title: Evaluation of prognostic factors in localized high-grade undifferentiated pleomorphic sarcoma: report of a multi-institutional experience of Anatolian Society of Medical Oncology.
abstract: Most data on prognostic factors for patients with high-grade undifferentiated pleomorphic sarcoma (HGUPS) is obtained from analyses of soft tissue sarcomas. The purpose of this study was to evaluate the clinicopathologic features and their impact on outcomes specifically in patients diagnosed with HGUPS. In this multicenter trial, we retrospectively analyzed 112 patients who were diagnosed and treated at 12 different institutions in Turkey. We collected data concerning the patients, tumor characteristics, and treatment modalities. There were 69 males (61.6 %) and 43 females (38.4 %). Median age was 56 years (19-90). The most common anatomic site of tumor origin was the upper extremity. Pleomorphic variant was the predominant histological subtype. Median tumor size was 8.2 cm (0.6-30 cm). Tumors were mainly deeply seated (57.1 %). Fifty-seven patients (50.9 %) were stage II and the remainder were stage III at the time of diagnosis. Median follow-up was 30 months (2-160). The primary site of distant metastasis was the lung (73.5 %) and the second most common site was the liver (11.7 %). The 5-year overall survival, distant metastasis-free survival, and local recurrence-free survival rates were 56.3, 53.4, and 67.2 %, respectively. Multivariate analysis showed that Eastern Cooperative Oncology Group (ECOG) performance score of II (p = 0.033), deep tumor location (p = 0.000), and development of distant metastasis (p = 0.004) were negatively correlated with overall survival, and perioperative radiotherapy and negative microscopic margins were significant factors for local control rates (p = 0.000 for each). Deep tumor location (p = 0.003) was the only adverse factor related to distant metastasis-free survival. Deep tumor location, ECOG performance score of II, and development of distant metastasis carry a poor prognostic implication on overall survival. These will aid clinicians in predicting survival and treatment decision.
authors.affiliation: Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey. drmelike.ozcelik@gmail.com.
authors.forename: Melike
authors.initials: M
authors.lastname: Ozcelik
authors.affiliation: Department of Medical Oncology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Seker
authors.affiliation: Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Emrah
authors.initials: E
authors.lastname: Eraslan
authors.affiliation: Department of Medical Oncology, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Koca
authors.affiliation: Department of Medical Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Dogan
authors.initials: D
authors.lastname: Yazilitas
authors.affiliation: Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Ercelep
authors.affiliation: Department of Medical Oncology, Erciyes University School of Medicine, Kayseri, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Ozaslan
authors.affiliation: Department of Medical Oncology, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey.
authors.forename: Serap
authors.initials: S
authors.lastname: Kaya
authors.affiliation: Department of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey.
authors.forename: Ilhan
authors.initials: I
authors.lastname: Hacibekiroglu
authors.affiliation: Department of Medical Oncology, Celal Bayar University School of Medicine, Manisa, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Menekse
authors.affiliation: Department of Medical Oncology, Inonu University School of Medicine, Malatya, Turkey.
authors.forename: Asude
authors.initials: A
authors.lastname: Aksoy
authors.affiliation: Department of Medical Oncology, Pamukkale University School of Medicine, Denizli, Turkey.
authors.forename: Burcu Yapar
authors.initials: BY
authors.lastname: Taskoylu
authors.affiliation: Department of Medical Oncology, Izmir Katip Celebi University Atatürk Education and Research Hospital, Izmir, Turkey.
authors.forename: Umut
authors.initials: U
authors.lastname: Varol
authors.affiliation: Department of Medical Oncology, Sakarya University School of Medicine, Sakarya, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Arpaci
authors.affiliation: Department of Medical Oncology, Ordu University School of Medicine, Ordu, Turkey.
authors.forename: Aydin
authors.initials: A
authors.lastname: Ciltas
authors.affiliation: Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Oksuzoglu
authors.affiliation: Department of Medical Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Nurullah
authors.initials: N
authors.lastname: Zengin
authors.affiliation: Department of Medical Oncology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Gumus
authors.affiliation: Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aliustaoglu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000556:secondary; D008175:Lung Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology*; D011379:Prognosis; D012509:Sarcoma / Q000453:epidemiology / Q000473:pathology*; D034941:Upper Extremity / Q000473:pathology
keywords: High-grade undifferentiated pleomorphic sarcoma; Malignant fibrous histiocytoma; Prognostic factors; Soft tissue sarcoma