Prognostic factors predictive of survival for truncal and retroperitoneal soft-tissue sarcoma
The authors identified prognostic factors relevant to clinical outcomes (especially survival) in truncal and retroperitoneal soft-tissue sarcoma. These results can be used to optimize surgical management and select patients most likely to benefit from novel therapeutic strategies in future trials. A...
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| Veröffentlicht in: | Annals of surgery 1995-02, Vol.221 (2), p.185-195 |
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| creator | SINGER, S CORSON, J. M DEMETRI, G. D HEALEY, E. A MARCUS, K EBERLEIN, T. J |
| description | The authors identified prognostic factors relevant to clinical outcomes (especially survival) in truncal and retroperitoneal soft-tissue sarcoma.
These results can be used to optimize surgical management and select patients most likely to benefit from novel therapeutic strategies in future trials.
A retrospective analysis was performed of a prospectively compiled database of 183 consecutive patients with truncal and retroperitoneal sarcomas seen at the Brigham and Women's Hospital and the Dana Farber Cancer Institute between 1970 to 1994.
For truncal sarcoma, multivariate analysis showed that high-grade histology was associated with an eightfold increased risk of death compared with low-grade histology (p = 0.001). In addition to grade, gross positive margin of resection (p = 0.001), microscopic positive margin (p = 0.023), and tumors greater than 5 cm in size (p = 0.018) were important independent prognostic factors for survival. In this series, postoperative radiation therapy for truncal sarcoma was associated with a 2.4-fold decreased risk of death compared with truncal sarcoma patients receiving no adjuvant radiation therapy, having adjusted for the other prognostic factors (p = 0.030). In contrast, for retroperitoneal sarcoma, multivariate analysis showed that high-grade and intermediate-grade histology were associated with a five- to sixfold increased risk of death compared with low-grade histology (p = 0.009). In addition to grade, gross positive margin of resection (p = 0.001) and microscopic positive margin (p = 0.004) were important independent prognostic factors for survival in retroperitoneal sarcoma. Patients who received either preoperative or postoperative chemotherapy for retroperitoneal sarcoma had a 4.6-fold (p = 0.002) and 3-fold (p = 0.010) increased risk of death, respectively, compared with patients receiving no adjuvant chemotherapy, having adjusted for the other prognostic factors.
The histologic grade and the margin of resection are prognostic for survival in both truncal and retroperitoneal soft-tissue sarcoma. Tumor size was an independent prognostic factor for truncal sarcoma, but not for retroperitoneal sarcoma. Postoperative adjuvant radiation was beneficial to overall survival for truncal sarcoma. In this series of patients receiving a heterogeneous mixture of chemotherapeutic regimens-either as preoperative "neoadjuvant" therapy or as postoperative "adjuvant" therapy, there were no beneficial effects on survival compared wit |
| doi_str_mv | 10.1097/00000658-199502000-00009 |
| format | Article |
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These results can be used to optimize surgical management and select patients most likely to benefit from novel therapeutic strategies in future trials.
A retrospective analysis was performed of a prospectively compiled database of 183 consecutive patients with truncal and retroperitoneal sarcomas seen at the Brigham and Women's Hospital and the Dana Farber Cancer Institute between 1970 to 1994.
For truncal sarcoma, multivariate analysis showed that high-grade histology was associated with an eightfold increased risk of death compared with low-grade histology (p = 0.001). In addition to grade, gross positive margin of resection (p = 0.001), microscopic positive margin (p = 0.023), and tumors greater than 5 cm in size (p = 0.018) were important independent prognostic factors for survival. In this series, postoperative radiation therapy for truncal sarcoma was associated with a 2.4-fold decreased risk of death compared with truncal sarcoma patients receiving no adjuvant radiation therapy, having adjusted for the other prognostic factors (p = 0.030). In contrast, for retroperitoneal sarcoma, multivariate analysis showed that high-grade and intermediate-grade histology were associated with a five- to sixfold increased risk of death compared with low-grade histology (p = 0.009). In addition to grade, gross positive margin of resection (p = 0.001) and microscopic positive margin (p = 0.004) were important independent prognostic factors for survival in retroperitoneal sarcoma. Patients who received either preoperative or postoperative chemotherapy for retroperitoneal sarcoma had a 4.6-fold (p = 0.002) and 3-fold (p = 0.010) increased risk of death, respectively, compared with patients receiving no adjuvant chemotherapy, having adjusted for the other prognostic factors.
The histologic grade and the margin of resection are prognostic for survival in both truncal and retroperitoneal soft-tissue sarcoma. Tumor size was an independent prognostic factor for truncal sarcoma, but not for retroperitoneal sarcoma. Postoperative adjuvant radiation was beneficial to overall survival for truncal sarcoma. In this series of patients receiving a heterogeneous mixture of chemotherapeutic regimens-either as preoperative "neoadjuvant" therapy or as postoperative "adjuvant" therapy, there were no beneficial effects on survival compared with nonrandomized patients not receiving chemotherapy.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/00000658-199502000-00009</identifier><identifier>PMID: 7857146</identifier><identifier>CODEN: ANSUA5</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Abdomen ; Adult ; Biological and medical sciences ; Chemotherapy, Adjuvant ; Extremities ; Female ; Humans ; Male ; Medical sciences ; Prognosis ; Proportional Hazards Models ; Radiotherapy, Adjuvant ; Retroperitoneal Neoplasms - mortality ; Retroperitoneal Neoplasms - surgery ; Retrospective Studies ; Risk Factors ; Sarcoma - mortality ; Sarcoma - surgery ; Soft Tissue Neoplasms - mortality ; Soft Tissue Neoplasms - surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Survival Analysis ; Time Factors</subject><ispartof>Annals of surgery, 1995-02, Vol.221 (2), p.185-195</ispartof><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c539t-e4e1bfec27d27f33349f5640629cfe05874423b0c7a49a44fc6f45dead1ecbe63</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1234952/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1234952/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3437813$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7857146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SINGER, S</creatorcontrib><creatorcontrib>CORSON, J. M</creatorcontrib><creatorcontrib>DEMETRI, G. D</creatorcontrib><creatorcontrib>HEALEY, E. A</creatorcontrib><creatorcontrib>MARCUS, K</creatorcontrib><creatorcontrib>EBERLEIN, T. J</creatorcontrib><title>Prognostic factors predictive of survival for truncal and retroperitoneal soft-tissue sarcoma</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>The authors identified prognostic factors relevant to clinical outcomes (especially survival) in truncal and retroperitoneal soft-tissue sarcoma.
These results can be used to optimize surgical management and select patients most likely to benefit from novel therapeutic strategies in future trials.
A retrospective analysis was performed of a prospectively compiled database of 183 consecutive patients with truncal and retroperitoneal sarcomas seen at the Brigham and Women's Hospital and the Dana Farber Cancer Institute between 1970 to 1994.
For truncal sarcoma, multivariate analysis showed that high-grade histology was associated with an eightfold increased risk of death compared with low-grade histology (p = 0.001). In addition to grade, gross positive margin of resection (p = 0.001), microscopic positive margin (p = 0.023), and tumors greater than 5 cm in size (p = 0.018) were important independent prognostic factors for survival. In this series, postoperative radiation therapy for truncal sarcoma was associated with a 2.4-fold decreased risk of death compared with truncal sarcoma patients receiving no adjuvant radiation therapy, having adjusted for the other prognostic factors (p = 0.030). In contrast, for retroperitoneal sarcoma, multivariate analysis showed that high-grade and intermediate-grade histology were associated with a five- to sixfold increased risk of death compared with low-grade histology (p = 0.009). In addition to grade, gross positive margin of resection (p = 0.001) and microscopic positive margin (p = 0.004) were important independent prognostic factors for survival in retroperitoneal sarcoma. Patients who received either preoperative or postoperative chemotherapy for retroperitoneal sarcoma had a 4.6-fold (p = 0.002) and 3-fold (p = 0.010) increased risk of death, respectively, compared with patients receiving no adjuvant chemotherapy, having adjusted for the other prognostic factors.
The histologic grade and the margin of resection are prognostic for survival in both truncal and retroperitoneal soft-tissue sarcoma. Tumor size was an independent prognostic factor for truncal sarcoma, but not for retroperitoneal sarcoma. Postoperative adjuvant radiation was beneficial to overall survival for truncal sarcoma. In this series of patients receiving a heterogeneous mixture of chemotherapeutic regimens-either as preoperative "neoadjuvant" therapy or as postoperative "adjuvant" therapy, there were no beneficial effects on survival compared with nonrandomized patients not receiving chemotherapy.</description><subject>Abdomen</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Chemotherapy, Adjuvant</subject><subject>Extremities</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Radiotherapy, Adjuvant</subject><subject>Retroperitoneal Neoplasms - mortality</subject><subject>Retroperitoneal Neoplasms - surgery</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sarcoma - mortality</subject><subject>Sarcoma - surgery</subject><subject>Soft Tissue Neoplasms - mortality</subject><subject>Soft Tissue Neoplasms - surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUctqHDEQFCbBXjv5BIMOIbdx9GiNRpdAMM4DDMkhOQah1bRsmdnRWtIs5O-jtddLoovUVdXVoosQytkVZ0Z_YPvTq6HjxigmWtHtEXNCVlyJBnNgr8iqQbIDI8UZOS_lgTEOA9On5FQPSnPoV-T3j5zu5lRq9DQ4X1MudJtxjL7GHdIUaFnyLu7cREPKtOZl9u3t5pFmrDltMceaZmxYSaF2NZayIC0u-7Rxb8jr4KaCbw_3Bfn1-ebn9dfu9vuXb9efbjuvpKkdAvJ1QC_0KHSQUoIJqgfWC-MDMjVoACHXzGsHxgEE3wdQI7qRo19jLy_Ix2ff7bLe4OhxrtlNdpvjxuU_Nrlo_2fmeG_v0s5y0WYp0QzeHwxyelywVLuJxeM0uRnTUqxu2wIw0ITDs9DnVErGcBzCmd1HY1-iscdoniDTWi___eSx8ZBF498deFfajkN2s4_lKJMg9cCl_AuLoZoW</recordid><startdate>19950201</startdate><enddate>19950201</enddate><creator>SINGER, S</creator><creator>CORSON, J. M</creator><creator>DEMETRI, G. D</creator><creator>HEALEY, E. A</creator><creator>MARCUS, K</creator><creator>EBERLEIN, T. J</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19950201</creationdate><title>Prognostic factors predictive of survival for truncal and retroperitoneal soft-tissue sarcoma</title><author>SINGER, S ; CORSON, J. M ; DEMETRI, G. D ; HEALEY, E. A ; MARCUS, K ; EBERLEIN, T. J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c539t-e4e1bfec27d27f33349f5640629cfe05874423b0c7a49a44fc6f45dead1ecbe63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Abdomen</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Chemotherapy, Adjuvant</topic><topic>Extremities</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Radiotherapy, Adjuvant</topic><topic>Retroperitoneal Neoplasms - mortality</topic><topic>Retroperitoneal Neoplasms - surgery</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sarcoma - mortality</topic><topic>Sarcoma - surgery</topic><topic>Soft Tissue Neoplasms - mortality</topic><topic>Soft Tissue Neoplasms - surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SINGER, S</creatorcontrib><creatorcontrib>CORSON, J. M</creatorcontrib><creatorcontrib>DEMETRI, G. D</creatorcontrib><creatorcontrib>HEALEY, E. A</creatorcontrib><creatorcontrib>MARCUS, K</creatorcontrib><creatorcontrib>EBERLEIN, T. J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SINGER, S</au><au>CORSON, J. M</au><au>DEMETRI, G. D</au><au>HEALEY, E. A</au><au>MARCUS, K</au><au>EBERLEIN, T. J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic factors predictive of survival for truncal and retroperitoneal soft-tissue sarcoma</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>1995-02-01</date><risdate>1995</risdate><volume>221</volume><issue>2</issue><spage>185</spage><epage>195</epage><pages>185-195</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><coden>ANSUA5</coden><abstract>The authors identified prognostic factors relevant to clinical outcomes (especially survival) in truncal and retroperitoneal soft-tissue sarcoma.
These results can be used to optimize surgical management and select patients most likely to benefit from novel therapeutic strategies in future trials.
A retrospective analysis was performed of a prospectively compiled database of 183 consecutive patients with truncal and retroperitoneal sarcomas seen at the Brigham and Women's Hospital and the Dana Farber Cancer Institute between 1970 to 1994.
For truncal sarcoma, multivariate analysis showed that high-grade histology was associated with an eightfold increased risk of death compared with low-grade histology (p = 0.001). In addition to grade, gross positive margin of resection (p = 0.001), microscopic positive margin (p = 0.023), and tumors greater than 5 cm in size (p = 0.018) were important independent prognostic factors for survival. In this series, postoperative radiation therapy for truncal sarcoma was associated with a 2.4-fold decreased risk of death compared with truncal sarcoma patients receiving no adjuvant radiation therapy, having adjusted for the other prognostic factors (p = 0.030). In contrast, for retroperitoneal sarcoma, multivariate analysis showed that high-grade and intermediate-grade histology were associated with a five- to sixfold increased risk of death compared with low-grade histology (p = 0.009). In addition to grade, gross positive margin of resection (p = 0.001) and microscopic positive margin (p = 0.004) were important independent prognostic factors for survival in retroperitoneal sarcoma. Patients who received either preoperative or postoperative chemotherapy for retroperitoneal sarcoma had a 4.6-fold (p = 0.002) and 3-fold (p = 0.010) increased risk of death, respectively, compared with patients receiving no adjuvant chemotherapy, having adjusted for the other prognostic factors.
The histologic grade and the margin of resection are prognostic for survival in both truncal and retroperitoneal soft-tissue sarcoma. Tumor size was an independent prognostic factor for truncal sarcoma, but not for retroperitoneal sarcoma. Postoperative adjuvant radiation was beneficial to overall survival for truncal sarcoma. In this series of patients receiving a heterogeneous mixture of chemotherapeutic regimens-either as preoperative "neoadjuvant" therapy or as postoperative "adjuvant" therapy, there were no beneficial effects on survival compared with nonrandomized patients not receiving chemotherapy.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>7857146</pmid><doi>10.1097/00000658-199502000-00009</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Annals of surgery, 1995-02, Vol.221 (2), p.185-195 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Journals@Ovid Complete |
| subjects | Abdomen Adult Biological and medical sciences Chemotherapy, Adjuvant Extremities Female Humans Male Medical sciences Prognosis Proportional Hazards Models Radiotherapy, Adjuvant Retroperitoneal Neoplasms - mortality Retroperitoneal Neoplasms - surgery Retrospective Studies Risk Factors Sarcoma - mortality Sarcoma - surgery Soft Tissue Neoplasms - mortality Soft Tissue Neoplasms - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Survival Analysis Time Factors |
| title | Prognostic factors predictive of survival for truncal and retroperitoneal soft-tissue sarcoma |
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