Epidemiology, treatment (tx) patterns and outcomes in Asian soft tissue sarcoma (STS) patients: Results from the Soft Tissue Sarcoma in the Asia Pacific Region (STAR) study.

Quek, Richard; Farid, Mohamad; Wang, Edward; Asavamongkolkul, Apichat; Leung, A. K. C.; Prayogo, Nugroho; Punyaratabandhu, Thipachart; Yeoh, Ee-Min; Shantakumar, Sumitra; Manson, Stephanie; Ngan, Roger K.C.

doi:10.1200/jco.2015.33.15_suppl.10549

Cited by 6 publications

(8 citation statements)

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“…For this reason, the distribution of entities seen in a different clinical setting may differ from the results of this study [ 17 ]. Moreover, results may differ from those of other comparable institutions due to different regional and practice-dependent referral patterns [ 3 , 18 ]. Finally, no further evaluation of MR characteristics was performed due to the large sample size and the inhomogeneity of MR examinations obtained at different institutions.…”

Section: Discussionmentioning

confidence: 99%

“…Malignant soft tissue tumors account for approximately 1% of all adult and approximately 20% of all pediatric solid malignant cancers [ 1 , 2 ]. The most common entities among malignant soft tissue sarcomas are liposarcoma, leiomyosarcoma, and undifferentiated pleomorphic sarcoma [ 3 ]. In the 5th edition of the classification of soft tissue tumors, the World Health Organisation (WHO) defined several categories of soft tissue lesions with further subcategories and indicated their dignity with either benign, intermediate (locally aggressive or rarely metastasizing) or malignant [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Soft tissue masses: distribution of entities and rate of malignancy in small lesions

Gassert

Specht

et al. 2021

BMC Cancer

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Background Small soft tissue masses are often falsely assumed to be benign and resected with failure to achieve tumor-free margins. Therefore, this study retrospectively investigated the distribution of histopathologic diagnosis to be encountered in small soft tissue tumors (≤ 5 cm) in a large series of a tertiary referral center. Methods Patients with a soft tissue mass (STM) with a maximum diameter of 5 cm presenting at our institution over a period of 10 years, who had undergone preoperative Magnetic resonance imaging and consequent biopsy or/and surgical resection, were included in this study. A final histopathological diagnosis was available in all cases. The maximum tumor diameter was determined on MR images by one radiologist. Moreover, tumor localization (head/neck, trunk, upper extremity, lower extremity, hand, foot) and depth (superficial / deep to fascia) were assessed. Results In total, histopathologic results and MR images of 1753 patients were reviewed. Eight hundred seventy patients (49.63%) showed a STM ≤ 5 cm and were therefore included in this study (46.79 +/− 18.08 years, 464 women). Mean maximum diameter of the assessed STMs was 2.88 cm. Of 870 analyzed lesions ≤ 5 cm, 170 (19.54%) were classified as superficial and 700 (80.46%) as deep. The malignancy rate of all lesions ≤ 5 cm was at 22.41% (superficial: 23.53% / deep: 22.14%). The malignancy rate dropped to 16.49% (20.79% / 15.32%) when assessing lesions ≤ 3 cm (p = 0.007) and to 15.0% (18.18% / 13.79%) when assessing lesions ≤ 2 cm (p = 0.006). Overall, lipoma was the most common benign lesion of superficial STMs (29.41%) and tenosynovial giant cell tumor was the most common benign lesion of deep STMs (23.29%). Undifferentiated pleomorphic sarcoma was the most common malignant diagnosis among both, superficial (5.29%) and deep (3.57%) STMs. Conclusions The rate of malignancy decreased significantly with tumor size in both, superficial and deep STMs. The distribution of entities was different between superficial and deep STMs, yet there was no significant difference found in the malignancy rate.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Soft tissue masses: distribution of entities and rate of malignancy in small lesions

Gassert

Specht

et al. 2021

BMC Cancer

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“…Reviewing the existing literature available for STS trends, there is a lack of outcomes and epidemiological data from Asia (5). There is no prospective data available, with most if not all, being retrospective data and are specific to a country (6,(8)(9)(10).…”

Section: The State Of Sts In Asiamentioning

confidence: 99%

“…While there is good published literature on the incidence and distribution of sarcoma subtypes in the western populations, there is a paucity of data from Asia, particularly on the epidemiology, treatment and outcomes of STS in Asia (5). Formalized prospective national registries in STS are lacking and little is known about how sarcomas are treated and managed throughout the Asia-Pacific region (6).…”

Section: Introduction To Soft Tissue Sarcoma (Sts)mentioning

confidence: 99%

Soft tissue sarcoma in Asia

Poon¹,

Quek²

2018

Chin. Clin. Oncol.

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Sarcoma is an uncommon and heterogeneous group of malignancies linked by their mesenchymal origin. They are rare and account for 1% of adult cancers, and 10-20% of adolescent and young adult (AYA) cancers. While there is good published literature on the incidence and distribution of sarcoma subtypes in the western populations, there is a paucity of data from Asia, particularly on the epidemiology, treatment and outcomes of STS in Asia. Formalized prospective national registries in soft tissue sarcoma (STS) are lacking and little is known about how sarcomas are treated and managed throughout the Asia-Pacific region. Due to geographical and varying affluence levels across over 50 countries, no single uniform guideline exists across Asia to inform of chemotherapeutic options. Any existent guidelines tend to be country-specific, reflecting resource availability and geographical limitation. To understand and improve STS care in Asia, one must appreciate the macroeconomics and healthcare structures in place and to work within the limitations imposed by them. Concurrently, there exists an urgency to develop strong sarcoma centres of excellence (SCE) across Asia to deliver state-of-art care to our patients. Equally important is the need to facilitate sarcoma education to patients and healthcare workers. Development of such centres is vital in improving clinical care as they provide high-quality sub-specialized care to patients within that geographical location, serve as reference centres for knowledge and education as well as nerve centres for care-coordination in a hub-and-spoke model. Key to these centres of excellence is the sarcoma multi-disciplinary team (MDT). Studies have consistently shown that patients managed in high-volume sarcoma centres, by an expert sarcoma MDT, achieve better clinical outcomes. This report serves to highlight the challenges and opportunities of sarcoma care in Asia, map out a vision for the development of SCE across Asia and highlight the areas of potential collaboration between centres to advance the science of sarcoma.

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“…In the Asia-Pacific region, the epidemiological distribution of sarcomas remains poorly defined. In a previous observational study across five Asian countries, the most common histological subtypes include leiomyosarcoma, undifferentiated pleomorphic sarcoma, liposarcoma, synovial sarcoma, and angiosarcoma 3 . Interestingly, the proportion of angiosarcomas was larger as compared to that reported in Western studies (7.5% vs. 1–2%, respectively).…”

Section: Introductionmentioning

confidence: 99%

Clinical implications of systemic and local immune responses in human angiosarcoma

et al. 2021

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Angiosarcomas are a rare subtype of soft-tissue sarcomas which exhibit aggressive clinical phenotypes with limited treatment options and poor outcomes. In this study, we investigated the clinical relevance of the peripheral blood neutrophil-to-lymphocyte ratio (NLR) as a marker of systemic immune response, as well as its correlation with intra-tumoral immune profiles in a subgroup of cases (n = 35) using the NanoString PanCancer IO360 panel and multiplex immunohistochemistry. In the overall cohort (n = 150), angiosarcomas of the head and neck (AS-HN) comprised most cases (58.7%) and median overall survival (OS) was 1.1 year. NLR, classified as high in 78 of 112 (70%) evaluable patients, was independently correlated with worse OS (HR 1.84, 95%CI 1.18–2.87, p = 0.0073). Peripheral blood NLR was positively correlated with intra-tumoral NLR (tNLR) (Spearman’s rho 0.450, p = 0.0067). Visualization of tumor-infiltrating immune cells confirmed that tNLR scores correlated directly with both neutrophil (CD15+ cells, rho 0.398, p = 0.0198) and macrophage (CD68+ cells, rho 0.515, p = 0.0018) cell counts. Interestingly, tNLR correlated positively with oncogenic pathway scores including angiogenesis, matrix remodeling and metastasis, and cytokine and chemokine signaling, as well as myeloid compartment scores (all p < 0.001). In patients with documented response assessment to first-line chemotherapy, these pathway scores were all significantly higher in non-responders (47%) compared to responders. In conclusion, systemic and local immune responses may inform chemotherapy response and clinical outcomes in angiosarcomas.

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Epidemiology, treatment (tx) patterns and outcomes in Asian soft tissue sarcoma (STS) patients: Results from the Soft Tissue Sarcoma in the Asia Pacific Region (STAR) study.

Cited by 6 publications

References 0 publications

Soft tissue masses: distribution of entities and rate of malignancy in small lesions

Soft tissue masses: distribution of entities and rate of malignancy in small lesions

Soft tissue sarcoma in Asia

Clinical implications of systemic and local immune responses in human angiosarcoma

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