Delayed Treatment Associated With Worse Survival in High-grade Undifferentiated Pleomorphic Sarcoma

Area of Science:

• Oncology
• Surgical Pathology
• Clinical Research

Background:

• Time to treatment initiation impacts survival in various cancers.
• The role of treatment delay in soft tissue sarcomas, especially high-grade undifferentiated pleomorphic sarcoma (UPS), is not well understood.
• Individualized evaluation of histologic subtypes is key for patient-centered care.

Purpose of the Study:

• To investigate the association between the time to treatment initiation and survival rates.
• To specifically analyze this association in patients diagnosed with localized, high-grade UPS.

Main Methods:

• Retrospective analysis of 6220 patients with localized, high-grade UPS from the National Cancer Database (2004-2021).
• Exclusion of non-eligible cases to ensure study cohort integrity.
• Application of Kaplan-Meier and multivariable Cox proportional hazards models to assess survival outcomes relative to treatment delay.

Main Results:

• Initiating treatment more than 4 weeks after diagnosis was linked to a significant decrease in 5-year survival (P < 0.001).
• For extremity and trunk tumors, longer delays in treatment initiation were independently associated with poorer survival (HR = 1.01 per week; P = 0.013).
• No significant association between treatment delay and survival was found for head and neck or abdominal/pelvic tumors.

Conclusions:

• Prolonged time to treatment initiation is an independent predictor of reduced survival for localized, high-grade UPS in the extremity and trunk.
• Observed increases in treatment initiation time may stem from evolving diagnostic procedures and insurance-related delays.
• Findings underscore the importance of timely treatment for specific soft tissue sarcoma subtypes.