Ozcelik Melike, Seker Mesut, Eraslan Emrah, Koca Sinan, Yazilitas Dogan, Ercelep Ozlem, Ozaslan Ersin, Kaya Serap, Hacibekiroglu Ilhan, Menekse Serkan, Aksoy Asude, Taskoylu Burcu Yapar, Varol Umut, Arpaci Erkan, Ciltas Aydin, Oksuzoglu Berna, Zengin Nurullah, Gumus Mahmut, Aliustaoglu Mehmet
Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey.
Department of Medical Oncology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.
Tumour Biol. 2016 Apr;37(4):5231-7. doi: 10.1007/s13277-015-4359-1. Epub 2015 Nov 10.
Most data on prognostic factors for patients with high-grade undifferentiated pleomorphic sarcoma (HGUPS) is obtained from analyses of soft tissue sarcomas. The purpose of this study was to evaluate the clinicopathologic features and their impact on outcomes specifically in patients diagnosed with HGUPS. In this multicenter trial, we retrospectively analyzed 112 patients who were diagnosed and treated at 12 different institutions in Turkey. We collected data concerning the patients, tumor characteristics, and treatment modalities. There were 69 males (61.6 %) and 43 females (38.4 %). Median age was 56 years (19-90). The most common anatomic site of tumor origin was the upper extremity. Pleomorphic variant was the predominant histological subtype. Median tumor size was 8.2 cm (0.6-30 cm). Tumors were mainly deeply seated (57.1 %). Fifty-seven patients (50.9 %) were stage II and the remainder were stage III at the time of diagnosis. Median follow-up was 30 months (2-160). The primary site of distant metastasis was the lung (73.5 %) and the second most common site was the liver (11.7 %). The 5-year overall survival, distant metastasis-free survival, and local recurrence-free survival rates were 56.3, 53.4, and 67.2 %, respectively. Multivariate analysis showed that Eastern Cooperative Oncology Group (ECOG) performance score of II (p = 0.033), deep tumor location (p = 0.000), and development of distant metastasis (p = 0.004) were negatively correlated with overall survival, and perioperative radiotherapy and negative microscopic margins were significant factors for local control rates (p = 0.000 for each). Deep tumor location (p = 0.003) was the only adverse factor related to distant metastasis-free survival. Deep tumor location, ECOG performance score of II, and development of distant metastasis carry a poor prognostic implication on overall survival. These will aid clinicians in predicting survival and treatment decision.
大多数关于高级别未分化多形性肉瘤（HGUPS）患者预后因素的数据来自软组织肉瘤分析。本研究的目的是评估临床病理特征及其对确诊为HGUPS患者预后的影响。在这项多中心试验中，我们回顾性分析了在土耳其12个不同机构诊断和治疗的112例患者。我们收集了有关患者、肿瘤特征和治疗方式的数据。男性69例（61.6%），女性43例（38.4%）。中位年龄为56岁（19 - 90岁）。肿瘤起源最常见的解剖部位是上肢。多形性变异是主要的组织学亚型。中位肿瘤大小为8.2 cm（0.6 - 30 cm）。肿瘤主要位于深部（57.1%）。57例患者（50.9%）诊断时为II期，其余为III期。中位随访时间为30个月（2 - 160个月）。远处转移的主要部位是肺（73.5%），第二常见部位是肝（11.7%）。5年总生存率、无远处转移生存率和无局部复发生存率分别为56.3%、53.4%和67.2%。多变量分析显示，东部肿瘤协作组（ECOG）体能状态评分为II（p = 0.033）、肿瘤深部位置（p = 0.000）和远处转移的发生（p = 0.004）与总生存率呈负相关，围手术期放疗和显微镜下切缘阴性是局部控制率的重要因素（每项p = 0.000）。肿瘤深部位置（p = 0.003）是与无远处转移生存率相关的唯一不良因素。肿瘤深部位置、ECOG体能状态评分为II和远处转移的发生对总生存率具有不良预后意义。这些将有助于临床医生预测生存率和做出治疗决策。
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