Role of adjuvant chemotherapy in patients with localized, undifferentiated pleomorphic sarcoma of soft tissue: a population-based cohort study.
Int J Clin Oncol
; 27(4): 802-810, 2022 Apr.
Article
in En
| MEDLINE
| ID: mdl-35064354
ABSTRACT
BACKGROUND:
Primary tumor resection is the mainstay of treatment for undifferentiated pleomorphic sarcoma (UPS); however, the necessity of adjuvant chemotherapy has been debated. We aimed to clarify the effect of adjuvant chemotherapy on survival rates in patients with UPS with localized and resectable primary lesions.METHODS:
This retrospective analysis included data of 2112 patients with localized UPS arising in the extremities and trunk, extracted from a registry in Japan. We estimated overall survival (OS), identified prognostic factors, and adjusted patient characteristics in the two groups treated with or without chemotherapy using propensity score matching (PSM).RESULTS:
The 5-year OS rate was 79.4%. In multivariate OS analysis, adjuvant chemotherapy was a good prognostic factor (hazard ratio 0.65; 95% confidence interval 0.48-0.9, P = 0.009). Large tumor size was the poorest prognostic factor, and OS decreased with the tumor size (P < 0.0001). In all patients, adjuvant chemotherapy prolonged OS (5-year OS 82.3% vs. 78.6%, P = 0.03). Adjuvant chemotherapy did not affect OS in patients with tumor size < 5 cm; the benefit was strong in patients with tumor size 10 to < 15 cm (5-year OS 79.5% vs. 66.8%, P = 0.003). Adjuvant chemotherapy efficacy was not pronounced in patients with tumor size 5 to < 10 cm (5-year OS 87% vs. 80%, P = 0.06) and ≥ 15 cm (5-year OS 60.7% vs. 49.5%, P = 0.08). After PSM, adjuvant chemotherapy was significantly associated with improved OS (P = 0.02).CONCLUSIONS:
In patients with localized UPS, adjuvant chemotherapy tended to improve OS when tumors were ≥ 5 cm, especially when they were 10 to < 15 cm.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Sarcoma
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Int J Clin Oncol
Journal subject:
NEOPLASIAS
Year:
2022
Document type:
Article
Affiliation country:
Japón