Brain metastasis in sarcoma: Does metastasectomy or aggressive multi‐disciplinary treatment improve survival outcomes

Chua, Clarinda; Jeevan, Raaj; Pan, Summer; Farid, Mohamad; Lee, Jin Fu Marcus; Ho, Zhen Chong; Sairi, A.; Sittampalam, Kesavan; Tao, Miriam; Tay, Kevin; Lim, Soon Thye; Chin, Francis; Teo, Melissa Ching Ching; Quek, Richard

doi:10.1111/ajco.12111

Cited by 15 publications

(28 citation statements)

References 17 publications

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“…All patients in this study had presented with or developed metastatic disease in the lung or bone prior to their diagnosis of brain metastasis. This finding is consistent with that in other studies 12 , 15 , 17 where the rates of metastatic disease at other sites range from 77 to 100%. Salvati et al 2 reported a lower rate of 51% of concurrent pulmonary metastasis in their series and this may reflect a referral bias, owing to their study being a consecutive series of patients who underwent surgical excision of their brain metastasis.…”

Section: Discussionsupporting

confidence: 93%

“…This interval is similar to that in other studies. 7,12,14,15 However, the longest interval from diagnosis of primary to diagnosis of brain metastasis was 17 years, and similarly long disease free intervals have also been reported in other studies. 12,16 All patients in this study had presented with or developed metastatic disease in the lung or bone prior to their diagnosis of brain metastasis.…”

Section: Discussionsupporting

confidence: 76%

“…The poor survival outcomes in this study mirror those in numerous other studies that document the grim prognosis that sarcomatous brain metastasis carry. 1,5,13–15…”

Section: Discussionmentioning

confidence: 99%

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Brain metastases from Truncal and extremity bone and soft tissue sarcoma: Single institution study of oncologic outcomes

et al. 2020

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Brain metastases are a rare occurrence in patients with sarcoma. The prognosis for patients is poor, and treatment can contribute to considerable morbidity. We sought to examine the experience of our institution in managing these patients over a period of 17 years. We performed a retrospective cohort study of patients managed for sarcoma of the extremity or trunk who developed brain metastases from 2000 to 2017. Clinical data were analyzed and we assessed survival outcomes. 14 patients presenting at a mean age of 46.7 years were included. All patients were treated with radiotherapy for their brain metastases. 3 patients underwent surgical excision of their intracranial metastases. Two patients were treated with radium-223 dichloride. Kaplan–Meier survival analysis and the log rank test were used to calculate the survival probability, and to compare patient subgroups. All patients in this study developed lung or bone metastases at a mean interval of 13.3 months prior to the development of brain metastasis. The median interval from diagnosis of a brain metastasis to death was 3.6 months. The Kaplan–Meier survival probability at 6 months was 28.6%, and 14.3% at 1 year. Surgery was not found to be associated with increased survival. Patients with cerebellar metastasis had increased survival probability as compared to those with cerebral metastasis. Patients with extremity or trunk sarcoma who develop brain metastases frequently develop lung or bone metastases in the year preceding their diagnosis of brain metastasis. Patients with cerebellar metastasis may have better survival than those with cerebral metastasis, and an aggressive treatment approach should be considered. Despite aggressive treatment, the prognosis is grim.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 76%

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Brain metastases from Truncal and extremity bone and soft tissue sarcoma: Single institution study of oncologic outcomes

et al. 2020

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“…reported the prognosis of brain metastasis from sarcomas and revealed that the median OS was low at 3.5 months (95% confidence interval 1.1–6.3 months). [2]…”

Section: Discussionmentioning

confidence: 99%

“…[13] Chua et al . [2] reported that, for patients with brain metastasis from sarcomas, aggressive therapy including surgical resection or multimodality treatment, especially chemotherapy, can improve OS (3.7 months vs. 1.2 months). Kasper et al .…”

Section: Discussionmentioning

confidence: 99%

Rapid growth of metastatic brain tumor from gastric undifferentiated pleomorphic sarcoma: A case report

Miki

Yoshimoto

Yamada

et al. 2019

Surgical Neurology International

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Background: Brain metastasis from undifferentiated pleomorphic sarcoma (UPS) is a rare occurrence, and its clinical course is little known. In this report, we investigate a case of a rapidly growing brain metastasis from gastric UPS. Case Description: An 82-year-old man with a known gastric tumor, pathologically compatible with UPS, underwent partial gastrectomy at an outside facility. 3 months later, a 4-cm brain tumor was detected, which was completely resected. The patient was diagnosed with metastatic tumor from previously treated gastric UPS. Within 2 months of the initial resection, a large recurrent mass was detected in the same location, which was again removed. Although the patient underwent radiotherapy and chemotherapy for other metastatic tumors, he died 5 months after the second craniotomy. Conclusions: Brain metastasis from gastric UPS is rare and difficult to treat. Although aggressive treatment, such as surgical intervention, may improve patient survival in some cases, the timing of treatment is challenging because cerebral metastasis rapidly grows and and patients frequently suffer from synchronous systematic metastasis. Therefore, early detection and close follow-up of rapidly progressing brain metastasis are important to improve treatment outcomes.

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A retrospective analysis of the prognosis of Japanese patients with sarcoma brain metastasis

Toda¹,

Kobayashi²,

Kubota

et al. 2023

Cancer Medicine

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Background Bone and soft tissue sarcomas are rare tumors and extremely rarely metastasize to the brain. Previous studies have examined the characteristics and poor prognostic factors in cases of sarcoma brain metastasis (BM). Due to the rarity of cases of BM from sarcoma, limited data exist concerning the prognostic factors and treatment strategies. Methods A retrospective single‐center study was performed on sarcoma patients with BM. The clinicopathological characteristics and treatment options for BM of sarcoma were investigated to identify predictive prognostic factors. Results Between 2006 and 2021, 32 patients treated for newly diagnosed BM at our hospital were retrieved among 3133 bone and soft tissue sarcoma patients via our database. The most common symptom was headache (34%), and the most common histological subtypes were alveolar soft part sarcoma (ASPS) and undifferentiated pleomorphic sarcoma (25%). Non‐ASPS ( p = 0.022), presence of lung metastasis ( p = 0.046), a short duration between initial metastasis, and the diagnosis of brain metastasis ( p = 0.020), and the absence of stereotactic radiosurgery for BM ( p = 0.0094) were significantly correlated with a poor prognosis. Conclusions In conclusion, the prognosis of patients with brain metastases of sarcomas is still dismal, but it is necessary to be aware of the factors associated with a relatively favorable prognosis and to select treatment options appropriately.

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Brain metastasis in sarcoma: Does metastasectomy or aggressive multi‐disciplinary treatment improve survival outcomes

Cited by 15 publications

References 17 publications

Brain metastases from Truncal and extremity bone and soft tissue sarcoma: Single institution study of oncologic outcomes

Brain metastases from Truncal and extremity bone and soft tissue sarcoma: Single institution study of oncologic outcomes

Rapid growth of metastatic brain tumor from gastric undifferentiated pleomorphic sarcoma: A case report

A retrospective analysis of the prognosis of Japanese patients with sarcoma brain metastasis

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