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Prognostic and survival factors in myxofibrosarcomas.

Dewan V, Darbyshire A, Sumathi V, Jeys L, Grimer R - Sarcoma (2012)

Bottom Line: Size, grade of tumour, age, and metastases were all found to be prognostic factors.Previous inadvertent excision significantly raised this risk to 45%.Future treatment may lie in developing an understanding molecular basis of the tumour and directing therapies accordingly.

View Article: PubMed Central - PubMed

Affiliation: Queen Elizabeth Hospital, Birmingham B15 2TH, UK.

ABSTRACT
Aim. Our study aimed to determine prognostic factors for survival and recurrence in myxofibrosarcomas based on the experience of a single institution. Methods. Patients who had been diagnosed with a myxofibrosarcoma were identified from our database. Survival and recurrence were evaluated with Kaplan Meier survival curves for univariate and cox regression for multivariate analysis. Results. 174 patients with a diagnosis of myxofibrosarcoma were identified. Two patients were excluded due to incomplete information, leaving 172 patients with a mean age of 67 years. Surgery was undertaken in all but 6 patients. Five-year survival was better for myxofibrosarcomas when compared to other soft tissue sarcomas (63% versus 57%). Size, grade of tumour, age, and metastases were all found to be prognostic factors. Local recurrence occurred in 29 patients (17%) with an overall risk of 15% at 5 years. Previous inadvertent excision significantly raised this risk to 45%. Wide surgical margins and depth of tumour, however, had no impact on recurrence. Conclusion. Factors previously identified as prognostic did not demonstrate such a relationship in our study, highlighting the unpredictable nature of myxofibrosarcomas. Future treatment may lie in developing an understanding molecular basis of the tumour and directing therapies accordingly.

No MeSH data available.


Related in: MedlinePlus

The effect of unplanned excision on locally recurrent disease, with the cumulative risk of LR rising from 15% at 5 years for those tumours primarily treated at our unit to 45% at 5 years for those treated with a previously unplanned sarcoma excision (P = 0.0009).
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Related In: Results  -  Collection


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fig3: The effect of unplanned excision on locally recurrent disease, with the cumulative risk of LR rising from 15% at 5 years for those tumours primarily treated at our unit to 45% at 5 years for those treated with a previously unplanned sarcoma excision (P = 0.0009).

Mentions: The type of treatment was excision alone in 133 patients (73%), excision with split skin grafting in 26 patients (15%), excision and endoprosthetic replacement in one patient, and amputation in 6 patients (4%), and no definitive surgery was undertaken in 6 patients (4%) (Figure 3). Amputation was not more likely if the patient had undergone a previous excision. Surgical margins in the patients treated primarily in our unit were intralesional in 26%, marginal in 50%, and wide in 24%. Of the 21 patients with intralesional margins, 8 patients underwent further localised excision, achieving wide margins and 1 patient underwent an amputation, achieving a marginal margin, all those with intralesional underwent postoperative prophylactic radiotherapy. Local recurrence occurred in 5 patients with intralesional margins (24%), all of whom had undergone a further excision to extend the margins (Table 1).


Prognostic and survival factors in myxofibrosarcomas.

Dewan V, Darbyshire A, Sumathi V, Jeys L, Grimer R - Sarcoma (2012)

The effect of unplanned excision on locally recurrent disease, with the cumulative risk of LR rising from 15% at 5 years for those tumours primarily treated at our unit to 45% at 5 years for those treated with a previously unplanned sarcoma excision (P = 0.0009).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3379161&req=5

fig3: The effect of unplanned excision on locally recurrent disease, with the cumulative risk of LR rising from 15% at 5 years for those tumours primarily treated at our unit to 45% at 5 years for those treated with a previously unplanned sarcoma excision (P = 0.0009).
Mentions: The type of treatment was excision alone in 133 patients (73%), excision with split skin grafting in 26 patients (15%), excision and endoprosthetic replacement in one patient, and amputation in 6 patients (4%), and no definitive surgery was undertaken in 6 patients (4%) (Figure 3). Amputation was not more likely if the patient had undergone a previous excision. Surgical margins in the patients treated primarily in our unit were intralesional in 26%, marginal in 50%, and wide in 24%. Of the 21 patients with intralesional margins, 8 patients underwent further localised excision, achieving wide margins and 1 patient underwent an amputation, achieving a marginal margin, all those with intralesional underwent postoperative prophylactic radiotherapy. Local recurrence occurred in 5 patients with intralesional margins (24%), all of whom had undergone a further excision to extend the margins (Table 1).

Bottom Line: Size, grade of tumour, age, and metastases were all found to be prognostic factors.Previous inadvertent excision significantly raised this risk to 45%.Future treatment may lie in developing an understanding molecular basis of the tumour and directing therapies accordingly.

View Article: PubMed Central - PubMed

Affiliation: Queen Elizabeth Hospital, Birmingham B15 2TH, UK.

ABSTRACT
Aim. Our study aimed to determine prognostic factors for survival and recurrence in myxofibrosarcomas based on the experience of a single institution. Methods. Patients who had been diagnosed with a myxofibrosarcoma were identified from our database. Survival and recurrence were evaluated with Kaplan Meier survival curves for univariate and cox regression for multivariate analysis. Results. 174 patients with a diagnosis of myxofibrosarcoma were identified. Two patients were excluded due to incomplete information, leaving 172 patients with a mean age of 67 years. Surgery was undertaken in all but 6 patients. Five-year survival was better for myxofibrosarcomas when compared to other soft tissue sarcomas (63% versus 57%). Size, grade of tumour, age, and metastases were all found to be prognostic factors. Local recurrence occurred in 29 patients (17%) with an overall risk of 15% at 5 years. Previous inadvertent excision significantly raised this risk to 45%. Wide surgical margins and depth of tumour, however, had no impact on recurrence. Conclusion. Factors previously identified as prognostic did not demonstrate such a relationship in our study, highlighting the unpredictable nature of myxofibrosarcomas. Future treatment may lie in developing an understanding molecular basis of the tumour and directing therapies accordingly.

No MeSH data available.


Related in: MedlinePlus