Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities Journal Article

Authors: Pisters, P. W.; Leung, D. H. Y.; Woodruff, J.; Shi, W.; Brennan, M. F.
Article Title: Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities
Abstract: Purpose: To identify specific independent adverse clinicopathologic factors for event-free survival in a cohort of consecutively treated patients with extremity soft tissue sarcomas. Patients and Methods: Prospectively collected data from a population of 1,041 adult patients with localized (American Joint Committee on Cancer [AJCC] stage IA to IIIB) extremity soft tissue sarcomas were analyzed. Patients were treated at a single institution between 1982 and 1994. Patient, tumor, and pathologic factors were analyzed by univariate and multivariate techniques to identify independent prognostic factors far the end points of local recurrence, distant recurrence, disease- specific survival, and postmetastasis survival. Results: The 5-year survival rate for this cohort of patients was 76%, with a median follow-up time of 3.95 years. Significant independent adverse prognostic factors for local recurrence were age greater than 50 years, recurrent disease at presentation, microscopically positive surgical margins, and the histologic subtypes fibrosarcoma and malignant peripheral-nerve tumor. For distant recurrence, intermediate tumor size, large tumor size, high histologic grade, deep location, recurrent disease at presentation, leiomyosarcoma, and nonliposarcoma histology were independent adverse prognostic factors. For disease-specific survival, large tumor size, high grade, deep location, recurrent disease at presentation, the histologic subtypes leiomyosarcoma and malignant peripheral-nerve tumor, microscopically positive surgical margins, and lower extremity site were adverse factors. For postmetastasis survival, only large tumor size (> 10 cm) was an adverse prognostic factor. Conclusion: The independent adverse prognostic factors for distant recurrence and disease-specific survival differ from those identified for subsequent local recurrence. Patients with microscopically positive surgical margins or patients who present with locally recurrent disease are at increased risk for subsequent local recurrence and tumor-related mortality. Specific histopathologic subtypes are associated with increased risks for local failure and tumor-related mortality.
Keywords: adolescent; adult; cancer survival; human tissue; aged; aged, 80 and over; disease-free survival; middle aged; survival rate; major clinical study; histopathology; cancer recurrence; combined modality therapy; prospective studies; neoplasm recurrence, local; tumor volume; risk factors; sarcoma; fibrosarcoma; neoplasm metastasis; limb tumor; soft tissue sarcoma; analysis of variance; humans; prognosis; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 14
Issue: 5
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1996-05-01
Start Page: 1679
End Page: 1689
Language: English
PUBMED: 8622088
PROVIDER: scopus
DOI: 10.1200/JCO.1996.14.5.1679
Notes: Article -- Export Date: 22 November 2017 -- Source: Scopus
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MSK Authors
  1. Murray F Brennan
    756 Brennan
  2. Weiji Shi
    111 Shi
  3. Denis Heng Yan Leung
    112 Leung
  4. James M Woodruff
    128 Woodruff