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Prognostic factors in alveolar soft part sarcoma: A SEER analysis
Author(s) -
Wang Haotong,
Jacobson Alex,
Harmon David C.,
Choy Edwin,
Hornicek Francis J.,
Raskin Kevin A.,
Chebib Ivan A.,
DeLaney Thomas F.,
Chen YenLin E.
Publication year - 2016
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24183
Subject(s) - medicine , proportional hazards model , hazard ratio , alveolar soft part sarcoma , multivariate analysis , oncology , soft tissue sarcoma , radiation therapy , sarcoma , surgery , gastroenterology , soft tissue , pathology , confidence interval
Objectives We reviewed the clinical characteristics and outcomes of patients treated for alveolar soft part sarcoma (ASPS) and analyzed the effect of surgery for patients presenting with and without metastatic disease (DM). Methods The SEER Registry was queried for patients with ASPS from 1973–2012. The Kaplan–Meier estimate and Cox proportional hazards were used to analyze survival outcomes and risk variables. Results Among 251 patients, 43% had DM and 67% locoregional disease (LR) on presentation. The 5‐year overall survival (OS) for all patients was 56% (82% and 27% for LR and DM, respectively). Multivariate analysis identified older age (hazard ratio [HR] = 1.03 per year, P < 0.001), tumor size >10 cm (HR = 2.76, P = 0.013), DM at diagnosis (HR = 3.79, P < 0.001), and truncal primary site (HR = 1.63, P = 0.035) as independent factors predicting worse OS. For LR patients, surgery plus radiotherapy (RT) resulted in better OS compared to surgery alone P = 0.014. For DM patients, primary site surgery significantly improved survival ( P < 0.001). Conclusion ASPS presents with high metastasis rate but has a relatively indolent clinical course and a favorable prognosis with prolonged survival. Aggressive treatment using adjuvant RT with surgery is indicated in patients with LR disease and surgery is indicated in patients presenting with DM. J. Surg. Oncol. 2016;113:581–586 . © 2016 Wiley Periodicals, Inc.