Progressive Improvement in 5-Year Survival Rates for Extremity Soft Tissue Sarcomas from 1999 to 2019.

Q2 Medicine Sarcoma Pub Date : 2024-02-19 eCollection Date: 2024-01-01 DOI:10.1155/2024/8880609

Ryley K Zastrow, Mohyeddine El Sayed, Christa L LiBrizzi, Andrew J Jacobs, Adam S Levin

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Abstract

Background: Extremity soft-tissue sarcoma (ESTS) is a group of rare, heterogeneous malignancies. Previous studies have demonstrated a progressive improvement in 5-year survival rate over time, but recent trends are unknown. Therefore, this study aimed to provide an update on the clinical characteristics and 5-year survival rate of ESTS from 1999 to 2019.

Methods: This retrospective cohort study used the Surveillance, Epidemiology, and End Results (SEER) database. Overall, 5,654 patients over the age of 15 years with primary ESTS diagnosed between 1999 and 2019 were included. Data on patient demographics, clinical characteristics, and survival were extracted. Patients were grouped by year of diagnosis: 1999-2005, 2006-2012, and 2013-2019. Kaplan-Meier and Cox proportional hazards regression analyses were performed.

Results: ESTS occurred primarily in the lower extremity (76.1%) and was frequently grade III (58.3%), >5 cm in size (69.9%), and without metastasis (77.9%) at diagnosis. Furthermore, there was a significant increase in the proportion of patients over age 60 (p < 0.001) and without metastasis (p < 0.001) over the study period. The 5-year survival rate successively improved, from 47% in 1999-2005, to 61% in 2006-2012, to 78% in 2013-2019. Similarly, in multivariate analysis, the mortality rate progressively declined from a hazard ratio (HR) of 3.4 in 1999-2005 to an HR of 2.1 in 2006-2012, with the 2013-2019 group having the best overall survival (p < 0.001). Age, tumor size, grade, and metastasis were negative prognostic factors for survival; radiation and surgery were positive prognostic factors.

Conclusions: The 5-year overall survival rate for ESTS progressively improved over the 20-year study period, perhaps due to an increasing proportion of older patients diagnosed with local disease. These findings may also be related to earlier detection or more effective treatment over the study period.

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从 1999 年到 2019 年，四肢软组织肉瘤的 5 年生存率逐步提高。

背景：肢体软组织肉瘤（ESTS）是一组罕见的异质性恶性肿瘤。以往的研究表明，随着时间的推移，5 年生存率会逐步提高，但最近的趋势尚不清楚。因此，本研究旨在提供1999年至2019年ESTS临床特征和5年生存率的最新情况：这项回顾性队列研究使用了监测、流行病学和最终结果（SEER）数据库。研究共纳入了1999年至2019年期间确诊的5654名15岁以上原发性ESTS患者。研究人员提取了患者的人口统计学、临床特征和存活率数据。患者按诊断年份分组：1999-2005年、2006-2012年和2013-2019年。进行了卡普兰-梅耶和考克斯比例危险回归分析：ESTS主要发生在下肢（76.1%），诊断时常为III级（58.3%），大小>5厘米（69.9%），无转移（77.9%）。此外，在研究期间，60 岁以上（P < 0.001）和无转移（P < 0.001）的患者比例明显增加。5年生存率连续提高，从1999-2005年的47%，到2006-2012年的61%，再到2013-2019年的78%。同样，在多变量分析中，死亡率从1999-2005年的危险比（HR）3.4逐渐下降到2006-2012年的2.1，其中2013-2019年组的总生存率最高（P < 0.001）。年龄、肿瘤大小、分级和转移是生存率的负预后因素；放射和手术是正预后因素：结论：在20年的研究期间，ESTS的5年总生存率逐步提高，这可能是由于确诊为局部疾病的老年患者比例增加所致。这些发现也可能与研究期间发现得更早或治疗更有效有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sarcoma Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

14 weeks

期刊介绍： Sarcoma is dedicated to publishing papers covering all aspects of connective tissue oncology research. It brings together work from scientists and clinicians carrying out a broad range of research in this field, including the basic sciences, molecular biology and pathology and the clinical sciences of epidemiology, surgery, radiotherapy and chemotherapy. High-quality papers concerning the entire range of bone and soft tissue sarcomas in both adults and children, including Kaposi"s sarcoma, are published as well as preclinical and animal studies. This journal provides a central forum for the description of advances in diagnosis, assessment and treatment of this rarely seen, but often mismanaged, group of patients.