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- Title
Surgical outcome and graded prognostic assessment of patients with brain metastasis from adult sarcoma: multi-institutional retrospective study in Japan.
- Authors
Deguchi, Shoichi; Nakasu, Yoko; Sakaida, Tsukasa; Akimoto, Jiro; Tanahashi, Kuniaki; Natsume, Atsushi; Takahashi, Masamichi; Okuda, Takeshi; Asakura, Hirofumi; Mitsuya, Koichi; Hayashi, Nakamasa; Narita, Yoshitaka
- Abstract
Background: Brain metastasis (BM) is an uncommon complication of sarcomas with a poor prognosis. Little information is available about the feasibility and prognostic factors of surgical resection of BM from sarcomas. Methods: This study involved a retrospective analysis of 22 patients with BM from sarcomas who underwent resection at six institutes in Japan. Prognostic factors were analyzed to develop a graded prognostic assessment (GPA) using the log-rank test and Cox regression analysis. For validation of this GPA, we collected data on 100 surgical cases from 48 published reports. Results: Postoperative Karnofsky Performance Status (KPS) improved in 50% of our patients. Median overall survival (OS) was 21 months. Multivariate analysis showed age and alveolar soft part sarcoma (ASPS) were significant preoperative prognostic factors (P < 0.05). RTOG-RPA classification had no significant prognostic value. We developed a GPA system for OS after resection of BM. A score of 0 was assigned to patients aged 18–29 years with non-ASPS, 2 to patients aged 18–29 years with ASPS or 30–76 years with non-ASPS, and 4 to patients aged 30–76 years with ASPS. Median OS for patients with GPA scores of 0, 2, and 4 were 6.5, 16.0, and 44.0 months, respectively (P = 0.002). The results were validated by the data of 100 cases compiled (P < 0.001). Conclusion: Median OS of patients with BM from sarcomas was comparable to that from carcinomas after resection. A new sarcoma-specific GPA may help patients and clinicians to select resection as an option for treatment of BM from sarcomas.
- Subjects
JAPAN; BRAIN metastasis; SARCOMA; KARNOFSKY Performance Status; SURGICAL excision; LOG-rank test
- Publication
International Journal of Clinical Oncology, 2020, Vol 25, Issue 11, p1995
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-020-01740-8