Materiały źródłowe

• #1 Prognosis and survival for soft tissue sarcoma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/soft-tissue-sarcoma/prognosis-and-survival

  If you have soft tissue sarcoma, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] The size of a soft tissue tumour is an important prognostic factor. Tumours that are 5 cm or smaller have a better prognosis than tumours larger than 5 cm. […] Low-grade soft tissue sarcomas are linked with a better prognosis because they are less likely to spread (metastasize) or come back (recur) than high-grade sarcomas.

• #2 Soft Tissue Sarcoma: Your Chances of Recovery (Prognosis) | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/soft-tissue-sarcoma-your-chances-recovery-prognosis

  Prognosis is the word your healthcare team may use to describe your likely outcome from cancer and cancer treatment. A prognosis is a calculated guess. Its a question many people have when they learn they have cancer. […] A healthcare provider who is most familiar with your health is in the best position to discuss your prognosis with you. He or she can explain what the statistics may mean in your case. At the same time, you should keep in mind that your prognosis can change. Cancer and cancer treatment outcomes are hard to predict. For instance, a favorable prognosis (which means youre likely going to do well) can change if the cancer spreads to key organs or doesnt respond to treatment. An unfavorable prognosis can change, too. This can happen if treatment shrinks and controls the cancer so it doesnt grow or spread.

• #3 Soft Tissue Sarcoma: Your Chances of Recovery (Prognosis) | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/soft-tissue-sarcoma-your-chances-recovery-prognosis

  If your cancer is likely to respond well to treatment, your healthcare provider will say you have a favorable prognosis. If your cancer is likely to be hard to control, your prognosis may be less favorable. Its important to keep in mind that a prognosis states whats likely or probable. It isnt a prediction of what will definitely happen. No healthcare provider can be fully certain about an outcome. […] In general, the prognosis for people with soft tissue sarcoma tends to be better if the cancer is caught early instead of at a later stage. […] Overall, the 5-year survival rate for soft tissue sarcomas is about 65%. The 5-year survival rate for cancer that has reached nearby organs or lymph nodes is about 50%. Once soft tissue sarcoma has spread to other parts of the body, the 5-year survival rate is about 18%. […] You can ask your healthcare provider about survival rates and what you might expect. But remember that statistics are based on large groups of people. They cannot be used to say what will happen to you. No two people are exactly alike. Treatment and how well people respond to treatment vary.

• #4 Predicting radiotherapy response for patients with soft tissue sarcoma by developing a molecular signature

  https://www.spandidos-publications.com/10.3892/or.2017.5999

  Soft tissue sarcomas are rare and aggressive tumors arising from connective tissues. […] The patients survival has slightly improved over the last 20 years. A recent report from the National Cancer Institute shows that the 5-year relative survival rate for soft tissue sarcoma is approximately 65%. […] We argue that if we can identify a molecular signature predictive of radiotherapeutic sensitivity and response, we might be able to improve local control, side-effects and overall survival in patients with soft tissue sarcoma. […] The results showed that the predicted radiosensitive patients who received radiotherapy had significantly improved survival than patients who did not. […] These results are consistent with our expectation, suggesting that the identified gene signature and radiosensitivity prediction are effective.

• #5 Sarcoma – Wikipedia

  https://en.wikipedia.org/wiki/Sarcoma

  The AJCC has identified several factors that affect prognosis of bone sarcomas: […] For soft-tissue sarcomas other than GISTs, factors that affect prognosis include: […] For GISTs, the key factor that affects prognosis is: […] According to data published by the US National Cancer Institute (NCI), the overall 5-year survival for bone sarcomas is 66.9%. […] For soft-tissue sarcomas, the overall 5-year survival (irrespective of stage) is 64.5%, but survival is affected by many factors, including stage.

• #6 Survival statistics for soft tissue sarcoma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/soft-tissue-sarcoma/prognosis-and-survival/survival-statistics

  Survival statistics for soft tissue sarcoma are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival. […] In Canada, the 5-year net survival for soft tissue sarcoma is 61%. This means that about 61% of people diagnosed with soft tissue sarcoma will survive at least 5 years. […] Survival varies with each stage of soft tissue sarcoma. Generally, the earlier soft tissue sarcoma is diagnosed and treated, the better the outcome. […] There are no specific Canadian statistics available for the different stages of soft tissue sarcoma. […] Talk to your doctor about your prognosis. A prognosis depends on many factors, including: […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.

• #7 Comprehensive Molecular Characterization of Soft Tissue Sarcoma for Prediction of Pazopanib-Based Treatment Response

  https://www.e-crt.org/journal/view.php?doi=10.4143/crt.2022.251

  Despite several treatment possibilities, the prognosis of STS remains poor with a median overall survival (OS) of 12 months. […] We identified possible molecular predictors of pazopanib efficacy that can be employed in future clinical trials aimed at evaluating therapeutic strategies. […] Patients with CDK4 amplification exhibited shorter PFS (3.7 vs. 7.9 months, p=2.09104) and a poorer response (ORR; 0% vs. 33.3%) compared to those without a gene amplification (copy ratio 2). […] The lack of understanding of the molecular background underlying the pazopanib response represents a major challenge in STS. […] Our findings lay the basis for patient stratifications with respect to therapeutic strategies for STS, which may be useful in future clinical trials investigating the effects of novel agents.

• #8 Survival Rates for Soft Tissue Sarcoma | American Cancer Society

  https://www.cancer.org/cancer/types/soft-tissue-sarcoma/detection-diagnosis-staging/survival-rates.html

  Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] They do not apply later on if the cancer grows, spreads, or comes back after treatment. […] People now being diagnosed with soft tissue sarcoma may have a better outlook than these numbers show.

• #9 Prognostic Factors in Extremity Soft Tissue Sarcomas Treated with Radiotherapy: Systematic Review of the Literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10526842/

  The 5- and 10-year LC rates ranged from 75% to 100% and from 70.4% to 100%, respectively. […] The overall results and prognostic factors are summarized in Table 4. […] For patients treated with preoperative RT, the 5-year OS rates ranged from 59.0% to 68.3%. […] Local and distant recurrences were significantly associated with lower OS rates in four studies. High grades and high stages seemed to be the most reported prognostic factors responsible for lower OS. […] This review describes the variability of prognostic factors found in the eSTS, which are not consistently retrieved or analyzed among these highly heterogeneous studies. Positive margins, size 5 cm, deep tumors, and high grades were the most significant factors identified that could benefit from RT, particularly in terms of improving LC. However, for several reasons, achieving LC must be an independent objective when considering radiotherapy for the patient, regardless of DC or OS goals. Additionally, we emphasize the low rates of acute and chronic serious adverse effects of multimodal treatment combining limb-sparing surgery and RT, leading to favorable functional outcomes. Consequently, RT is a relevant treatment option for eSTS, which can also benefit from the advancements in new RT techniques currently available.

• #10 Predicting the prognosis of undifferentiated pleomorphic soft tissue sarcoma: a 20-year experience of 266 cases – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31364245/

  Undifferentiated pleomorphic sarcoma (UPS) is a rare malignant tumour of mesenchymal origin, which was conceived following re-classification of malignant fibrous histiocytoma (MFH). The objective of this study is to determine prognostic factors for the outcome of UPS, following multi-modal treatment. […] The 5- and 10-year OS rates for all ages were 60% and 48%, respectively, with a median survival time of 10.1 years. Multivariate analysis revealed that the adverse prognostic factors associated with decreased OS were older age (P 0.001; hazard ratio 1.03) and MD at diagnosis (P = 0.001; 2.89), with upper extremity tumours being favourable (P = 0.043; 2.30). Poor prognosis for post-operative LR was associated with older age (P = 0.046; 1.03) and positive surgical margins (P = 0.028; 2.68). Increased post-treatment MD was seen in patients with large tumours (5-9 cm (P 0.001; 4.42), 10 cm (P 0.001; 6.80)) and MD at diagnosis (P 0.001; 3.99), adjuvant therapy was favourable, shown to reduce MD (P 0.001; 0.34). […] UPS is a high-grade soft tissue sarcoma, for which surgery striving for negative margins, with radiotherapy, is the treatment of choice. Older age, lower extremity location, MD at presentation, large size and positive surgical margins, were unfavourable.

• #11 Soft Tissue Sarcoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/soft-tissue-sarcoma/hp/adult-soft-tissue-treatment-pdq

  Estimated new cases and deaths from soft tissue sarcoma in the United States in 2025: […] Poor prognostic factors in adults with soft tissue sarcomas include: […] Small low-grade tumors, particularly in the trunk or extremities, are frequently curable by surgery alone. Higher-grade sarcomas are associated with higher local-treatment failure rates and increased metastatic potential. […] Prognostic nomograms (incorporating specific variables) have been developed for soft tissue sarcomas of the retroperitoneum and the extremities. […] Local disease control is crucial in patients with retroperitoneal sarcomas. Disease-specific mortality caused by local recurrence (without synchronous metastasis) was reported in up to 77% of patients with retroperitoneal sarcomas compared with 9% of patients with extremity or trunk sarcomas.

• #12 Prognosis and survival for soft tissue sarcoma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/soft-tissue-sarcoma/prognosis-and-survival

  Soft tissue tumours close to the surface of the body (superficial tumours) have a better prognosis than tumours that are growing deep within the body. Tumours that are deep within the connective tissue that wraps around muscles, nerves, blood vessels and organs (called fascia) tend to have a poor prognosis. […] Soft tissue sarcomas of the arms, legs or surface of the trunk of the body usually have a better prognosis than soft tissue sarcomas that start in other parts of the body. […] Some types of soft tissue sarcoma tend to have a worse prognosis, including malignant peripheral nerve sheath tumours (MPNSTs), leiomyosarcoma, desmoplastic small round cell tumours and epithelioid sarcoma. […] The lower the stage of soft tissue sarcoma at diagnosis, the better the prognosis. Stage 4 soft tissue sarcoma (metastatic soft tissue sarcoma) has a poor prognosis. Soft tissue sarcoma that has grown into bone, nerves or vessels usually has a poor prognosis.

• #13 Childhood Soft Tissue Sarcoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/soft-tissue-sarcoma/hp/child-soft-tissue-treatment-pdq

  Dramatic improvements in survival have been achieved for children and adolescents with cancer. Between 1975 and 2020, childhood cancer mortality decreased by more than 50%. […] Pediatric soft tissue sarcomas are a heterogenous group of malignant tumors that originate from primitive mesenchymal tissue and account for 6% of all childhood tumors (rhabdomyosarcomas, 3%; other soft tissue sarcomas, 3%). […] The prognosis of NRSTS varies greatly depending on the following factors: Site of the primary tumor, Tumor size, Tumor grade, Tumor histology, Depth of tumor invasion, Presence of metastases and site of the metastatic tumor, Resectability of the tumor, Use of radiation therapy. […] In a review of a large adult series of NRSTS, patients with superficial extremity sarcomas had a better prognosis than did patients with deep tumors.

• #14 Childhood Soft Tissue Sarcoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/soft-tissue-sarcoma/hp/child-soft-tissue-treatment-pdq

  Data specific to NRSTS in children and adolescents are difficult to separate. Several adult and pediatric series have shown that patients with large or invasive tumors have a significantly worse prognosis than do those with small, noninvasive tumors. […] Some pediatric NRSTS are associated with a better outcome. For instance, patients with infantile fibrosarcoma who present at age 4 years or younger have an excellent prognosis. […] Soft tissue sarcomas in older children and adolescents often behave similarly to those in adult patients. […] The COG ARST0332 trial was a risk-based stratification study. Overall, local control after radiation therapy was as follows: R0, 106 of 109 patients (97%); R1, 51 of 60 patients (85%); and R2/unresectable, 2 of 6 patients (33%). […] Pediatric patients with unresected localized NRSTS have a poor outcome. Only about one-third of patients treated with multimodality therapy remain disease free. […] The EpSSG conducted a prospective trial for patients younger than 21 years with NRSTS. They reported an analysis of 206 patients with synovial sarcoma and 363 with adult-type NRSTS. […] The 5-year EFS rate was 73.7% (95% CI, 69.7%-77.2%), and the OS rate was 83.8% (95% CI, 80.3%-86.7%).

• #15 Long-term outcome after local recurrence of soft tissue sarcoma: a retrospective analysis of factors predictive of survival in 135 patients with locally recurrent soft tissue sarcoma | British Journal of Cancer

  https://www.nature.com/articles/bjc201421

  The aim of this study was to identify prognostic indicators of survival in patients with locally recurrent soft tissue sarcoma (STS) through a long-term follow-up. […] The 5-year estimate of the PRS rate was 53.1% (95% CI: 44.361.2%) for the entire series. […] In a multivariate analysis, the significant prognostic indicators for PRS were histologic grade, tumour site, time to initial recurrence, the number of recurrences and the surgical margin status attained at the last resection. […] Complete surgical resection with microscopically clear margins is desirable in patients with locally recurrent STS. […] The total median survival times were 6.2 years after initial recurrence (95% CI: 4.47.6) and 1.5 years after the diagnosis of distant metastasis (95% CI: 0.932.17). […] Patients who developed distant metastases had a 5-year survival of 17.0% (95% CI: 8.428.2) after the diagnosis of initial metastasis.

• #16 Prognosis and survival for soft tissue sarcoma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/soft-tissue-sarcoma/prognosis-and-survival

  If cancer cells are found in the margin (called a positive surgical margin), there is a poorer prognosis compared to when there are no cancer cells in the margin (called a negative surgical margin). […] Soft tissue sarcoma that is completely removed by surgery has a much more favourable prognosis than soft tissue sarcoma that is not completely removed or if surgery cant be done. […] People with soft tissue sarcoma who are under the age of 50 tend to have a better prognosis than those over the age of 50.

• #17 Long-term outcome after local recurrence of soft tissue sarcoma: a retrospective analysis of factors predictive of survival in 135 patients with locally recurrent soft tissue sarcoma | British Journal of Cancer

  https://www.nature.com/articles/bjc201421

  The Cox model demonstrated that surgical attainment of negative margins at the last resection was associated with a significantly lower HR for death. The HR for negative compared with positive margin status after the last resection was 0.57 (95% CI: 0.340.94; P=0.026). […] Adverse prognostic features include early recurrence, truncal location and high-grade histology. […] The data from this study underscore the long-term benefit of negative margins achieved at the end of surgical treatment in patients with locally recurrent STS without distant metastases.

• #18 Soft Tissue Sarcoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/soft-tissue-sarcoma/hp/adult-soft-tissue-treatment-pdq

  The role of chemotherapy is not well defined. […] There is evidence that favorable clinical outcomes may be associated with referral to a specialized sarcoma treatment center. […] Adjuvant chemotherapy remains controversial. Any potential benefits should be considered in the context of the short- and long-term toxicities of the chemotherapy regimen. […] The impact of adjuvant chemotherapy on survival is still controversial but is likely to be small in absolute magnitude. […] Neoadjuvant chemotherapy with or without radiation therapy has shown response rates of 17% to 32%, 10-year RFS rates of up to 58%, and 10-year OS rates of up to 64%. […] In the setting of distant metastasis, surgery may be associated with long-term disease-free survival (DFS) in patients with pulmonary metastasis and optimal underlying disease biology.

• #19 Survival | Soft tissue sarcoma | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/soft-tissue-sarcoma/survival

  The outlook for leiomyosarcoma is affected by age. Generally, people who are younger than 50 have a better outlook than those in older age groups. […] The outlook for liposarcoma is affected by age. People who are younger than 60 years old have a better outlook than those aged 70 years or older. […] Survival is also affected by where the cancer is in your body. […] If you have a good response your outlook is better.

• #20 Outcome of patients with soft tissue sarcomas of the extremities and trunk treated by (neo)adjuvant intensity modulated radiation therapy with curative intent | Radiation Oncology | Full Text

  https://ro-journal.biomedcentral.com/articles/10.1186/s13014-023-02238-z

  Soft tissue sarcomas (STS) are a relatively rare group of malignant tumors. Currently, there is very little published clinical data, especially in the context of curative multimodal therapy with image-guided, conformal, intensity-modulated radiotherapy. […] The two-years overall survival rate was 88%. The median DFS was 48 months and the median DMFS was 51 months. Female gender (HR 0.460 (0.217; 0.973)) and histology of liposarcomas compared to UPS proved to be significantly more favorable in terms of DFS (HR 0.327 (0.126; 0.852)). […] Conformal, intensity-modulated radiotherapy is an effective treatment modality in the preoperative or postoperative management of STS. Especially for the prevention of distant metastases, the establishment of modern systemic therapies or multimodal therapy approaches is necessary.

• #21 Soft Tissue Sarcoma: An Insight on Biomarkers at Molecular, Metabolic and Cellular Level

  https://www.mdpi.com/2072-6694/13/12/3044

  Soft tissue sarcomas (STSs) are a heterogeneous group of rare tumors. […] New prognostic stratification markers are needed to help identify patients at risk of recurrence and possibly apply more intensive or novel treatments. […] Reliable biomarkers to enable the screening and surveillance of STSs are still unavailable. […] The aim of this review is mainly to highlight the state of the art and the more recent achievements in the understanding of the most relevant metabolic, genetic and molecular biomarkers related to STS; these will be detailed in the following sections, bearing in mind their clinical relevance. […] A study that evaluated the presence of B cells in 249 STSs showed that infiltration is associated with a better prognosis, and a concordant result emerged from an analysis carried out evaluating CD20+ in 33 patients with STS and confirmed by the evaluation of the expression of the MS4A1 gene (which codes for CD20+) in 265 patients.

• #22 Soft Tissue Sarcoma: An Insight on Biomarkers at Molecular, Metabolic and Cellular Level

  https://www.mdpi.com/2072-6694/13/12/3044

  The presence of CD8+ and CD4+ T cells is associated with an improvement in survival and response to therapies, whereas the presence of FOXP3+ T cells is associated with an immunosuppressive response. […] A high number of CD8+ has also been detected in myxofibrosarcoma and pleomorphic sarcoma. […] Tumor mutation burden (TMB) is defined as the number of somatic mutations per megabase of the genomic sequence analyzed. […] Numerous studies show that in sarcoma, and also specifically in STS, the TMB tends to be low. […] The presence of MSI in some types of cancer appears to be related to specific clinical-pathological features, such as localization, tumor lymphocyte infiltration, differentiation, frequency of distant metastases, and prognosis. […] There is a lot of evidence that shows a correlation between genetic events that lead to the loss of function of oncosuppressor genes and the incidence and evolution of STSs.

• #23 Genomic, transcriptomic, and immunogenomic landscape of over 1300 sarcomas of diverse histology subtypes | Nature Communications

  https://www.nature.com/articles/s41467-025-58678-6

  Given their rarity and diversity, a fundamental understanding of the genomic underpinnings for many sarcoma subtypes is still lacking. […] We observe inferior overall survival in immune deplete clusters compared to immune enriched (p<0.01). [...] We highlight expression pathways that are enriched in histologic subtypes that cluster most distinctly from others, providing a subtype-specific roadmap for further translational efforts. [...] Patients with tumors assigned to Group C had higher overall survival, which was expected given the predominance of GIST tumors in this group as GIST has greater survival expectations compared to most other sarcoma subtypes due to the availability of highly effective tyrosine kinase inhibitor therapy and also excellent expected survival of early-stage tumors included in the cohort treated with curative surgery. [...] Patients with tumors in the immune hot Groups D and E had higher overall survival compared to those with tumors in immune cold Groups A and B.

• #24 Prognostic Assessment in High-Grade Soft-Tissue Sarcoma Patients: A Comparison of Semantic Image Analysis and Radiomics

  https://www.mdpi.com/2072-6694/13/8/1929

  In this work, we demonstrated that a standardized semantic prognostic model predicted survival with moderate performance. Radiomic models achieved an added benefit in predicting OS relative to semantic features. Interestingly, the performance of Radiomics-T1 and Radiomics-T2 was comparable in terms of C-index. Both models achieved significant risk stratifications in the testing cohort. Importantly, combining the T1FSGd and T2FS radiomic feature sets with or without the semantic features did not trigger an additional benefit. The best combined model using T2FS-based radiomics features (Radiomics-T2+AJCC+Age) achieved a modest incremental benefit above the clinical model (AJCC+Age) alone. […] Multiple studies previously demonstrated significant associations of semantic imaging features with prognosis in STS patients. For instance, in a previous study, we demonstrated that semantic features, such as tumor size, septa thickness, contrast enhancement could distinguish atypical lipomatous tumors from benign lipomas. The presence of perilesional edema and T2 heterogeneity of liposarcomas detected with MRI predicted pulmonary metastases in a previous study. Moreover, perilesional edema detected on MR images of myxofibrosarcomas correlated significantly with a poor OS rate. The “tail sign” describing tumor cell infiltrations extending from the primary tumor along the deep fascia has been shown to correlate with LPFS in myxofibrosarcoma and undifferentiated sarcomas. In a non-histology-specific STS cohort, the three semantic features found by Crombé et al. (peritumoral enhancement, necrosis, heterogenous T2-weighted signal intensity) were also correlated to OS and DPFS. In our analysis, necrosis was associated with worse survival as well. Besides necrosis, peritumoral enhancement and the tail sign were selected into the final Semantic feature set, signaling a predictive relevance in our study, too.

• #25 Predicting radiotherapy response for patients with soft tissue sarcoma by developing a molecular signature

  https://www.spandidos-publications.com/10.3892/or.2017.5999

  The clinical benefit of radiotherapy on soft tissue sarcomas has not been observed significantly. […] The results showed that the predicted radiosensitive patients who received radiotherapy had significantly better survival than both predicted radiosensitive patients under non-radiotherapy, and predicted non-radiosensitive patients who receive radiotherapy. […] The predicted radiosensitive patients who received radiotherapy had a significantly reduced rate of new tumor events. […] The predicted radiosensitive patients strongly benefited from radiotherapy. […] The predicted radiosensitive and non-radiosensitive patients were appropriate predictions, suggesting that gene signature is potentially a predictive biomarker for sensitivity prediction for both radiosensitive and non-radiosensitive patients.

• #26 Outcome of patients with soft tissue sarcomas of the extremities and trunk treated by (neo)adjuvant intensity modulated radiation therapy with curative intent | Radiation Oncology | Full Text

  https://ro-journal.biomedcentral.com/articles/10.1186/s13014-023-02238-z

  The histological subtype is crucial for the prognosis of STS patients. […] The overall survival of our cohort is similar or slightly higher than the results of other comparable cohorts with localized STS. […] The extent to which combined targeted drug therapy affects the effectiveness and severity of side effects of additional radiotherapy in STS patients is not yet known and should be investigated in the future. […] Conformal, intensity-modulated radiotherapy with daily imaging is an effective treatment modality in the preoperative or postoperative treatment of soft tissue STSs. Histology constitutes an important predictor for disease-free survival. Especially for the prevention of distant metastases, the establishment of modern system therapies or multimodal therapy approaches is necessary.

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