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01-11-2015 | Bone and Soft Tissue Sarcomas

Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions

Authors: Sean P. Dineen, MD, Christina L. Roland, MD, Rachel Feig, Caitlin May, BS, Shouhao Zhou, PhD, Elizabeth Demicco, MD, PhD, Ghadah Al Sannaa, MD, Davis Ingram, BS, Wei-lein Wang, MD, Vinod Ravi, MD, Ashleigh Guadagnolo, MD, Dina Lev, MD, Raphael E. Pollock, MD, PhD, Kelly Hunt, MD, Janice Cormier, MD, Alex Lazar, MD, PhD, Barry Feig, MD, Keila E. Torres, MD, PhD

Published in: Annals of Surgical Oncology | Issue 12/2015

Abstract

Background

Radiation therapy is used increasingly as a component of multidisciplinary treatment for many solid tumors. One complication of such treatment is the development of radiation-associated sarcoma (RAS). Undifferentiated pleomorphic sarcoma (UPS), previously termed “malignant fibrous histiocytoma” (MFH) is the most common histologic subtype of RAS. This study investigated the clinical outcomes for patients with radiation-associated UPS (RA-UPS/MFH).

Methods

The study identified 1068 patients with UPS/MFH treated at the authors’ institution. Patient and tumor factors were collected and compared. Regression analysis was performed to identify independent predictors of survival. A matched-cohort survival and recurrence analysis was performed for radiation-associated and sporadic UPS/MFH.

Results

The findings showed that RA-UPS/MFH comprised 5.1 % of the UPS population. The median latency to the development of RA-UPS/MFH was 9.3 years. The 5-year disease-specific survival (DSS) was 52.2 % for patients identified with RA-UPS/MFH (n = 55) compared with 76.4 % for patients with unmatched sporadic UPS/MFH (n = 1,013; p < 0.001). A matched-cohort analysis also demonstrated that the 5-year DSS was significantly worse for RA-UPS/MFH (52.2 vs 73.4 %; p = 0.002). Furthermore, higher local recurrence rates were observed for patients with RA-UPS/MFH than for patients with sporadic lesions (54.5 vs 23.5 %; p < 0.001). Radiation-associated status and incomplete resection were identified as independent predictors of local recurrence.

Conclusion

This study demonstrated worse clinical outcomes for patients with RA-UPS/MFH than for patients with sporadic UPS/MFH. Local recurrence was significantly higher for patients with RA-UPS/MFH, suggesting a unique tumor biology for this challenging disease.

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Title: Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions
Authors: Sean P. Dineen, MD
Christina L. Roland, MD
Rachel Feig
Caitlin May, BS
Shouhao Zhou, PhD
Elizabeth Demicco, MD, PhD
Ghadah Al Sannaa, MD
Davis Ingram, BS
Wei-lein Wang, MD
Vinod Ravi, MD
Ashleigh Guadagnolo, MD
Dina Lev, MD
Raphael E. Pollock, MD, PhD
Kelly Hunt, MD
Janice Cormier, MD
Alex Lazar, MD, PhD
Barry Feig, MD
Keila E. Torres, MD, PhD
Publication date: 01-11-2015
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 12/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-015-4453-z

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Springer Medicine

Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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