title: Extremity soft tissue sarcoma with multiple primary malignancies--Characteristics and outcome.
abstract: BACKGROUND
  Understanding the incidence and characteristics of multiple primary malignancies (MPM) has implications for guiding appropriate treatment and surveillance of extremity soft tissue sarcoma (STS).
  
  
  OBJECTIVE
  We sought to examine the incidence of MPM in STS (MPM-STS), and compare their clinicopathologic characteristics and survival to those with STS only.
  
  
  METHODS
  585 patients who underwent surgery for extremity STS were reviewed. Logistic regression analyses to identify factors contributing to the development of MPMs and a 1:2 matched case-control analysis to compare survival outcome were performed.
  
  
  RESULTS
  Of the 585 patients analyzed, 34 (6%) with MPM were identified. On univariate logistic regression analysis, older age (>49 years) at STS diagnosis (p = 0.008) and histologic types of undifferentiated pleomorphic sarcoma or myxofibrosarcoma (p = 0.033) were significant. In multivariate analysis, only older age at STS diagnosis remained significant (OR = 2.5, p = 0.029). Cancer-specific survival of the MPM-STS group was significantly lower than that of the STS-only group (p = 0.031). However, there was no significant difference in STS-specific survival between the two groups (p = 0.208).
  
  
  CONCLUSIONS
  Our study suggests that MPM is not uncommon in extremity STS and older age at STS diagnosis is associated with risk of MPM. Prognosis of STS in the MPM-STS group seems similar to that of the STS-only group.
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 03080, South Korea. Electronic address: claire.lopezoliva@yahoo.com.
authors.forename: C L L
authors.initials: CL
authors.lastname: Lopez-Oliva
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 03080, South Korea. Electronic address: lateage@naver.com.
authors.forename: J Y
authors.initials: JY
authors.lastname: Yun
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 03080, South Korea. Electronic address: hankim@snu.ac.kr.
authors.forename: H-S
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 03080, South Korea. Electronic address: hik19@snu.ac.kr.
authors.forename: I
authors.initials: I
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005121:Extremities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
keywords: Multiple primary malignancy; Risk; Soft tissue sarcoma; Survival