Epithelioid sarcoma: clinical behavior and prognostic factors of survival.
BACKGROUND
Epithelioid sarcoma is a rare histologic subtype of sarcoma. The clinical behavior and prognostic factors influencing survival in this disease are examined.


METHODS
A review of clinicopathologic features of patients with epithelioid sarcoma prospectively followed between July 1982 and July 1995 at Memorial Sloan-Kettering Cancer Center was performed. Kaplan-Meier and log-rank analysis were used.


RESULTS
Eleven men (69%) and five women (31%) were treated during this period. Mean age at diagnosis was 33 years, and length of symptoms before diagnosis was 18 months. Tumors presented in the trunk in 44% of patients, the lower extremity in 31%, and the upper extremity in 25%. Median follow-up time was 45 months. At least one local recurrence was experienced by 69% of patients. Metastases to regional lymph nodes during the course of the disease developed in 44% of patients and to the lungs in 44%. Median survival was 88.8 months, with a 66% 5-year survival rate. Pulmonary metastasis was correlated with decreased survival.


CONCLUSIONS
A delay in diagnosis of epithelioid sarcoma is common. Epithelioid sarcoma differs from other sarcoma subtypes in propensity for nodal spread and local recurrence. Careful follow-up evaluating local recurrence, nodal spread, and pulmonary metastases is warranted.
Ross
H M
HM
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Lewis
J J
JJ
Woodruff
J M
JM
Brennan
M F
MF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012509:Sarcoma / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents