Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan.
Department of Medicine for Orthopaedics and Motor Organ, Juntendo University School of Medicine, Tokyo, Japan.
Cancer Med. 2023 Apr;12(8):9471-9481. doi: 10.1002/cam4.5710. Epub 2023 Feb 22.
Bone and soft tissue sarcomas are rare tumors and extremely rarely metastasize to the brain. Previous studies have examined the characteristics and poor prognostic factors in cases of sarcoma brain metastasis (BM). Due to the rarity of cases of BM from sarcoma, limited data exist concerning the prognostic factors and treatment strategies.
A retrospective single-center study was performed on sarcoma patients with BM. The clinicopathological characteristics and treatment options for BM of sarcoma were investigated to identify predictive prognostic factors.
Between 2006 and 2021, 32 patients treated for newly diagnosed BM at our hospital were retrieved among 3133 bone and soft tissue sarcoma patients via our database. The most common symptom was headache (34%), and the most common histological subtypes were alveolar soft part sarcoma (ASPS) and undifferentiated pleomorphic sarcoma (25%). Non-ASPS (p = 0.022), presence of lung metastasis (p = 0.046), a short duration between initial metastasis, and the diagnosis of brain metastasis (p = 0.020), and the absence of stereotactic radiosurgery for BM (p = 0.0094) were significantly correlated with a poor prognosis.
In conclusion, the prognosis of patients with brain metastases of sarcomas is still dismal, but it is necessary to be aware of the factors associated with a relatively favorable prognosis and to select treatment options appropriately.
骨和软组织肉瘤是罕见的肿瘤,极罕见转移至脑部。先前的研究已经探讨了肉瘤脑转移(BM)的特征和不良预后因素。由于肉瘤脑转移的病例罕见,关于预后因素和治疗策略的资料有限。
对患有 BM 的肉瘤患者进行了回顾性单中心研究。研究了肉瘤 BM 的临床病理特征和治疗选择,以确定预测预后因素。
在 2006 年至 2021 年间,通过我们的数据库从 3133 例骨和软组织肉瘤患者中检索到 32 例在我院新诊断为 BM 的患者。最常见的症状是头痛(34%),最常见的组织学亚型是腺泡状软组织肉瘤(ASPS)和未分化多形性肉瘤(25%)。非 ASPS(p=0.022)、存在肺转移(p=0.046)、初始转移和脑转移诊断之间的时间间隔短(p=0.020),以及 BM 未行立体定向放射外科治疗(p=0.0094)与预后不良显著相关。
总之,肉瘤脑转移患者的预后仍然很差,但有必要了解与相对较好预后相关的因素,并适当选择治疗方案。