Akademik Veri Yönetim Sistemi
Journal of B.U.ON., cilt.5, sa.3, ss.281-286, 2000 (Scopus)
Purpose: The aim of this study was to evaluate prognostic factors and survival in patients with metastatic soft tissue sarcoma. Patients and methods: We retrospectively analysed 44 patients with soft tissue sarcoma, who either developed metastatic disease after first-line treatment for localized disease during follow-up or initially presented with metastatic disease. All patients received anthracycline-based chemotherapy as first-line treatment. In case of complete (CR) or partial response (PR), the patients were assessed for possible local resection or metastasectomy. Endpoints were progression-free (PFS) and overall survival. Univariate and multivariate associations between these endpoints and selected variables like age, sex, tumor size, grade, surgical treatment and premetastatic disease-free survival (DFS) were also assessed. Results: At the time of the last follow-up, 32 (72.7%) patients died mainly of their disease, 3 (6.8%) were lost to follow-up, 4 (9.1%) are alive with disease and 5 (11.4%) are followed-up with no evidence of disease. Median overall survival of the whole group was 8.6±1.8months. Metastasectomy and complete response after treatment were the only significant parameters by univariate analysis (p= 0.0098 and p=0.0009, respectively). Median PFS of the whole group was 3.63±0.7 months. By univariate analysis CR after treatment and metastasectomy were found to have a significant impact a on PFS (p=0.003 and p=0.05, respectively). Overall survival was significantly higher in a subgroup of initially nonmetastatic patients with a DFS of 12 months or longer, when compared to those with a shorter period (p=0.03). Although not significant, there was a tendency to a longer postmetastasic PFS with a DFS of 12 months or longer (p=0.055). Multivariate analysis revealed CR to treatment for metastatic disease, achieved by surgery ± chemotherapy, as the only independent prognostic factor with an impact on PFS or overall survival (p=0.02 and p= 0.0098, respectively). Conclusion: The poor outcome of patients with metastatic soft tissue sarcomas can be improved with active surgical measures in selected patients. Outcome is most likely to depend on the biological characteristics of the tumor rather, than the generally accepted prognostic factors for primary disease.