The Effect of Surgical Resection on Cancer-Specific Mortality in Pelvic Soft Tissue Sarcoma According to Histologic Subtype and Stage

<b>Background/Objectives</b>: The impact of surgical resection versus non-resection on cancer-specific mortality (CSM) in soft tissue pelvic sarcoma remains largely unclear, particularly when considering histologic subtypes such as liposarcoma, leiomyosarcoma, and sarcoma NOS. The objective of the present study was to first report data regarding the association between surgical resection status and CSM in soft tissue pelvic sarcoma. <b>Methods</b>: Using data from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2019, we identified 2491 patients diagnosed with pelvic soft tissue sarcoma. Cumulative incidence plots were used to illustrate CSM and other-cause mortality rates based on the histologic subtype and surgical resection status. Competing risk regression models were employed to assess whether surgical resection was an independent predictor of CSM in both non-metastatic and metastatic patients. <b>Results</b>: Among the 2491 patients with soft tissue pelvic sarcoma, liposarcoma was the most common subtype (41%), followed by leiomyosarcoma (39%) and sarcoma NOS (20%). Surgical resection rates were 92% for liposarcoma, 91% for leiomyosarcoma, and 58% for sarcoma NOS in non-metastatic patients, while for metastatic patients, the rates were 55%, 49%, and 23%, respectively. In non-metastatic patients who underwent surgical resection, five-year CSM rates by histologic subtype were 10% for liposarcoma, 32% for leiomyosarcoma, and 27% for sarcoma NOS. The multivariable competing risk regression analysis showed that surgical resection provided a protective effect across all histologic subtypes in non-metastatic patients (liposarcoma HR: 0.2, leiomyosarcoma HR: 0.5, sarcoma NOS HR: 0.4). In metastatic patients, surgical resection had a protective effect for those with leiomyosarcoma (HR: 0.6) but not for those with sarcoma NOS. An analysis for metastatic liposarcoma was not possible due to insufficient data. <b>Conclusions:</b> In non-metastatic soft tissue pelvic sarcoma, surgical resection may be linked to a reduction in CSM. However, in metastatic patients, this protective effect appears to be limited primarily to those with leiomyosarcoma.

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Journal
Journal of Clinical Medicine
Published
2024-09-28
DOI
https://doi.org/10.3390/jcm13195787
Citations
3
Primary Topic
Sarcoma Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
1.26
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article

The Effect of Surgical Resection on Cancer-Specific Mortality in Pelvic Soft Tissue Sarcoma According to Histologic Subtype and Stage

Zhe Tian, Felix K.‐H. Chun, Matteo Ferro, Francesco Barletta et al.
3 citations
Journal of Clinical Medicine
Sarcoma Diagnosis and Treatment
1.26
article

The Effect of Surgical Resection on Cancer-Specific Mortality in Pelvic Soft Tissue Sarcoma According to Histologic Subtype and Stage

Zhe Tian, Felix K.‐H. Chun, Matteo Ferro, Francesco Barletta, Sascha Ahyai, Derya Tilki, Alberto Briganti, Simone Morra, Nicola Longo, Carlo Terrone, Gennaro Musi, Ottavio De Cobelli, Lukas Scheipner, Fred Saad, Reha‐Baris Incesu, Francesco Alessandro Mistretta, Cristina Cano Garcia, Andrea Baudo, Stefano Tappero, Mattia Luca Piccinelli, Stefano Luzzago, Luca Carmignani, Pierre I. Karakiewicz, Shahrokh F. Shariat
article en
3 citations

Abstract

<b>Background/Objectives</b>: The impact of surgical resection versus non-resection on cancer-specific mortality (CSM) in soft tissue pelvic sarcoma remains largely unclear, particularly when considering histologic subtypes such as liposarcoma, leiomyosarcoma, and sarcoma NOS. The objective of the present study was to first report data regarding the association between surgical resection status and CSM in soft tissue pelvic sarcoma. <b>Methods</b>: Using data from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2019, we identified 2491 patients diagnosed with pelvic soft tissue sarcoma. Cumulative incidence plots were used to illustrate CSM and other-cause mortality rates based on the histologic subtype and surgical resection status. Competing risk regression models were employed to assess whether surgical resection was an independent predictor of CSM in both non-metastatic and metastatic patients. <b>Results</b>: Among the 2491 patients with soft tissue pelvic sarcoma, liposarcoma was the most common subtype (41%), followed by leiomyosarcoma (39%) and sarcoma NOS (20%). Surgical resection rates were 92% for liposarcoma, 91% for leiomyosarcoma, and 58% for sarcoma NOS in non-metastatic patients, while for metastatic patients, the rates were 55%, 49%, and 23%, respectively. In non-metastatic patients who underwent surgical resection, five-year CSM rates by histologic subtype were 10% for liposarcoma, 32% for leiomyosarcoma, and 27% for sarcoma NOS. The multivariable competing risk regression analysis showed that surgical resection provided a protective effect across all histologic subtypes in non-metastatic patients (liposarcoma HR: 0.2, leiomyosarcoma HR: 0.5, sarcoma NOS HR: 0.4). In metastatic patients, surgical resection had a protective effect for those with leiomyosarcoma (HR: 0.6) but not for those with sarcoma NOS. An analysis for metastatic liposarcoma was not possible due to insufficient data. <b>Conclusions:</b> In non-metastatic soft tissue pelvic sarcoma, surgical resection may be linked to a reduction in CSM. However, in metastatic patients, this protective effect appears to be limited primarily to those with leiomyosarcoma.

Journal of Clinical MedicineVol. 13(19)
Al-Ahliyya Amman University (JO), Goethe University Frankfurt (DE), Koç University (TR), Universität Hamburg (DE), University of Milan (IT), Medical University of Graz (AT), Cornell University (US), Comprehensive Cancer Center Vienna (AT), IRCCS Policlinico San Donato (IT), University Medical Center Hamburg-Eppendorf (DE), Martini-Klinik (DE), IRCCS Ospedale Galeazzi - Sant'Ambrogio (IT), Ripamonti (IT), University Hospital Frankfurt (DE), Ospedale Policlinico San Martino (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT), European Institute of Oncology (IT), Université de Montréal (CA), University of Naples Federico II (IT), Medical University of Vienna (AT), University of Genoa (IT), The University of Texas Southwestern Medical Center (US)
Good health and well-being
Openalex Percentile: Top 19%
Sarcoma Diagnosis and Treatment
1.26
DOIOpen Access PDFOpenAlex
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