Prognostic factors, treatment, and survival in cutaneous pleomorphic sarcoma

J Am Acad Dermatol. 2020 Aug;83(2):388-396. doi: 10.1016/j.jaad.2018.08.054. Epub 2018 Nov 8.

Abstract

Background: Limited information exists on the influence of demographics, tumor characteristics, and treatment on survival in cutaneous pleomorphic sarcoma (CPS).

Objective: To describe incidence rates and prognostic factors affecting survival in CPS.

Methods: National Cancer Institute's Surveillance, Epidemiology, and End Results data (1972-2013) was analyzed for 2423 patients with CPS diagnoses.

Results: The age-adjusted incidence rate was 0.152 cases/100,000 person-years and was 4.5-fold higher in male than female patients. Male sex, white race, and increasing age >40 years were significantly associated with decreased overall survival. Head and neck tumors, tumors >15 mm, and tumors with grade III or IV histology were associated with significantly decreased survival. Surgical excision had a survival benefit compared with no treatment. Radiation therapy did not provide a survival benefit. Patients with localized disease had the greatest survival followed by regional and distant disease.

Limitations: Surveillance, Epidemiology, and End Results data might not be reflective of all CPS patients. Recurrences, restaging, or other nonmortality events over time were not tracked.

Conclusion: Tumor size, grade, sex, age at diagnosis, and race appear to influence survival as prognostic factors in CPS. Surgical tumor extirpation provides a survival benefit over no treatment whereas primary or adjuvant radiation does not provide a survival benefit.

Keywords: demographics; epidemiology; prognostic factors; treatment; undifferentiated pleomorphic sarcoma.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cryosurgery / statistics & numerical data
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Laser Therapy / statistics & numerical data
  • Male
  • Middle Aged
  • Mohs Surgery / statistics & numerical data
  • Neoadjuvant Therapy / methods
  • Neoadjuvant Therapy / statistics & numerical data
  • Neoplasm Grading
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / prevention & control
  • Prognosis
  • Radiotherapy, Adjuvant / statistics & numerical data
  • Risk Factors
  • SEER Program / statistics & numerical data
  • Sarcoma / diagnosis
  • Sarcoma / mortality*
  • Sarcoma / pathology
  • Sarcoma / therapy*
  • Sex Factors
  • Skin / pathology
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / mortality*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*
  • Tumor Burden
  • United States / epidemiology
  • Young Adult