Abstract
Objective: The objective of this study was to investigate the prognosis of patients with metastatic soft tissue sarcomas (STS) and to define prognostic indicators for overall survival (OS). Methods: All patients who were treated at the Sarcoma Unit at the Mannheim University Medical Center between 2010 and 2016 and who developed metastatic disease deriving from a STS were included in this retrospective analysis. OS was investigated using data from clinical records and German registry offices. Clinical and pathological characteristics were recorded and analyzed. Results: A total number of 212 patients developed metastatic disease from STS during that period. Median OS after first documentation of metastatic disease was 24 months (95% CI 21–33). 1-, 2-, and 5-year OS rates were 70.0% (95% CI 64–77), 49.9% (95% CI 43–58), and 24.8% (95% CI 19–33), respectively. In multivariate analysis, significant predictors for mortality appeared to be gender, age, location and size of the primary tumor, histology, and disease-free interval. Conclusion: Being treated in a high-volume STS reference center in Germany, patients with metastatic disease could demonstrate an increased OS compared to former analyses. These data can be used as a benchmark for upcoming studies and highlight that further research on treatment strategies in this rare disease is urgently needed.
Journal Section:
Research Article
References
1.
Stiller
CA
, Trama
A
, Serraino
D
, Rossi
S
, Navarro
C
, Chirlaque
MD
, et al; RARECARE Working Group
. Descriptive epidemiology of sarcomas in Europe: report from the RARECARE project
. Eur J Cancer
. 2013
Feb
;49
(3
):684
–95
.
[PubMed]
0959-80492.
Coindre
JM
, Terrier
P
, Guillou
L
, Le Doussal
V
, Collin
F
, Ranchère
D
, et al. Predictive value of grade for metastasis development in the main histologic types of adult soft tissue sarcomas: a study of 1240 patients from the French Federation of Cancer Centers Sarcoma Group
. Cancer
. 2001
May
;91
(10
):1914
–26
.
[PubMed]
0008-543X3.
Potter
DA
, Glenn
J
, Kinsella
T
, Glatstein
E
, Lack
EE
, Restrepo
C
, et al. Patterns of recurrence in patients with high-grade soft-tissue sarcomas
. J Clin Oncol
. 1985
Mar
;3
(3
):353
–66
.
[PubMed]
0732-183X4.
Ferguson
PC
, Deheshi
BM
, Chung
P
, Catton
CN
, O’Sullivan
B
, Gupta
A
, et al. Soft tissue sarcoma presenting with metastatic disease: outcome with primary surgical resection
. Cancer
. 2011
Jan
;117
(2
):372
–9
.
[PubMed]
0008-543X5.
Riad
S
, Griffin
AM
, Liberman
B
, Blackstein
ME
, Catton
CN
, Kandel
RA
, et al. Lymph node metastasis in soft tissue sarcoma in an extremity
. Clin Orthop Relat Res
. 2004
Sep
;(426
):129
–34
.
[PubMed]
0009-921X6.
ESMO Guidelines Committee and EURACAN
. Soft tissue and visceral sarcomas: ESMO–EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up
. Ann Oncol
. 2018
;•••
:29
.0923-75347.
Treasure
T
, Fiorentino
F
, Scarci
M
, Møller
H
, Utley
M
. Pulmonary metastasectomy for sarcoma: a systematic review of reported outcomes in the context of Thames Cancer Registry data
. BMJ Open
. 2012
Oct
;2
(5
):e001736
.
[PubMed]
2044-60558.
Le Cesne
A
, Blay
JY
, Judson
I
, Van Oosterom
A
, Verweij
J
, Radford
J
, et al. Phase II study of ET-743 in advanced soft tissue sarcomas: a European Organisation for the Research and Treatment of Cancer (EORTC) soft tissue and bone sarcoma group trial
. J Clin Oncol
. 2005
Jan
;23
(3
):576
–84
.
[PubMed]
0732-183X9.
van der Graaf
WT
, Blay
JY
, Chawla
SP
, Kim
DW
, Bui-Nguyen
B
, Casali
PG
, et al; EORTC Soft Tissue and Bone Sarcoma Group
; PALETTE study group
. Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial
. Lancet
. 2012
May
;379
(9829
):1879
–86
.
[PubMed]
0140-673610.
Schöffski
P
, Chawla
S
, Maki
RG
, Italiano
A
, Gelderblom
H
, Choy
E
, et al. Eribulin versus dacarbazine in previously treated patients with advanced liposarcoma or leiomyosarcoma: a randomised, open-label, multicentre, phase 3 trial
. Lancet
. 2016
Apr
;387
(10028
):1629
–37
.
[PubMed]
0140-673611.
Billingsley
KG
, Lewis
JJ
, Leung
DH
, Casper
ES
, Woodruff
JM
, Brennan
MF
. Multifactorial analysis of the survival of patients with distant metastasis arising from primary extremity sarcoma
. Cancer
. 1999
Jan
;85
(2
):389
–95
.
[PubMed]
0008-543X12.
Italiano
A
, Mathoulin-Pelissier
S
, Cesne
AL
, Terrier
P
, Bonvalot
S
, Collin
F
, et al. Trends in survival for patients with metastatic soft-tissue sarcoma
. Cancer
. 2011
Mar
;117
(5
):1049
–54
.
[PubMed]
0008-543X13.
Nagar
SP
, Mytelka
DS
, Candrilli
SD
, D’yachkova
Y
, Lorenzo
M
, Kasper
B
, et al. Treatment Patterns and Survival among Adult Patients with Advanced Soft Tissue Sarcoma: A Retrospective Medical Record Review in the United Kingdom, Spain, Germany, and France
. Sarcoma
. 2018
May
;2018
(5467057
):5467057
.
[PubMed]
1357-714X14.
Tap
WD
. ANNOUNCE. ASCO 2019
.15.
Tap
WD
, Papai
Z
, Van Tine
BA
, Attia
S
, Ganjoo
KN
, Jones
RL
, et al. Doxorubicin plus evofosfamide versus doxorubicin alone in locally advanced, unresectable or metastatic soft-tissue sarcoma (TH CR-406/SARC021): an international, multicentre, open-label, randomised phase 3 trial
. Lancet Oncol
. 2017
Aug
;18
(8
):1089
–103
.
[PubMed]
1470-204516.
Kaplan
EL
, Meier
P
. Nonparametric-Estimation from Incomplete Observations
. J Am Stat Assoc
. 1958
;53
(282
):457
–81
. 0162-145917.
Mantel
N
. Citation Classic - Evaluation of Survival-Data and 2 New Rank Order-Statistics Arising in Its Consideration. Cc
. Life Sci
. 1983
;(8
):19
.0024-320518.
Cox
DR
. Regression Models and Life-Tables
. J R Stat Soc B
. 1972
;34
(2
):187
–202
. 0035-924619.
Verschoor
AJ
, Litière
S
, Marréaud
S
, Judson
I
, Toulmonde
M
, Wardelmann
E
, et al. Prognostic relevance of distant metastases versus locally advanced disease in soft tissue sarcomas: an EORTC-STBSG database study
. Eur J Cancer
. 2018
May
;94
:187
–98
.
[PubMed]
0959-804920.
García-Del-Muro
X
, López-Pousa
A
, Maurel
J
, Martín
J
, Martínez-Trufero
J
, Casado
A
, et al; Spanish Group for Research on Sarcomas
. Randomized phase II study comparing gemcitabine plus dacarbazine versus dacarbazine alone in patients with previously treated soft tissue sarcoma: a Spanish Group for Research on Sarcomas study
. J Clin Oncol
. 2011
Jun
;29
(18
):2528
–33
.
[PubMed]
0732-183X21.
Savina
M
, Le Cesne
A
, Blay
JY
, Ray-Coquard
I
, Mir
O
, Toulmonde
M
, et al. Patterns of care and outcomes of patients with METAstatic soft tissue SARComa in a real-life setting: the METASARC observational study
. BMC Med
. 2017
Apr
;15
(1
):78
.
[PubMed]
1741-701522.
Kasper
B
, Lecointe-Artzner
E
, Wait
S
, Boldon
S
, Wilson
R
, Gronchi
A
, et al. Working to improve the management of sarcoma patients across Europe: a policy checklist
. BMC Cancer
. 2018
Apr
;18
(1
):424
.
[PubMed]
1471-240723.
Derbel
O
, Heudel
PE
, Cropet
C
, Meeus
P
, Vaz
G
, Biron
P
, et al. Survival impact of centralization and clinical guidelines for soft tissue sarcoma (A prospective and exhaustive population-based cohort)
. PLoS One
. 2017
Feb
;12
(2
):e0158406
.
[PubMed]
1932-620324.
Bauer
HC
, Trovik
CS
, Alvegård
TA
, Berlin
O
, Erlanson
M
, Gustafson
P
, et al. Monitoring referral and treatment in soft tissue sarcoma: study based on 1,851 patients from the Scandinavian Sarcoma Group Register
. Acta Orthop Scand
. 2001
Apr
;72
(2
):150
–9
.
[PubMed]
0001-647025.
Gutierrez
JC
, Perez
EA
, Moffat
FL
, Livingstone
AS
, Franceschi
D
, Koniaris
LG
. Should soft tissue sarcomas be treated at high-volume centers? An analysis of 4205 patients
. Ann Surg
. 2007
Jun
;245
(6
):952
–8
.
[PubMed]
0003-493226.
Ray-Coquard
I
, Thiesse
P
, Ranchère-Vince
D
, Chauvin
F
, Bobin
JY
, Sunyach
MP
, et al. Conformity to clinical practice guidelines, multidisciplinary management and outcome of treatment for soft tissue sarcomas
. Ann Oncol
. 2004
Feb
;15
(2
):307
–15
.
[PubMed]
0923-753427.
Que
Y
, Xiao
W
, Xu
BS
, Wen
XZ
, Weng
DS
, Zhang
X
. The changing landscape of phase II/III metastatic sarcoma clinical trials-analysis of ClinicalTrials.gov
. BMC Cancer
. 2018
Dec
;18
(1
):1251
.
[PubMed]
1471-240728.
Lewis
JJ
, Leung
D
, Woodruff
JM
, Brennan
MF
. Retroperitoneal soft-tissue sarcoma: analysis of 500 patients treated and followed at a single institution
. Ann Surg
. 1998
Sep
;228
(3
):355
–65
.
[PubMed]
0003-4932© 2020 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2020
You do not currently have access to this content.
