Prognostic factors affecting survival in metastatic soft tissue sarcoma: an analysis of 110 patients

Clin Transl Oncol. 2016 Mar;18(3):310-6. doi: 10.1007/s12094-015-1369-9. Epub 2015 Aug 5.

Abstract

Background: Data on treatment outcome and prognostic factors in patients with metastatic soft tissue sarcoma (STS) are limited in the literature.

Methods: A total of 119 patients with metastatic STS treated between June 2003 and December 2012 were analyzed for treatment outcome and prognostic factors.

Results: Median age was 37 years (range 2-72 years) with a male to female ratio of 1.5:1. Most common histologic subtypes were synovial sarcoma (36 %) and leiomyosarcoma (16 %). Median tumor size was 12 cm (range 1.6-30 cm). Twenty-four (20 %) patients were treated with multimodality therapy and 80 % patients received systemic chemotherapy alone. At a median follow-up of 10 months (range 1-66 months), the 2-year EFS and OS were 10 and 19 %, respectively, with a median EFS and OS of 6 and 10 months, respectively. Univariate analysis identified albumin ≤4 g/dl (p = 0.001), histologic subtypes other than synovial sarcoma (p = 0.02), non-extremity tumors (p = 0.03) and single modality treatment (p = 0.03) as factors predicting poor EFS; however, for OS, hemoglobin ≤10 g/dl (p = 0.02), tumor size >10 cm (p = 0.01) and single modality treatment (p = 0.04) were identified as poor prognostic factors. Multivariate analysis identified only serum albumin ≤4 g/dl (p = 0.002, HR 0.47, 95 % CI 0.29-0.75) associated with poor EFS; however, for OS, hemoglobin ≤10 g/dl (p = 0.009, HR 0.49, 95 % CI 0.29-0.83), tumor size >10 cm (p = 0.003, HR 2.11, 95 % CI 1.28-3.47) and single modality treatment (p = 0.01, HR 0.47, 95 % CI 0.25-0.86) emerged as poor prognostic factors.

Conclusions: Serum albumin, tumor size, hemoglobin and treatment modality affect survival in metastatic STS.

Keywords: Metastatic disease; Prognostic factors; Soft tissue sarcoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Hemoglobins
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Metastasis
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Sarcoma / mortality
  • Sarcoma / pathology*
  • Sarcoma / therapy*
  • Serum Albumin
  • Soft Tissue Neoplasms / mortality
  • Soft Tissue Neoplasms / pathology*
  • Soft Tissue Neoplasms / therapy*
  • Treatment Outcome
  • Young Adult

Substances

  • Hemoglobins
  • Serum Albumin