrating the STSs tumors and discuss different immunotherapies, as well as promising clinical trials, that would target these immune cells to enhance the antitumor immune responses and improve the prognosis of metastatic STSs patients.

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Bone metastasis in extremity soft tissue sarcomas: risk factors and survival analysis using the SEER registry

Cited by 7 publications

References 21 publications

Development and Validation of Novel Nomograms for Predicting Specific Distant Metastatic Sites and Overall Survival of Patients With Soft Tissue Sarcoma

Development and Validation of Novel Nomograms for Predicting Specific Distant Metastatic Sites and Overall Survival of Patients With Soft Tissue Sarcoma

Musculoskeletal Metastasis From Soft-tissue Sarcomas: A Review of the Literature

Novel Insights into the Immunotherapy of Soft Tissue Sarcomas: Do We Need a Change of Perspective?

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