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Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2015 Nov; Vol. 22 (12), pp. 3913-20. Date of Electronic Publication: 2015 Mar 06. - Publication Year :
- 2015
-
Abstract
- Background: Radiation therapy is used increasingly as a component of multidisciplinary treatment for many solid tumors. One complication of such treatment is the development of radiation-associated sarcoma (RAS). Undifferentiated pleomorphic sarcoma (UPS), previously termed "malignant fibrous histiocytoma" (MFH) is the most common histologic subtype of RAS. This study investigated the clinical outcomes for patients with radiation-associated UPS (RA-UPS/MFH).<br />Methods: The study identified 1068 patients with UPS/MFH treated at the authors' institution. Patient and tumor factors were collected and compared. Regression analysis was performed to identify independent predictors of survival. A matched-cohort survival and recurrence analysis was performed for radiation-associated and sporadic UPS/MFH.<br />Results: The findings showed that RA-UPS/MFH comprised 5.1 % of the UPS population. The median latency to the development of RA-UPS/MFH was 9.3 years. The 5-year disease-specific survival (DSS) was 52.2 % for patients identified with RA-UPS/MFH (n = 55) compared with 76.4 % for patients with unmatched sporadic UPS/MFH (n = 1,013; p < 0.001). A matched-cohort analysis also demonstrated that the 5-year DSS was significantly worse for RA-UPS/MFH (52.2 vs 73.4 %; p = 0.002). Furthermore, higher local recurrence rates were observed for patients with RA-UPS/MFH than for patients with sporadic lesions (54.5 vs 23.5 %; p < 0.001). Radiation-associated status and incomplete resection were identified as independent predictors of local recurrence.<br />Conclusion: This study demonstrated worse clinical outcomes for patients with RA-UPS/MFH than for patients with sporadic UPS/MFH. Local recurrence was significantly higher for patients with RA-UPS/MFH, suggesting a unique tumor biology for this challenging disease.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Disease-Free Survival
Female
Histiocytoma, Malignant Fibrous surgery
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Grading
Neoplasm, Residual
Neoplasms, Radiation-Induced surgery
Proportional Hazards Models
Radiotherapy adverse effects
Survival Rate
Young Adult
Histiocytoma, Malignant Fibrous mortality
Histiocytoma, Malignant Fibrous pathology
Neoplasm Recurrence, Local epidemiology
Neoplasms, Radiation-Induced mortality
Neoplasms, Radiation-Induced pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 22
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 25743327
- Full Text :
- https://doi.org/10.1245/s10434-015-4453-z