title: Improvement in Overall Survival from Extremity Soft Tissue Sarcoma over Twenty Years.
abstract: Several patient demographic factors, including marital status, have been demonstrated to have prognostic significance for survival in extremity soft tissue sarcoma (ESTS). A study population of 12,546 adult patients diagnosed with ESTS from 1991 to 2010 was identified from the SEER database, a large population-based registry, in order to determine whether overall survival had changed over this recent 20-year period. The study population was divided into three groups by year of diagnosis: 1991-1996, 1997-2003, and 2004-2010. We used the Kaplan-Meier method and Cox proportional hazards regression to assess survival differences between different demographic groups and prognostic clinical characteristics. Over the course of time, the 5-year overall survival rates have increased from 28% in the earliest time period to 62% in the latest (P < 0.0001). On multivariate analysis, the mortality rate progressively declined from the 1991-1996 group (HR: 3.02, CI: 2.78-3.29) to the 1997-2003 group (HR: 2.21, CI: 2.06-2.37), with the 2004-2010 group having the best overall survival, despite increases in the proportion of patients with tumors greater than 5 cm in size (P < 0.0001), and those presenting with metastasis (P < 0.0001).
authors.affiliation: Hofstra North Shore-LIJ School of Medicine, 500 Hofstra University, Hempstead, NY 11549, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Jacobs
authors.affiliation: Department of Orthopaedics, North Shore Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY 11040, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Michels
authors.affiliation: Biostatistics Unit, Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA.
authors.forename: Joanna
authors.initials: J
authors.lastname: Stein
authors.affiliation: Department of Orthopaedic Surgery, Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Levin
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