Long-Term Follow-Up of Patients Receiving Neoadjuvant Treatment Modalties for Soft Tissue Sarcomas of the Extremities
Abstract
:Simple Summary
Abstract
1. Introduction
2. Patients and Methods
2.1. Patient Selection and Data
2.2. Neoadjuvant Therapy
2.3. Conduct of Surgery and Response Assessment
2.4. Follow Up and Statistical Analysis
3. Results
3.1. Demographics and Clinical Characteristics
3.2. Therapeutic Characteristics
3.3. Clinical and Pathological Response to the Neoadjuvant Therapy
3.4. Follow-Up
3.5. Prognostic Factors and Group Differences
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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nRT (n = 74) | PS (n = 62) | Total (n = 136) | p-Value ** | |
---|---|---|---|---|
Sex, no. (%) | ||||
Male | 43 (58.1%) | 30 (48.4%) | 73 (53.7%) | 0.302 a |
Female | 31 (41.9%) | 32 (51.6%) | 63 (46.3%) | |
Age in years | ||||
Mean (±SD) | 61.69 (±13.57) | 61.89(±16.61) | 61.8 (±15.0) | 0.940 b |
Median | 64.0 | 63.5 | 64.0 | |
Range (min.-max.) | 24–87 | 21–93 | 21–93 | |
Histological Type, no. (%) | ||||
Undifferentiated pleomorph sarcoma | 28 (37.8%) | 7 (11.3%) | 35 (25.7%) | <0.001 a |
Well differentiated Liposarcoma | 3 (4.1%) | 29 (46.8%) | 32 (23.5%) | <0.001 c |
Myxofibrosarcoma | 8 (10.9%) | 8 (12.9%) | 16 (11.8%) | 0.706 a |
Leiomyosarcoma | 5 (6.7%) | 5 (8.1%) | 10 (7.4%) | 0.771 a |
Myxoid liposarcoma | 5 (6.7%) | 4 (6.5%) | 9 (6.7%) | 1.000 c |
Synovialsarcoma | 5 (6.7%) | 2 (3.2%) | 7 (5.1%) | 0.454 c |
Spindle cell sarcoma | 5 (6.7%) | 1 (1.6%) | 6 (4.4%) | 0.219 c |
Dedifferentiated liposarcoma | 3 (4.1%) | 0 (0%) | 3 (2.2%) | 0.250 c |
Angiosarcoma | 0 (0%) | 2 (3.2%) | 2 (1.5%) | 0.206 c |
Alveolar sarcoma | 1 (1.4%) | 1 (1.6%) | 2 (1.5%) | 1.000 c |
Other sarcoma * | 11 (14.9%) | 3 (4.8%) | 14 (10.3%) | 0.087 c |
Tumor location, no. (%) | ||||
Upper Extremity | 15 (20.2%) | 15 (24.2%) | 30 (22%) | 0.679 a |
Lower Extremity | 59 (79.8%) | 47 (75.8%) | 106 (78%) | |
Tumor depth, no. (%) | ||||
Epifascial Tumor | 15 (20.2%) | 18 (29.1%) | 33 (24.3%) | 0.248 a |
Subfascial Tumor | 57 (77.1%) | 43 (69.3%) | 100 (73.5%) | |
Missing value | 2 (2.7%) | 1 (1.6%) | 3 (2.2%) | |
Initial tumorsize in cm | ||||
Mean (±SD) | 11.3 (±6.3) | 12.0 (±8.8) | 11.6 (±7.5) | 0.617 b |
Median | 10.0 | 9.8 | 10.0 | |
Range (min.-max.) | 2.5–30.0 | 0.5–35.0 | 0.5–35 | |
G-Grading (histological differentiation) | ||||
G1 | 4 (5.4%) | 33 (53.3%) | 37 (27.2%) | <0.001 a |
G2 | 20 (27.0%) | 14 (22.6%) | 34 (25.0%) | |
G3 | 45 (60.8%) | 10 (16.1%) | 55 (40.4%) | |
G4 | 1 (1.4%) | 1 (1.6%) | 2 (1.5%) | |
GX | 3 (4.0%) | 3 (4.8%) | 6 (4.4%) | |
Missing value | 1 (1.4%) | 1 (1.6%) | 2 (1.5%) | |
High-/low grade STS | ||||
Low-grade | 14 (18.9%) | 42 (67.7%) | 56 (42.4%) | <0.001 a |
High-grade | 58 (78.4%) | 18 (29.1%) | 76 (57.6%) | |
Missing value | 2 (2.7%) | 2 (3.2%) | 4 (2.9%) |
NT (n = 74) | PS (n = 62) | Total (n = 136) | p-Value * | |
---|---|---|---|---|
Group, no. (%) | ||||
Primary surgery | -- | 62 (100%) | 62 (45.6%) | -- |
Neoadjuvant therapy | 74 (100%) | -- | 74 (54.4%) | -- |
RCT | 66 (89.2%) | -- | 66 (48.5%) | |
With hyperthermia | 29 | -- | ||
RT | 8 (10.8%) | -- | 8 (5.9%) | |
With hyperthermia | 2 | |||
Adjuvant therapy | -- | 11 (17.7%) | 11 (8.1%) | |
RCT | -- | 6 (9.6%) | 6 (4.4%) | |
RT | -- | 4 (6.5%) | 4 (2.9%) | |
CTx | -- | 1 (1.6%) | 1 (0.7%) | |
Outpatient practice primary R1-excision, no. (%) | ||||
No outpatient practice primary excision | 53 (71.5%) | 48 (77.5%) | 101 (74.3%) | 0.441 |
Outpatient practice primary excision | 21 (28.5%) | 14 (22.5%) | 35 (25.7%) | |
Surgical procedure, no. (%) | ||||
Wide resection | 46 (62.2%) | 45 (72.5%) | 91 (66.9%) | 0.198 |
Compartmental resection | 28 (37.8%) | 17 (27.5%) | 45 (33.1%) | |
R-Stage (residual tumor) | ||||
R0 | 65 (87.8%) | 51 (82.3%) | 116 (85.3%) | 0.482 |
R1 | 8 (10.8%) | 9 (14.5%) | 17 (12.5%) | |
RX | 1 (1.4%) | 2 (3.2%) | 3 (2.2%) | |
Postoperative complications, no. (%) | ||||
No complications | 37 (50.0%) | 47 (75.8%) | 83 (61.0%) | 0.003 |
With Complications | 37 (50.0%) | 15 (24.2%) | 52 (38.2%) | |
Grade I | 20 (27.0%) | 13 (20.9%) | 33 (24.3%) | |
Grade II | 6 (8.1%) | 2 (3.3%) | 8 (5.9%) | |
Grade III | 11 (14.9%) | 0 (0%) | 11 (8.1%) | |
Grade IV | 0 (0%) | 0 (0%) | 0 (0%) | |
Grade V | 0 (0%) | 0 (0%) | 0 (0%) |
Survival Rates | Low-Risk STS (n = 24) | High-Risk STS (n = 46) | p-Value * |
---|---|---|---|
OS | 111.97 (±10.00) | 92.93 (±13.22) | 0.018 * |
LRFS | 127.01 (±7.64) | 176.19 (±9.32) | 0.962 |
MFS | 104.91 (±11.83) | 120.79 (±14.51) | 0.346 |
DFS | 99.21 (±12.46) | 115.65 (±14.76) | 0.442 |
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Rauch, M.; Agaimy, A.; Semrau, S.; Willner, A.; Ott, O.; Fietkau, R.; Hohenberger, W.; Croner, R.S.; Grützmann, R.; Fechner, K.; et al. Long-Term Follow-Up of Patients Receiving Neoadjuvant Treatment Modalties for Soft Tissue Sarcomas of the Extremities. Cancers 2021, 13, 5244. https://doi.org/10.3390/cancers13205244
Rauch M, Agaimy A, Semrau S, Willner A, Ott O, Fietkau R, Hohenberger W, Croner RS, Grützmann R, Fechner K, et al. Long-Term Follow-Up of Patients Receiving Neoadjuvant Treatment Modalties for Soft Tissue Sarcomas of the Extremities. Cancers. 2021; 13(20):5244. https://doi.org/10.3390/cancers13205244
Chicago/Turabian StyleRauch, Miriam, Abbas Agaimy, Sabine Semrau, Alexander Willner, Oliver Ott, Rainer Fietkau, Werner Hohenberger, Roland S. Croner, Robert Grützmann, Katja Fechner, and et al. 2021. "Long-Term Follow-Up of Patients Receiving Neoadjuvant Treatment Modalties for Soft Tissue Sarcomas of the Extremities" Cancers 13, no. 20: 5244. https://doi.org/10.3390/cancers13205244