Back to Search
Start Over
Undifferentiated pleomorphic sarcoma: Factors predictive of adverse outcomes.
- Source :
-
Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2018 Nov; Vol. 79 (5), pp. 853-859. Date of Electronic Publication: 2018 May 19. - Publication Year :
- 2018
-
Abstract
- Background: Undifferentiated pleomorphic sarcoma (UPS) encompasses rare neoplasms that can arise either in the dermis or in the subfascial soft tissue. The behavior of UPS ranges from indolent to aggressive, but data predicting outcomes are limited.<br />Objective: Identify predictors of poor outcomes by analyzing a large collection of UPS cases.<br />Methods: We evaluated all available cases of UPS (including those termed atypical fibroxanthoma, malignant fibrous histiocytoma, pleomorphic dermal sarcoma, and subfascial UPS) across 3 tertiary care centers.<br />Results: Among the 319 patients, 45 experienced recurrence, 33 experienced metastasis, and 96 died of any cause. Risk factors for recurrence were clinical tumor size larger than 5 cm and invasion beyond subcutaneous fat. Risk factors for distant metastases were tumor site, tumor size larger than 2 cm, invasion beyond subcutaneous fat, and lymphovascular invasion. Risk factors for overall mortality were age, immunosuppression, tumor size larger than 2 cm, and lymphovascular invasion. History of skin cancer was associated with a lower risk of recurrence and metastasis.<br />Limitations: This was a retrospective study.<br />Conclusions: Using the unbiased approach of pooling all UPS cases regardless of terminology, we identified clinical and histologic factors predicting poor outcomes. We propose subcategorization of UPS (into superficial versus deep UPS), which is consistent with the American Joint Committee on Cancer staging of soft-tissue sarcoma.<br /> (Published by Elsevier Inc.)
- Subjects :
- Adult
Aged
Analysis of Variance
Biopsy, Needle
Carcinoma mortality
Carcinoma pathology
Carcinoma surgery
Cohort Studies
Disease-Free Survival
Female
Histiocytoma, Malignant Fibrous mortality
Histiocytoma, Malignant Fibrous surgery
Humans
Immunohistochemistry
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local mortality
Neoplasm Recurrence, Local surgery
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Registries
Retrospective Studies
Risk Assessment
Sarcoma mortality
Sarcoma surgery
Skin Neoplasms mortality
Skin Neoplasms surgery
Soft Tissue Neoplasms mortality
Soft Tissue Neoplasms surgery
Survival Analysis
United States
Histiocytoma, Malignant Fibrous pathology
Mohs Surgery methods
Neoplasm Recurrence, Local pathology
Sarcoma pathology
Skin Neoplasms pathology
Soft Tissue Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6787
- Volume :
- 79
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 29787841
- Full Text :
- https://doi.org/10.1016/j.jaad.2018.05.022