Early outcomes of soft tissue sarcomas presenting with metastases and treated with chemotherapy.
OBJECTIVE
The purpose of this study is to describe outcomes for patients with metastatic soft tissue sarcoma treated with chemotherapy.


METHODS
We retrospectively reviewed the records of 383 soft tissue sarcoma patients treated at our institution from 1997 to 2006. Thirty-five patients met the inclusion criteria-metastatic disease on presentation; primary tumor outside the abdomen; treatment with chemotherapy; and minimum follow-up of 3 months. Treatments were individualized and determined by a multidisciplinary oncology team. Patient survival was calculated from the diagnostic biopsy to the date of death or last follow-up using the Kaplan-Meier method.


RESULTS
Mean age was 47 years (range 17-74 years). Most common tumors involved were MFH and leiomyosarcoma. Sixteen of 35 (46%) patients had died at last follow-up. Mean patient survival was 24 months (range 4-102). The 2-year and 5-year survival rates were 64% and 24%, respectively. Twenty-nine patients (83%) presented with pulmonary metastasis, 6 with bone metastases (17%), 4 with regional node metastases (11%), and 4 with soft tissue metastases (11%). Survival was the same for those with pulmonary and only extrapulmonary metastases. The 10 patients with complete resection or complete chemotherapy response of all detectable lesions had longer mean survival (34 months) than the 25 patients who had partial/no resection or response (20 months) (P = 0.02).


CONCLUSIONS
Soft tissue sarcoma patients presenting with metastatic disease have a low survival rate, but complete eradication of tumor correlated with longer survival. Longer-term studies especially those tracking the outcome of complete responders and those completely resected will help determine the efficacy of chemotherapy.
Department of Orthopedic Surgery, Drexel University, Philadelphia, PA, USA.
Joseph J
JJ
King
Reginald S
RS
Fayssoux
Richard D
RD
Lackman
Christian M
CM
Ogilvie
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000188:drug therapy* / Q000556:secondary; D012983:Soft Tissue Neoplasms / Q000188:drug therapy* / Q000473:pathology; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult