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A Mouse Model of Incompletely Resected Soft Tissue Sarcoma for Testing (Neo)adjuvant Therapies
Published on: July 28, 2020
New perspectives for staging and prognosis in soft tissue sarcoma
1Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe St., Unit 1104, Houston, TX, 77030, USA. glahat@mdanderson.org
Annals of Surgical Oncology
|June 4, 2008
Summary
The American Joint Committee on Cancer (AJCC) soft tissue sarcoma (STS) staging system needs updates. Tumor size, grade, site, histology, margin status, and recurrence significantly impact survival and should be incorporated.
Area of Science:
- Oncology
- Surgical Pathology
- Cancer Staging
Background:
- Current AJCC staging for soft tissue sarcoma (STS) requires evaluation.
- Need for enhanced descriptors of STS clinical behavior identified.
Purpose of the Study:
- Identify and validate prognostic factors for STS.
- Improve the accuracy of STS clinical staging.
Main Methods:
- Analysis of prospectively accrued data from 1,091 primary STS patients (AJCC stages I-III).
- Inclusion of patients with complete macroscopic resection (1996-2007).
- Univariable and multivariable analyses to identify independent prognostic factors for mortality and overall survival (OS).
Main Results:
- Three distinct tumor size cohorts identified (15 cm) with significantly different 5-year OS rates (85%, 68%, 52%).
- A two-category histologic grade system proved as informative as the current four-category system.
- Independent adverse prognostic factors include tumor size, non-extremity primary site, high histologic grade, specific histology, and margin positivity. Recurrence was the most significant risk factor for STS-specific mortality.
Conclusions:
- Revision of tumor size and grade criteria in the AJCC STS staging system is recommended.
- Incorporating primary site, histologic subtype, margin status, and recurrence can enhance prognostic accuracy.
- Improved staging facilitates individualized therapeutic strategies for STS patients.
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