1. Post-metastasis survival in extremity soft tissue sarcoma: A recursive partitioning analysis of prognostic factors
- Author
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Han-Soo Kim, Wanlim Kim, Seungcheol Kang, Ilkyu Han, and SungJu Kim
- Subjects
Adult ,Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Prognostic variable ,Lung Neoplasms ,Multivariate analysis ,Adolescent ,Bone Neoplasms ,Recursive partitioning ,Metastasis ,Young Adult ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Child ,Aged ,Aged, 80 and over ,business.industry ,Soft tissue sarcoma ,Metastasectomy ,Extremities ,Sarcoma ,Middle Aged ,Prognosis ,medicine.disease ,Surgery ,Homogeneous ,Female ,Epidemiologic Methods ,business ,Median survival - Abstract
Recursive partitioning analysis (RPA) enables grouping of patients into homogeneous prognostic groups in a visually intuitive form and has the capacity to account for complex interactions among prognostic variables. In this study, we employed RPA to generate a prognostic model for extremity soft tissue sarcoma (STS) patients with metastatic disease.A retrospective review was conducted on 135 patients with metastatic STS who had undergone surgical removal of their primary tumours. Patient and tumour variables along with the performance of metastasectomy were analysed for possible prognostic effect on post-metastatic survival. Significant prognostic factors on multivariate analysis were incorporated into RPA to build regression trees for the prediction of post-metastatic survival.RPA identified six terminal nodes based on histological grade, performance of metastasectomy and disease-free interval (DFI). Based on the median survival time of the terminal nodes, four prognostic groups with significantly different post-metastatic survival were generated: (1) group A: low grade/metastasectomy; (2) group B: low grade/no metastasectomy/DFI ⩾ 12 months or high grade/metastasectomy; (3) group C: low grade/no metastasectomy/DFI12 months or high grade/no metastasectomy/DFI ⩾ 12 months; and (4) group D: high grade/no metastasectomy/DFI12 months. The 3-year survival rates for each group were: group A, 76.1 ± 9.6%; group B, 42.3 ± 10.3%; group C, 18.8 ± 8.0%; and group D, 0.0 ± 0.0%.Our prognostic model using RPA successfully divides STS patients with metastasis into groups that can be easily implemented using standard clinical parameters.
- Published
- 2014