Optimal percent myxoid component to predict outcome in high-grade myxofibrosarcoma and undifferentiated pleomorphic sarcoma Journal Article
| Authors: | Lee, A. Y.; Agaram, N. P.; Qin, L. X.; Kuk, D.; Curtin, C.; Brennan, M. F.; Singer, S. |
| Article Title: | Optimal percent myxoid component to predict outcome in high-grade myxofibrosarcoma and undifferentiated pleomorphic sarcoma |
| Abstract: | Background: Myxofibrosarcoma and undifferentiated pleomorphic sarcoma (UPS) are aggressive, genetically complex sarcomas. The minimum myxoid component used as a criterion for myxofibrosarcoma varies widely, so we determined the optimal myxoid component cutpoints for stratifying outcomes of UPS and myxofibrosarcoma. We also analyzed clinicopathologic factors associated with outcome. Methods: Review of a prospective, single-institution database identified 197 patients with primary, high-grade extremity/truncal myxofibrosarcoma or UPS resected during 1992–2013. Histology was reviewed and percent myxoid component determined for each tumor. Disease-specific survival (DSS) and distant recurrence-free survival (DRFS) were analyzed using the Kaplan–Meier method, log-rank test, and Cox regression. Results: Median follow-up for survivors was 6.4 years. In minimum p value analysis of myxoid component, the best cutpoint for both DSS and DRFS was 5 % (adjusted p ≤ 0.001), followed by 70 %. Therefore, sarcomas with <5 % myxoid component (n = 69) were classified as UPS and those with ≥5 % myxoid component (n = 128) as myxofibrosarcoma. Five-year DRFS was 24 % for UPS, 51 % for 5–69 % myxoid component myxofibrosarcoma, and 65 % for ≥70 % myxoid component myxofibrosarcoma. Myxoid component, tumor size, and age were independently associated with DSS; myxoid component and tumor size were associated with DRFS. Only tumor site was associated with local recurrence. Conclusions: Percent myxoid component and tumor size are the two most important predictors of DSS and DRFS in high-grade myxofibrosarcoma and UPS. A 5 % myxoid component cutpoint is an improved criterion for classifying myxofibrosarcoma. Myxoid component-based classification improves stratification of patient outcome and will aid in selection of patients for systemic therapy and clinical trials. © 2016, Society of Surgical Oncology. |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 23 |
| Issue: | 3 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2016-03-01 |
| Start Page: | 818 |
| End Page: | 825 |
| Language: | English |
| DOI: | 10.1245/s10434-015-5063-5 |
| PROVIDER: | scopus |
| PUBMED: | 26759307 |
| PMCID: | PMC4964786 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 March 2016 -- Source: Scopus |
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