Evaluation of a clinically applicable post-surgical classification system for primary retroperitoneal soft-tissue sarcoma Journal Article
| Authors: | Van Dalen, T.; Hennipman, A.; Van Coevorden, F.; Hoekstra, H. J.; Van Geel, B. N.; Slootweg, P.; Lutter, C. F. A.; Brennan, M. F.; Singer, S. |
| Article Title: | Evaluation of a clinically applicable post-surgical classification system for primary retroperitoneal soft-tissue sarcoma |
| Abstract: | Background: The present AJCC/TNM staging system is of limited value for prediction of prognosis for patients with retroperitoneal sarcoma. The objective of the present study was to develop a postsurgical classification system that would enable comparison of outcomes for patients with primary retroperitoneal soft-tissue sarcoma. Methods: Four classes were defined: I, low-grade/complete resection/no metastasis; II, high-grade/complete resection/no metastasis; III, any-grade/incomplete resection/no metastasis; and IV, any-grade/any resection/distant metastasis. The prognostic value of this classification system was analyzed in a population-based multicenter group(MCG) of patients with primary retroperitoneal soft-tissue sarcoma (n = 124) and in a cohort of patients treated in a single tertiary referral center (SCG; n = 107). Results: Overall 5-year survival rates were 55% in the SCG and 43% in the MCG (P = 0.02). Class III (incomplete resection) was more frequent in the MCG than in the SCG (33% vs. 16%; P = 0.02). In the SCG, stage-specific 5-year survival rates were 89%, 40%, 26%, and 17% for classes I, II, III, and IV, respectively (P < 0.001), in comparison with 68%, 46%, 24%, and 0% in the MCG (P < 0.001). In a comparison of class-specific survival between the groups, only class I patients in the SCG had significantly better survival than class I patients in the MCG (P = 0.048). Conclusions: Classification based on grade, completeness of resection, and distant metastasis offers a reproducible prognostic tool that can be used to evaluate treatment strategies for primary retroperitoneal soft-tissue sarcoma. The probability of complete resection was significantly higher in the SCG than in the MCG. In patients with low-grade, completely resected sarcoma, there is a significant survival benefit with treatment in a high-volume tertiary center of excellence. © 2004 The Society of Surgical Oncology, Inc. |
| Keywords: | survival; adult; cancer survival; controlled study; human tissue; treatment outcome; middle aged; survival analysis; cancer surgery; survival rate; major clinical study; clinical trial; disease classification; cancer staging; methodology; neoplasm staging; sensitivity and specificity; reproducibility; metastasis; controlled clinical trial; cohort studies; classification; cohort analysis; pathology; sarcoma; survival time; population research; disease severity; statistical significance; evaluation; probability; multicenter study; prognostic factors; neoplasm metastasis; soft tissue sarcoma; intermethod comparison; retroperitoneal tumor; retroperitoneal neoplasms; outcomes; soft tissue neoplasms; soft tissue tumor; frequency analysis; health center; retroperitoneal; retroperitoneal sarcoma; humans; prognosis; human; male; female; article |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 11 |
| Issue: | 5 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2004-05-01 |
| Start Page: | 483 |
| End Page: | 490 |
| Language: | English |
| DOI: | 10.1245/aso.2004.09.005 |
| PROVIDER: | scopus |
| PUBMED: | 15078637 |
| DOI/URL: | |
| Notes: | Ann. Surg. Oncol. -- Cited By (since 1996):39 -- Export Date: 16 June 2014 -- CODEN: ASONF -- Source: Scopus |
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