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Nomograms predicted OS, DFS in retroperitoneal soft tissue sarcoma
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Two straightforward, multi-institution nomograms accurately predicted OS and DFS in a cohort of patients with retroperitoneal soft tissue sarcoma.
Researchers recommend for these nomograms to be utilized for counseling patients and for categorizing patients across clinical trials.
Retroperitoneal soft tissue sarcoma (RPS) is a group of rare neoplasms of mesenchymal origin that account for only 0.15% to 0.25% of all malignancies. Accurate risk stratification is needed to guide clinical decisions and inform patient counseling, and it also may be useful in identifying prognostically distinct patient cohorts for research purposes, according to background information in the study.
Alessandro Gronchi
Alessandro Gronchi, MD, of the department of surgery at Fondazione Istituto di Ricovero e Cura a Carattere Scientifico at Istituto Nazionale dei Tumori in Milan, and colleagues combined data pooled from three large referral centers to improve the available risk-stratification tools via two distinct nomograms to predict OS and DFS among 523 patients with primary localized RPS resected between 1999 and 2009.
“[Nomograms] can be used to accurately assess individual patient risk, leading to improved prognosis-based decision making within the specific RPS tumor cohort and enhanced clinical trial stratification,” Gronchi told HemOnc Today. “These tools are already providing new refinements in our understanding of the natural history of RPS and will possibly be incorporated into the next edition of the American Joint Committee on Cancer Staging Manual.”
At 45-month follow-up, researchers reported 171 deaths; 139 of them were associated with sarcoma. Overall, OS was 56.8% at 5-year follow-up (95% CI, 51.4-62.6) and 46.7% at 7-year follow-up (95% CI, 39.9-54.6).
Disease recurrence occurred in 221 patients. Local recurrence developed in 128 patients as a first event, 93 developed distant metastasis and 32 patients died without developing any recurrence. Overall, DFS was 39.4% at 5 years (95% CI, 34.5-45) and 35.7% at 7 years (95% CI, 30.3-42.1).
In a subset of patients from a fourth institution included in the external validation cohort (n=135), the Harrell’s C statistic was 0.67 for the OS nomogram and 0.68 for the DFS nomogram.
Alessandro Gronchi, MD, can be reached at Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezina 1 — 20133 Milan, Italy; email: alessandro.gronchi@istitutotumori.mi.it.
Disclosure: The researchers report no relevant financial disclosures.
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