Soft-tissue sarcoma involving bone or neurovascular structures: MR imaging prognostic factors.
OBJECTIVE
To determine if magnetic resonance (MR) imaging findings of soft-tissue sarcoma involving bone or neurovascular structures allow prediction of local recurrence, distant metastasis, or disease-specific survival.


METHODS
Preoperative MR images of 46 patients with soft-tissue sarcoma were reviewed for tumor involving bone or major vessels or nerves. MR imaging findings were correlated with local recurrence, distant metastasis, and disease-specific survival after surgery and chemotherapy and/or radiation therapy. Primary tumors were predominantly in the lower extremity (n = 35 [76%]), deep (n = 44 [96%]), and high-grade (n = 35 [76%]).


RESULTS
On MR images, bone invasion occurred in 12 patients (26%), major-vessel encasement in five patients (11%), and major-nerve encasement in seven patients (15%). In patients with (n = 12) and those without (n = 34) bone invasion, frequencies of disease-related death (in nine [75%] and 12 [35%] patients, respectively) were significantly different (P = .02); frequencies of local recurrence or distant metastasis were not significantly different. In patients with and those without major-vessel or major-nerve encasement, there were no significant differences between frequencies of local recurrence, distant metastasis, or disease-specific survival.


CONCLUSIONS
In soft-tissue sarcoma, bone invasion on MR images was predictive of decreased disease-specific survival. MR imaging findings of bone or neurovascular involvement otherwise appear to be more important for tailoring surgery than for predicting local recurrence, distant metastasis, or survival.
Panicek
D M
DM
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Go
S D
SD
Healey
J H
JH
Leung
D H
DH
Brennan
M F
MF
Lewis
J J
JJ
D001859:Bone Neoplasms / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D010524:Peripheral Nervous System Neoplasms / Q000453:epidemiology / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012509:Sarcoma / Q000453:epidemiology / Q000473:pathology*; D012680:Sensitivity and Specificity; D012983:Soft Tissue Neoplasms / Q000453:epidemiology / Q000473:pathology*; D015996:Survival Rate; D019043:Vascular Neoplasms / Q000453:epidemiology / Q000473:pathology*