Background
Methods
Patients
Outcomes
Statistical analysis
Results
Patients
All patients | Patients alive at 5 years | Patients treated with metastatic chemotherapy | ||||
---|---|---|---|---|---|---|
(n = 2165) | (n = 224) | (n = 1575) | ||||
n | % | n | % | n | % | |
Sex | ||||||
Male | 1055 | 48.73 | 92 | 41.07 | 754 | 47.87 |
Female | 1110 | 51.27 | 132 | 58.93 | 821 | 52.13 |
Age at first metastasis | ||||||
< 75 years old | 1886 | 87.11 | 216 | 96.43 | 1429 | 90.73 |
≥ 75 years old | 279 | 12.89 | 8 | 3.57 | 146 | 9.27 |
Histology | ||||||
Leiomyosarcoma | 502 | 23.19 | 60 | 26.79 | 396 | 25.14 |
UPS | 203 | 9.38 | 9 | 4.02 | 141 | 8.95 |
DLPS | 172 | 7.94 | 12 | 5.36 | 112 | 7.11 |
Synovial sarcoma | 188 | 8.68 | 16 | 7.14 | 150 | 9.52 |
MPNST | 80 | 3.70 | 11 | 4.91 | 50 | 3.17 |
Other | 1020 | 47.11 | 116 | 51.79 | 726 | 46.10 |
Grade | ||||||
1 | 138 | 6.37 | 48 | 21.43 | 94 | 5.97 |
2 | 590 | 27.25 | 74 | 33.04 | 440 | 27.94 |
3 | 1083 | 50.02 | 63 | 28.13 | 765 | 48.57 |
Not available | 354 | 16.35 | 39 | 17.41 | 276 | 17.52 |
Number of metastatic sites | ||||||
1 | 1780 | 82.22 | 199 | 88.84 | 1248 | 79.24 |
> 1 | 385 | 17.78 | 25 | 11.16 | 327 | 20.76 |
Metastatic sites | ||||||
Lung | 1399 | 64.62 | 149 | 66.52 | 1075 | 68.25 |
Liver | 410 | 18.94 | 34 | 15.18 | 352 | 22.35 |
Peritoneum | 396 | 18.29 | 60 | 26.79 | 319 | 20.25 |
Bone | 370 | 17.09 | 29 | 12.95 | 305 | 19.37 |
Lymph node | 304 | 14.04 | 35 | 15.63 | 236 | 14.98 |
Skin | 172 | 7.94 | 25 | 11.16 | 136 | 8.63 |
Soft tissue | 173 | 7.99 | 36 | 16.07 | 135 | 8.57 |
Pleura | 163 | 7.53 | 11 | 4.91 | 140 | 8.89 |
Brain | 113 | 5.22 | 5 | 2.23 | 89 | 5.65 |
Bone marrow | 12 | 0.55 | 0 | 0.00 | 10 | 0.63 |
Other | 228 | 10.53 | 32 | 14.29 | 166 | 10.54 |
General treatment patterns
All patients | Patients alive at 5 years | Patients treated with chemotherapy | ||||
---|---|---|---|---|---|---|
(n = 2165) | (n = 224) | (n = 1575) | ||||
n | % | n | % | |||
Metastatic treatment received | ||||||
Best supportive care only | 340 | 15.70 | 13 | 5.80 | 0 | 0.00 |
Locoregional treatment | 1054 | 48.68 | 187 | 83.48 | 804 | 51.05 |
Surgery | 408 | 38.71 | 82 | 43.85 | 282 | 35.07 |
Radiotherapy | 254 | 24.10 | 12 | 6.42 | 213 | 26.49 |
Radiofrequency | 42 | 3.98 | 9 | 4.81 | 33 | 4.10 |
Other | 30 | 2.85 | 3 | 1.60 | 19 | 2.36 |
Combination | 320 | 30.36 | 81 | 43.32 | 257 | 31.97 |
None | 1111 | 51.32 | 37 | 16.52 | 771 | 48.95 |
Chemotherapy | 1575 | 72.75 | 156 | 69.64 | 1575 | 100 |
None | 590 | 27.25 | 68 | 30.36 | – | – |
1 line | 489 | 22.59 | 54 | 34.62 | 489 | 31.05 |
2 lines | 293 | 13.53 | 24 | 15.38 | 293 | 18.60 |
3 lines | 240 | 11.09 | 21 | 13.46 | 240 | 15.24 |
4 lines | 157 | 7.25 | 11 | 7.05 | 157 | 9.97 |
> 4 lines | 396 | 17.27 | 46 | 29.49 | 396 | 25.15 |
Anthracycline received | ||||||
Yes | – | – | 109 | 69.87 | 951 | 60.38 |
No | – | – | 47 | 30.13 | 624 | 39.62 |
Anthracycline received as first line | ||||||
Yes | – | – | 98 | 62.82 | 852 | 54.10 |
No | – | – | 58 | 37.18 | 723 | 45.90 |
Polychemotherapy received as first line | ||||||
Yes | – | – | 95 | 60.90 | 716 | 45.46 |
No | – | – | 61 | 39.10 | 859 | 54.54 |
Inclusion in a clinical trial | ||||||
Yes: | – | – | 55 | 35.26 | 332 | 21.08 |
Line 1 | – | – | 10 | 6.41 | 122 | 7.75 |
Line 2 | – | – | 17 | 16.67 | 107 | 9.85 |
Line 3 | – | – | 10 | 12.82 | 56 | 7.06 |
Line 4 | – | – | 7 | 12.28 | 30 | 5.42 |
Other lines | – | – | 11 | 23.91 | 17 | 4.29 |
No | – | – | 101 | 64.74 | 1243 | 78.92 |
Off-label drugs | ||||||
Yes: | – | – | 99 | 63.46 | 810 | 51.43 |
Line 1 | – | – | 21 | 13.46 | 194 | 12.32 |
Line 2 | – | – | 22 | 21.57 | 203 | 18.69 |
Line 3 | – | – | 14 | 17.95 | 169 | 21.31 |
Line 4 | – | – | 21 | 36.84 | 142 | 25.68 |
Other lines | – | – | 21 | 45.65 | 102 | 25.76 |
No | – | – | 57 | 36.54 | 765 | 48.57 |
Systemic treatment patterns (Table 2)
Time to next treatment and overall survival
Median TNT/OS (months) | ||||
---|---|---|---|---|
TNT1/OS1a
| TNT2/OS2b
| TNT3/OS3c
| TNT4/OS4d
| |
LMS | 8.0/24.9 | 5.6/17.3 | 4.6/12.3 | 4.4/9.2 |
UPS | 4.8/11.0 | 3.5/7.9 | 2.3/3.7 | 3.5/6.2 |
DLPS | 4.4/11.8 | 5.1/8.8 | 2.4/6.0 | 3.2/8.5 |
SS | 8.7/19.7 | 5.7/11.7 | 3.4/7.8 | 2.3/6.0 |
MPNST | 4.1/12.5 | 2.8/7.0 | 3.6/8.0 | 3.7/5.4 |
Spearman’s rho | 95% CI | |
---|---|---|
TNT1/OS1a
| 0.76 | 0.73–0.78 |
TNT2/OS2b
| 0.70 | 0.67–0.73 |
TNT3/OS3c
| 0.68 | 0.65–0.72 |
TNT4/OS4d
| 0.73 | 0.70–0.76 |
Prognostic factors for time to next treatment
Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|
Covariate |
P
| HR (95% CI) |
P
| HR (95% CI) |
Sex (ref: Male) | 0.0014 | 0.835 (0.747–0.933) | 0.0013 | 0.825 (0.733–0.928) |
Age (ref: < 75 years old) | 0.0023 | 1.374 (1.120–1.686) | – | – |
Histotype (ref: Other) | ||||
LMS | 0.5114 | 0.955 (0.831–1.097) | – | – |
DLPS | 0.0068 | 1.357 (1.088–1.692) | – | – |
MPNST | 0.3703 | 1.154 (0.843–1.580) | – | – |
SS | 0.8580 | 0.983 (0.811–1.191) | – | – |
UPS | 0.0375 | 1.243 (1.013–1.525) | – | – |
Grade (ref: < 3) | < 0.0001 | 1.417 (1.258–1.596) | < 0.0001 | 1.372 (1.218–1.546) |
Number of metastatic sites (ref: 1) | 0.1175 | 1.118 (0.972–1.285) | – | – |
Liver metastasis (ref: no) | 0.1436 | 1.103 (0.967–1.259) | – | – |
Locoregional treatment (ref: no) | < 0.0001 | 0.496 (0.442–0.556) | < 0.0001 | 0.487 (0.432–0.550) |
Clinical trial in first line (ref: no) | 0.6453 | 1.048 (0.859–1.277) | – | – |
Anthracycline in first line (ref: no) | < 0.0001 | 0.756 (0.674–0.847) | – | – |
Polychemotherapy in first line (ref: no) | < 0.0001 | 0.729 (0.651–0.815) | < 0.0001 | 0.743 (0.660–0.836) |
Prognostic factors for OS
Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|
Covariate |
P
| HR (95% CI) |
P
| HR (95% CI) |
Sex (ref: Male) | 0.0002 | 0.801 (0.713–0.899) | 0.0003 | 0.792 (0.698–0.900) |
Age (ref: < 75 years old) | 0.0024 | 1.389 (1.123–1.717) | – | – |
Histotype (ref: Other) | ||||
LMS | 0.0004 | 0.765 (0.659–0.888) | 0.0010 | 0.765 (0.652–0.897) |
DLPS | 0.0269 | 1.291 (1.030–1.619) | 0.2034 | 1.171 (0.918–1.492) |
MPNST | 0.1368 | 1.273 (0.926–1.751) | 0.2183 | 1.234 (0.883–1.726) |
SS | 0.4738 | 1.074 (0.883–1.307) | 0.0764 | 1.206 (0.980–1.485) |
UPS | 0.0061 | 1.347 (1.089–1.668) | 0.1839 | 1.168 (0.929–1.469) |
Grade (ref: < 3) | < 0.0001 | 1.692 (1.491–1.920) | < 0.0001 | 1.687 (1.483–1.919) |
Number of metastatic sites (ref: 1) | 0.0136 | 1.200 (1.038–1.387) | 0.0009 | 1.305 (1.115–1.528) |
Liver metastasis (ref: no) | 0.1056 | 0.891 (0.774–1.025) | – | – |
Locoregional treatment (ref: no) | < 0.0001 | 0.412 (0.365–0.465) | < 0.0001 | 0.400 (0.351–0.455) |
Clinical trial (ref: no) | < 0.0001 | 0.750 (0.653–0.862) | 0.0002 | 0.755 (0.651–0.877) |
Off-label drugs (ref: no) | < 0.0001 | 0.791 (0.703–0.890) | – | – |
Anthracycline (ref: no) | 0.0046 | 0.838 (0.741–0.947) | – | – |
Anthracycline in first line (ref: no) | 0.0127 | 0.861 (0.765–0.968) | – | – |
Polychemotherapy in first line (ref: no) | 0.0003 | 0.804 (0.715–0.902) | 0.0023 | 0.822 (0.724–0.932) |