title: Performance status is the most powerful risk factor for early death among patients with advanced soft tissue sarcoma: the European Organisation for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group (STBSG) and French Sarcoma Group (FSG) study.
abstract: BACKGROUND
  We investigated prognostic factors (PFs) for 90-day mortality in a large cohort of advanced/metastatic soft tissue sarcoma (STS) patients treated with first-line chemotherapy.
  
  
  METHODS
  The PFs were identified by both logistic regression analysis and probability tree analysis in patients captured in the Soft Tissue and Bone Sarcoma Group (STBSG) database (3002 patients). Scores derived from the logistic regression analysis and algorithms derived from probability tree analysis were subsequently validated in an independent study cohort from the French Sarcoma Group (FSG) database (404 patients).
  
  
  RESULTS
  The 90-day mortality rate was 8.6 and 4.5% in both cohorts. The logistic regression analysis retained performance status (PS; odds ratio (OR)=3.83 if PS=1, OR=12.00 if PS ≥2), presence of liver metastasis (OR=2.37) and rare site metastasis (OR=2.00) as PFs for early death. The CHAID analysis retained PS as a major discriminator followed by histological grade (only for patients with PS ≥2). In both models, PS was the most powerful PF for 90-day mortality.
  
  
  CONCLUSIONS
  Performance status has to be taken into account in the design of further clinical trials and is one of the most important parameters to guide patient management. For those patients with poor PS, expected benefits from therapy should be weighed up carefully against the anticipated toxicities.
authors.affiliation: Department of General Oncology, Centre Oscar Lambret, Regional Comprehensive Cancer Centre, 3, rue F Combemale, 59020, Lille, France. n-penel@o-lambret.fr
authors.forename: N
authors.initials: N
authors.lastname: Penel
authors.forename: M V
authors.initials: MV
authors.lastname: Glabbeke
authors.forename: S
authors.initials: S
authors.lastname: Mathoulin-Pelissier
authors.forename: I
authors.initials: I
authors.lastname: Judson
authors.forename: S
authors.initials: S
authors.lastname: Sleijfer
authors.forename: B
authors.initials: B
authors.lastname: Bui
authors.forename: P
authors.initials: P
authors.lastname: Schoffski
authors.forename: M
authors.initials: M
authors.lastname: Ouali
authors.forename: S
authors.initials: S
authors.lastname: Marreaud
authors.forename: V
authors.initials: V
authors.lastname: Brouste
authors.forename: A
authors.initials: A
authors.lastname: Duhamel
authors.forename: P
authors.initials: P
authors.lastname: Hohenberger
authors.forename: J-Y
authors.initials: JY
authors.lastname: Blay
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012509:Sarcoma / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D012983:Soft Tissue Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D016896:Treatment Outcome