Improved prognosis in soft-tissue sarcoma of extremity and trunk wall

Figures & data

Table 1. Patient and tumor characteristics in patients of the 2 cohorts

	Cohort 2005–2010 n = 359	Cohort 1998–2001^c n = 215
Histology
UPS	123	89
Liposarcoma	59	41
Leiomyosarcoma	57	36
MPNST	14	1
Synovial sarcoma	19	22
Fibrosarcoma	15	8
Myxofibrosarcoma	20	2
Sarcoma otherwise specified	9	8
Sarcoma not otherwise specified	43	8
Grade
Low	73	56
High	286	158
Size (cm), mean (SD)^a	8.0 (5.4)	7.7 (5.6)
Site
Lower extremity	185	109
Trunk wall	119	62
Upper extremity	55	44
Depth
Superficial^b	122	66
Deep	237	149
Postirradition sarcoma
Yes	12	3
No	347	212
Age (years), mean (SD)	62 (18)	62 (17)
Sex
Male	192	132
Female	167	83

MPNST = malignant peripheral nervous sheath tumor.

UPS = undifferentiated pleomorphic sarcoma.

a Largest diameter in fixed specimen.

b Subcutaneous tumor with or without cutaneous extension.

c Of the characteristics only distributions of histologic subtypes differed significantly (p < 0.001), chi squared test or Fischers exact test.

Table 2. Characteristics of diagnostics and treatment in the 2 cohorts

Variable	Cohort 2005–2010 n = 359	Cohort 1998–2001 n = 215	p-value^d
Preoperative diagnosis			<0.001
None	94	96
Cytology	7	8
Core needle biopsy	236	99
Open biopsy	22	12
Number of operations			0.007
1	251	125
2	105	84
3	3	6
First margin^a			0.2
Intralesional	88	67
Marginal	20	23
Definite margin			<0.001
Intralesional	25	44
Marginal	217	112
Wide	117	58
Surgery extent^b			0.7
Amputation	26	15
Limb-sparing surgery	214	138
Radiation therapy^c			0.01
Yes	188	103
No	54	53
Chemotherapy			0.01
Yes	72	26
No	287	189

a For 108 and 90 patients having >1 surgery for the primary tumor.

b 240 and 153 tumors of the extremities.

c for 242 and 156 with intralesional or marginal definite surgery.

d χ² test or Fisher's exact test.

Figure 1. Local control plotted against time. Blue line: 2005–2010 cohort, green line: 1998–2001 cohort (p = 0.003)

Figure 2. Sarcoma-specific survival plotted against time. Blue line: 2005–2010 cohort, green line: 1998–2001 cohort (p = 0.005)

Table 3. Uni- and multivariate analyses on prognostic factors for local recurrence

	Univariate analysis			Multivariate analysis
	Relative risk	95% CI	p-value	Relative risk	95% CI	p-value
Cohort (former vs. latter)	0.6	0.4–0.8	0.003	0.6	0.4–0.9	0.01
Age per year	1.03	1.02–1.05	< 0.001	1.03	1.01–1.05	< 0.001
Margin category^a	0.3	0.2–0.5	< 0.001	0.4	0.3–0.6	< 0.001
Size per cm	1.006	1.0–1.01	0.08
Radiation therapy (yes vs. no)	1.2	0.8–1.2	0.4
Sex (female vs. male)	1.3	0.8–1.9	0.3
Depth (superficial vs. deep)	1.3	0.8–2.0	0.3
Grade (low grade vs. high grade)	1.1	0.7–1.8	0.7
Site (extremity vs. trunk wall)	1.2	0.8–1.8	0.4
Post-irradiation sarcoma (yes vs. no)	0.5	0.2–1.5	0.2
Chemotherapy (yes vs no)	0.8	0.5–1.5	0.5

a Intralesional vs. marginal vs. wide.

Table 4. Uni- and multivariate analyses on prognostic factors for metastases

	Univariate analysis			Multivariate analysis
	Relative risk	95% CI	p-value	Relative risk	95% CI	p-value
Cohort (former vs. latter)	0.7	0.5–1.0	0.05	0.8	0.6–1.1	0.2
Age per year	1.0	1.0–1.01	0.05
Margin category^a	0.6	0.5–0.8	< 0.001	0.7	0.5–0.9	0.04
Size per cm	1.09	1.07–1.1	< 0.001	1.07	1.05–1.1	< 0.001
Radiation therapy (yes vs. no)	1.6	1.2–2.2	0.003	0.8	0.5–1.3	0.4
Sex (female vs. male)	1.5	1.1–2.1	0.01	1.5	1.1–2.1	0.04
Depth (superficial vs. deep)	2.4	1.6–3.6	< 0.001	1.6	1.0–2.5	0.05
Grade (low grade vs. high grade)	3.9	2.2–6.7	< 0.001	4.0	2.0–7.9	< 0.001
Site (extremity vs. trunk wall)	1.0	0.7–1.3	0.8
Post-irradiation sarcoma (yes vs. no)	1.02	0.4–2.7	1.0
Chemotherapy (yes vs no)	1.3	0.9–1.9	0.2

a Intralesional vs. marginal vs. wide.

Table 5. Uni- and multivariate analyses on prognostic factors for sarcoma-related death

	Univariate analysis			Multivariate analysis
	Relative risk	95% CI	p-value	Relative risk	95% CI	p-value
Cohort (former vs. latter)	0.6	0.4–0.8	0.005	0.6	0.5–0.9	0.005
Age per year	1.02	1.01–1.04	< 0.001	1.02	1.01–1.03	0.001
Margin category^a	0.5	0.4–0.6	< 0.001	0.6	0.4–0.7	< 0.001
Size per cm	1.0	1.0–1.01	0.6
Radiation therapy (yes vs. no)	1.3	0.9–1.8	0.1
Sex (female vs. male)	1.2	0.9–1.7	0.2
Depth (superficial vs. deep)	2.2	1.5–3.3	< 0.001	1.8	1.2–2.8	0.003
Grade (low grade vs. high grade)	3.3	1.9–5.6	< 0.001	3.2	1.9–5.5	< 0.001
Site (extremity vs. trunk wall)	1.1	0.7–1.4	1
Post-irradiation sarcoma (yes vs. no)	0.9	0.4–2.3	0.8
Chemotherapy (yes vs no)	1.3	0.8–1.8	0.4

a Intralesional vs. marginal vs. wide.