Soft tissue sarcoma presenting with metastatic disease

Abstract

BACKGROUND:The objective of this study was to assess patient, tumor, and treatment factors that affected overall survival in a group of patients who underwent surgery for soft tissue sarcoma (STS) and presented with American Joint Commission on Cancer stage IV disease. METHODS: A retrospective review was undertaken of a single institution's database from the years 1986 to 2006 in all patients who met the following inclusion criteria: 1) surgical management of the primary tumor was undertaken, and 2) metastatic disease was present at the time of initial presentation. In total, 112 patients were identified who met the inclusion criteria. RESULTS: The 5-year survival rate for the entire group was 17%. In univariate analysis, the variables that were identified as statistically significant for predicting improved overall survival were resection of metastatic disease (P ¼ .003), <4 pulmonary metastases (P ¼ .05), and the presence of lymph node metastases versus pulmonary metastases (P ¼ .0002). In multivariate analysis, only the presence of lymph node metastases versus pulmonary metastases retained statistical significance (P ¼ .05).The 5-year survival rate for patients who had lymph nodes metastases at diagnosis was 59%, whereas it was only 8% for patients who presented with pulmonary metastases. CONCLUSIONS: Patients who presented with metastatic STS had a very poor prognosis despite aggressive surgical management of their primary tumor. The current results indicated that, although patients with isolated lymph node metastases may be cured by surgical resection, patients with pulmonary metastases are unlikely to be cured even with aggressive surgical management and should be treated with palliation of symptoms as the main objective. Cancer 2011;117:372-9.

Multidisciplinary Management of Soft Tissue Sarcoma

“…For those presenting with metastatic disease to the lymph nodes, 5-year overall survival is estimated at 23–59% [27, 66–68]. On an individual basis, the prognosis for metastatic disease to the lymph nodes depends on the timing of presentation of the metastatic lesion, with an improved prognosis given to those with metachronous rather than synchronous metastases [68, 69].…”

Using the serum lactate dehydrogenase level to predict prognosis in the patients with soft tissue sarcoma: a retrospective case-control study

“…In this study, patients with non-small-round cell sarcomas and metastatic disease were showed significantly high LDH levels. Patients with distant metastasis at first visit have been known to have poor prognosis [15] [16], and some reports showed high serum LDH levels indicated poor prognosis especially in Ewing sarcoma [12]. Therefore, survival in 49 patients with non-small-round cell tumor without distant metastasis was analyzed to eliminate their effects (Table 4).…”

Telomere maintenance in soft tissue sarcomas

“…[73][74][75] A significant proportion of patients with STS present with regional or metastatic disease at diagnosis. 76 As a result, developing more effective systemic therapies is pivotal to improving outcome for patients with STS. Although several potential therapeutic targets have been proposed, 77 only a few alternative agents have emerged to the chemotherapeutic regimes currently in use, for example, tyrosine kinase inhibitors in cases of dermatofibrosarcoma protuberans containing platelet-derived growth factor B mutations 78 and gastrointestinal stromal tumours.…”