Prognostic relevance of distant metastases versus locally advanced disease in soft tissue sarcomas: An EORTC-STBSG database study.

INTRODUCTION: In patients with advanced soft tissue sarcoma (STS) treated with chemotherapy, WHO performance status, histologic subtype and histologic grade are known prognostic factors. Although the difference between the subgroups: locally advanced disease only, metastatic disease only and both local and metastatic disease is easily made, its prognostic relevance is thus far unknown. The aim of this EORTC database study was to study the difference in prognosis between these subgroups in patients receiving first-line chemotherapy for advanced STS. METHODS: A retrospective database analysis was performed on 2473 patients receiving first-line chemotherapy for advanced STS from 12 EORTC sarcoma trials to establish the difference in prognosis for the three subgroups. End-points were overall survival, progression-free survival and overall response rate. Factors studied were age, sex, histologic subtype, histologic grade, WHO performance status, treatment and time since initial diagnosis. RESULTS: Overall survival differed significantly between patients with locally advanced disease only, with metastatic disease only and with both locally advanced and metastatic disease with a median overall survival of 15.4, 12.9 and 10.6 months, respectively. Similar differences were seen for progression-free survival (5.8, 4.3 and 3.2 months, respectively). CONCLUSION: This large retrospective database study shows that patients with advanced STSs treated with first-line chemotherapy with locally advanced disease, metastatic disease and both local and metastatic disease have different outcomes. This should be accounted for in future study design, interpretation and comparison of study results and daily practice.

[A case of sweet taste perception caused by lung cancer-related hyponatraemia]. / Een zoete smaak door hyponatriëmie bij longcarcinoom.

BACKGROUND: Ageusia is known to occur in patients with lung cancer. The type of dysgeusia resulting in all food tasting sweet is, however, rare. CASE REPORT: We describe the case of a 70-year-old woman presenting with an unpleasant sweet taste perception as the initial and only symptom of hyponatraemia. It was caused by the syndrome of inappropriate antidiuretic hormone (SIADH) secretion secondary to a small cell carcinoma of the lung. Treated by fluid restriction alone, the plasma sodium concentration increased and the sweet taste perception resolved. The exact pathophysiologic mechanism resulting in this type of dysgeusia is unclear to date. CONCLUSION: It is important to be alert when the medical history reveals a relatively rare dysgeusia or ageusia; this could indicate a potentially serious underlying condition, including hyponatraemia caused by SIADH associated with a pulmonary malignancy.