Metastatic appendicular soft tissue sarcoma: treatment and survival outcomes of 2,553 patients from the SEER database  

作　　者：Marcos R.Gonzalez Paul Rizk Thomas W.Hodo Angad Bedi Daniel Karczewski Santiago A.Lozano-Calderon 

机构地区：[1]Division of Orthopaedic Oncology,Department of Orthopaedic Surgery,Massachusetts General Hospital,Harvard Medical School,Boston,MA 02144,USA [2]Department of Orthopaedic Surgery,University of Florida,Gainesville,FL 32608,USA [3]Department of Orthopaedic Surgery,Tulane University School of Medicine,New Orleans,LA 70112,USA [4]Department of Orthopaedic Surgery,University Medical Center Groningen,University of Groningen,Groningen,The Netherlands

出　　处：《Journal of Cancer Metastasis and Treatment》2023年第1期480-496,共17页癌症转移与治疗（英文版）

摘　　要：Introduction:Patients with soft tissue sarcoma(STS)that present with metastasis at diagnosis have a dire prognosis.Within this patient population,we sought to assess:(1)demographic and clinical characteristics,(2)metastatic patterns,(3)treatment strategies,and(4)disease-specific survival(DSS).Materials and Methods:The SEER database was queried to identify patients with histologically confirmed STS of the pelvis or extremity.Univariate and multivariate analysis was performed using the Cox proportional hazards model.Disease-specific survival(DSS)was analyzed using the Kaplan-Meier method.Results:A total of 22,683 patients were retrieved,out of which 2,553(11.3%)had metastasis at diagnosis.Leiomyosarcoma,undifferentiated pleomorphic sarcoma(UPS),liposarcoma,synovial sarcoma,spindle cell sarcoma,and alveolar rhabdomyosarcoma(A-RMS)were the six most common STS presenting with metastasis.Among patients with metastasis,53.7%and 33.2%of patients had primary tumors located in the lower limb and pelvis,respectively.Lung was the most common site of metastasis in all subtypes except A-RMS,in which bone metastases and lymph node(LN)predominated(85.2%and 62.1%,respectively).Chemotherapy and radiotherapy were associated with higher DSS(HR=0.788 and HR=0.755,respectively).Five-year DSS was below 20%in all tumor histologies.Two-year DSS for patients with synchronous lung and liver metastases was 28%.Conclusion:Although the lung was the most common site of metastasis,metastatic patterns are highly variable depending on tumor histology.Metastatic A-RMS is most commonly presented with regional LN and bone involvement.Disease-specific survival remained poor for patients with metastatic disease at presentation regardless of(neo)-adjuvant radiotherapy or chemotherapy.

关 键 词：Soft tissue sarcoma METASTASIS TREATMENT SURVIVAL 

分 类 号：R738.6[医药卫生—肿瘤]