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Erschienen in: International Journal of Clinical Oncology 1/2018

10.08.2017 | Original Article

Clinical outcomes of patients with epithelioid sarcomas: impact and management of nodal metastasis

verfasst von: Hidetatsu Outani, Yoshinori Imura, Takaaki Tanaka, Satoshi Takenaka, Kazuya Oshima, Kenichiro Hamada, Shigeki Kakunaga, Susumu Joyama, Norifumi Naka, Ikuo Kudawara, Takafumi Ueda, Nobuhito Araki, Hideki Yoshikawa

Erschienen in: International Journal of Clinical Oncology | Ausgabe 1/2018

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Abstract

Purpose

An epithelioid sarcoma is a rare histological subtype of a soft tissue sarcoma with a high local recurrence rate, which frequently shows lymph node metastasis. However, because of the rarity of this tumor, the impact of nodal metastasis and its appropriate management remain unclear. The present study investigated the clinical outcomes of patients with epithelioid sarcomas, with a focus on lymph node metastasis.

Methods

We retrospectively evaluated the clinical outcomes of 27 patients with epithelioid sarcomas treated between 1985 and 2015. The log-rank test was used to assess the prognostic variables.

Results

The overall local recurrence rate was 33%, and the estimated overall 5-year survival rate was 62%. Hand and foot locations were associated with favorable overall survival. During the follow-up period, new nodal metastasis was noted in 14 patients (52%). The incidence of local recurrence was higher in patients with new nodal metastasis than in patients who did not develop nodal metastasis. The development of new nodal metastasis had a tendency to worsen survival; however, this association was not statistically significant. Lymphadenectomy did not affect overall survival.

Conclusions

Peripheral tumor location is associated with a better prognosis. The development of new nodal metastasis tends to be associated with poor prognosis; however, among patients with nodal metastasis, resection of the metastatic lesions has a low impact on survival.
Literatur
1.
Zurück zum Zitat Goldblum JR, Flope AL, Weiss SW (2013) Malignant soft tissue tumors of uncertain type. Enzinger and Weiss’s soft tissue tumors, 6th edn. Elsevier, Philadelphia, pp 1086–1098 Goldblum JR, Flope AL, Weiss SW (2013) Malignant soft tissue tumors of uncertain type. Enzinger and Weiss’s soft tissue tumors, 6th edn. Elsevier, Philadelphia, pp 1086–1098
2.
Zurück zum Zitat Enzinger FM (1970) Epithelioid sarcoma; a sarcoma simulating a granuloma or a carcinoma. Cancer 26:1029–1041CrossRefPubMed Enzinger FM (1970) Epithelioid sarcoma; a sarcoma simulating a granuloma or a carcinoma. Cancer 26:1029–1041CrossRefPubMed
3.
Zurück zum Zitat Prat J, Woodruff JM, Marcove RC (1978) Epithelioid sarcoma: an analysis of 22 cases indicating the prognostic significance of vascular invasion and regional lymph node metastasis. Cancer 41:1472–1487CrossRefPubMed Prat J, Woodruff JM, Marcove RC (1978) Epithelioid sarcoma: an analysis of 22 cases indicating the prognostic significance of vascular invasion and regional lymph node metastasis. Cancer 41:1472–1487CrossRefPubMed
4.
Zurück zum Zitat Jawad MU, Extein J, Min ES et al (2009) Prognostic factors for survival in patients with epithelioid sarcoma: 441 cases from the SEER database. Clin Orthop Relat Res 467:2939–2948CrossRefPubMedPubMedCentral Jawad MU, Extein J, Min ES et al (2009) Prognostic factors for survival in patients with epithelioid sarcoma: 441 cases from the SEER database. Clin Orthop Relat Res 467:2939–2948CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat de Visscher SA, van Ginkel RJ, Wobbes T et al (2006) Epithelioid sarcoma: still an only surgically curable disease. Cancer 107:606–612CrossRefPubMed de Visscher SA, van Ginkel RJ, Wobbes T et al (2006) Epithelioid sarcoma: still an only surgically curable disease. Cancer 107:606–612CrossRefPubMed
6.
Zurück zum Zitat Wolf PS, Flum DR, Tanas MR et al (2008) Epithelioid sarcoma: the University of Washington experience. Am J Surg 196:407–412CrossRefPubMed Wolf PS, Flum DR, Tanas MR et al (2008) Epithelioid sarcoma: the University of Washington experience. Am J Surg 196:407–412CrossRefPubMed
7.
Zurück zum Zitat Trojani M, Contesso G, Coindre JM et al (1984) Soft-tissue sarcomas of adults; study of pathological prognostic variables and definition of a histopathological grading system. Int J Cancer 33:37–42CrossRefPubMed Trojani M, Contesso G, Coindre JM et al (1984) Soft-tissue sarcomas of adults; study of pathological prognostic variables and definition of a histopathological grading system. Int J Cancer 33:37–42CrossRefPubMed
8.
Zurück zum Zitat Spillane AJ, Thomas JM, Fisher C (2000) Epithelioid sarcoma: the clinicopathological complexities of this rare soft tissue sarcoma. Ann Surg Oncol 7:218–225CrossRefPubMed Spillane AJ, Thomas JM, Fisher C (2000) Epithelioid sarcoma: the clinicopathological complexities of this rare soft tissue sarcoma. Ann Surg Oncol 7:218–225CrossRefPubMed
9.
Zurück zum Zitat Callister MD, Ballo MT, Pisters PW et al (2001) Epithelioid sarcoma: results of conservative surgery and radiotherapy. Int J Radiat Oncol Biol Phys 51:384–391CrossRefPubMed Callister MD, Ballo MT, Pisters PW et al (2001) Epithelioid sarcoma: results of conservative surgery and radiotherapy. Int J Radiat Oncol Biol Phys 51:384–391CrossRefPubMed
11.
Zurück zum Zitat Baratti D, Pennacchioli E, Casali PG et al (2007) Epithelioid sarcoma: prognostic factors and survival in a series of patients treated at a single institution. Ann Surg Oncol 14:3542–3551CrossRefPubMed Baratti D, Pennacchioli E, Casali PG et al (2007) Epithelioid sarcoma: prognostic factors and survival in a series of patients treated at a single institution. Ann Surg Oncol 14:3542–3551CrossRefPubMed
12.
Zurück zum Zitat Rekhi B, Gorad BD, Chinoy RF (2008) Clinicopathological features with outcomes of a series of conventional and proximal-type epithelioid sarcomas, diagnosed over a period of 10 years at a tertiary cancer hospital in India. Virchows Arch 453:141–153CrossRefPubMed Rekhi B, Gorad BD, Chinoy RF (2008) Clinicopathological features with outcomes of a series of conventional and proximal-type epithelioid sarcomas, diagnosed over a period of 10 years at a tertiary cancer hospital in India. Virchows Arch 453:141–153CrossRefPubMed
13.
Zurück zum Zitat Gasparini P, Facchinetti F, Boeri M et al (2011) Prognostic determinants in epithelioid sarcoma. Eur J Cancer 47:287–295CrossRefPubMed Gasparini P, Facchinetti F, Boeri M et al (2011) Prognostic determinants in epithelioid sarcoma. Eur J Cancer 47:287–295CrossRefPubMed
14.
15.
Zurück zum Zitat Levy A, Le Pechoux C, Terrier P et al (2014) Epithelioid sarcoma: need for a multimodal approach to maximize the chances of curative conservative treatment. Ann Surg Oncol 21:269–276CrossRefPubMed Levy A, Le Pechoux C, Terrier P et al (2014) Epithelioid sarcoma: need for a multimodal approach to maximize the chances of curative conservative treatment. Ann Surg Oncol 21:269–276CrossRefPubMed
16.
Zurück zum Zitat Asano N, Yoshida A, Ogura K et al (2015) Prognostic value of relevant clinicopathologic variables in epithelioid sarcoma: a multi-institutional retrospective study of 44 patients. Ann Surg Oncol 22:2624–2632CrossRefPubMedPubMedCentral Asano N, Yoshida A, Ogura K et al (2015) Prognostic value of relevant clinicopathologic variables in epithelioid sarcoma: a multi-institutional retrospective study of 44 patients. Ann Surg Oncol 22:2624–2632CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Chase DR, Enzinger FM (1985) Epithelioid sarcoma: diagnosis, prognostic indicators, and treatment. Am J Surg Pathol 9:241–263CrossRefPubMed Chase DR, Enzinger FM (1985) Epithelioid sarcoma: diagnosis, prognostic indicators, and treatment. Am J Surg Pathol 9:241–263CrossRefPubMed
18.
Zurück zum Zitat Jones RL, Constantinidou A, Olmos D et al (2012) Role of palliative chemotherapy in advanced epithelioid sarcoma. Am J Clin Oncol 35:351–357CrossRefPubMed Jones RL, Constantinidou A, Olmos D et al (2012) Role of palliative chemotherapy in advanced epithelioid sarcoma. Am J Clin Oncol 35:351–357CrossRefPubMed
19.
Zurück zum Zitat Nakamura T, Matsumine A, Kawai A et al (2016) The clinical outcome of pazopanib treatment in Japanese patients with relapsed soft tissue sarcoma: a Japanese Musculoskeletal Oncology Group (JMOG) study. Cancer 122:1408–1416CrossRefPubMedPubMedCentral Nakamura T, Matsumine A, Kawai A et al (2016) The clinical outcome of pazopanib treatment in Japanese patients with relapsed soft tissue sarcoma: a Japanese Musculoskeletal Oncology Group (JMOG) study. Cancer 122:1408–1416CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Casanova M, Ferrari A, Colloni P et al (2006) Epithelioid sarcoma in children and adolescents: a report from the Italian Soft Tissue Sarcoma Committee. Cancer 1068:708–717CrossRef Casanova M, Ferrari A, Colloni P et al (2006) Epithelioid sarcoma in children and adolescents: a report from the Italian Soft Tissue Sarcoma Committee. Cancer 1068:708–717CrossRef
21.
Zurück zum Zitat Daigeler A, Kuhnen C, Moritz R et al (2009) Lymph node metastases in soft tissue sarcoma: a single center analysis of 1597 patients. Langenbecks Arch Surg 394:321–329CrossRefPubMed Daigeler A, Kuhnen C, Moritz R et al (2009) Lymph node metastases in soft tissue sarcoma: a single center analysis of 1597 patients. Langenbecks Arch Surg 394:321–329CrossRefPubMed
22.
Zurück zum Zitat Fong Y, Colit DG, Woodruff JM et al (1993) Lymph node metastasis from soft tissue sarcoma in adults. Analysis of data from a prospective database of 1772 sarcoma patients. Ann Surg 217:72–77CrossRefPubMedPubMedCentral Fong Y, Colit DG, Woodruff JM et al (1993) Lymph node metastasis from soft tissue sarcoma in adults. Analysis of data from a prospective database of 1772 sarcoma patients. Ann Surg 217:72–77CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Al-Refaie WB, Andtbacka RH, Ensor J et al (2008) Lymphadenectomy for isolated lymph node metastasis from extremity soft-tissue sarcomas. Cancer 112:1821–1826CrossRefPubMed Al-Refaie WB, Andtbacka RH, Ensor J et al (2008) Lymphadenectomy for isolated lymph node metastasis from extremity soft-tissue sarcomas. Cancer 112:1821–1826CrossRefPubMed
24.
Zurück zum Zitat Sawamura C, Matsumoto S, Shimoji T et al (2013) Lymphadenectomy and histologic subtype affect overall survival of soft tissue sarcoma patients with nodal metastases. Clin Orthop Relat Res 471:926–931CrossRefPubMed Sawamura C, Matsumoto S, Shimoji T et al (2013) Lymphadenectomy and histologic subtype affect overall survival of soft tissue sarcoma patients with nodal metastases. Clin Orthop Relat Res 471:926–931CrossRefPubMed
25.
Zurück zum Zitat Herr MJ, Harmsen WS, Amadio PC et al (2005) Epithelioid sarcoma of the hand. Clin Orthod Relat Res 431:193–200CrossRef Herr MJ, Harmsen WS, Amadio PC et al (2005) Epithelioid sarcoma of the hand. Clin Orthod Relat Res 431:193–200CrossRef
Metadaten
Titel
Clinical outcomes of patients with epithelioid sarcomas: impact and management of nodal metastasis
verfasst von
Hidetatsu Outani
Yoshinori Imura
Takaaki Tanaka
Satoshi Takenaka
Kazuya Oshima
Kenichiro Hamada
Shigeki Kakunaga
Susumu Joyama
Norifumi Naka
Ikuo Kudawara
Takafumi Ueda
Nobuhito Araki
Hideki Yoshikawa
Publikationsdatum
10.08.2017
Verlag
Springer Japan
Erschienen in
International Journal of Clinical Oncology / Ausgabe 1/2018
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-017-1179-x

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