Prognostic Value of Relevant Clinicopathologic Variables in Epithelioid Sarcoma: A Multi-Institutional Retrospective Study of 44 Patients

Naofumi Asano, Akihiko Yoshida, Koichi Ogura, Eisuke Kobayashi, Michiro Susa, Hideo Morioka, Shintaro Iwata, Takeshi Ishii, Toru Hiruma, Hirokazu Chuman, Akira Kawai

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Abstract

Background: Epithelioid sarcoma (ES) is an extremely rare soft tissue sarcoma. Recently, the proximal variant has been reported to be a more aggressive subtype; however, as most reports of ES have involved small case series, the actual prognostic implications remain unclear. We investigated the clinicopathological features of patients with ES to identify the prognostic factors that influence survival. Methods: We retrospectively analyzed the clinicopathological features of 44 patients with ES who had been treated at our institutions between 1991 and 2011. Among these patients, 26 were diagnosed histologically as having classic-type ES, whereas the remaining 18 had proximal-type ES. Thirty-three of the patients, all without distant metastases, underwent curative surgery, and the remaining 11 with distant metastases (M1) received palliative treatment. Results: The proximal subtype was significantly correlated with a proximal tumor location, distant metastases at presentation, presence of rhabdoid cells, a higher tumor grade, and vascular invasion. The overall survival (OS) rate at 5 years for the 44 patients was 45 %. A superficial tumor location and lymph node metastases (N1) at presentation were independently predictive of local recurrence-free survival (LRFS), and N1 and M1 tumors were independently predictive of distant metastasis-free survival and OS, respectively. The proximal subtype was associated with unfavorable LRFS and OS, although not to a statistically significant degree. Conclusions: Proximal-type ES has significantly more aggressive clinicopathological features than classic-type ES, and lymph node or distant metastasis has the most critical impact on prognosis.

Original languageEnglish
Pages (from-to)2624-2632
Number of pages9
JournalAnnals of Surgical Oncology
Volume22
Issue number8
DOIs
Publication statusPublished - 2015 Aug 1

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Sarcoma
Retrospective Studies
Neoplasm Metastasis
Survival
Neoplasms
Lymph Nodes
Recurrence
Palliative Care
Blood Vessels
Survival Rate

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Prognostic Value of Relevant Clinicopathologic Variables in Epithelioid Sarcoma : A Multi-Institutional Retrospective Study of 44 Patients. / Asano, Naofumi; Yoshida, Akihiko; Ogura, Koichi; Kobayashi, Eisuke; Susa, Michiro; Morioka, Hideo; Iwata, Shintaro; Ishii, Takeshi; Hiruma, Toru; Chuman, Hirokazu; Kawai, Akira.

In: Annals of Surgical Oncology, Vol. 22, No. 8, 01.08.2015, p. 2624-2632.

Research output: Contribution to journalArticle

Asano, N, Yoshida, A, Ogura, K, Kobayashi, E, Susa, M, Morioka, H, Iwata, S, Ishii, T, Hiruma, T, Chuman, H & Kawai, A 2015, 'Prognostic Value of Relevant Clinicopathologic Variables in Epithelioid Sarcoma: A Multi-Institutional Retrospective Study of 44 Patients', Annals of Surgical Oncology, vol. 22, no. 8, pp. 2624-2632. https://doi.org/10.1245/s10434-014-4294-1
Asano, Naofumi ; Yoshida, Akihiko ; Ogura, Koichi ; Kobayashi, Eisuke ; Susa, Michiro ; Morioka, Hideo ; Iwata, Shintaro ; Ishii, Takeshi ; Hiruma, Toru ; Chuman, Hirokazu ; Kawai, Akira. / Prognostic Value of Relevant Clinicopathologic Variables in Epithelioid Sarcoma : A Multi-Institutional Retrospective Study of 44 Patients. In: Annals of Surgical Oncology. 2015 ; Vol. 22, No. 8. pp. 2624-2632.
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AU - Asano, Naofumi

AU - Yoshida, Akihiko

AU - Ogura, Koichi

AU - Kobayashi, Eisuke

AU - Susa, Michiro

AU - Morioka, Hideo

AU - Iwata, Shintaro

AU - Ishii, Takeshi

AU - Hiruma, Toru

AU - Chuman, Hirokazu

AU - Kawai, Akira

PY - 2015/8/1

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N2 - Background: Epithelioid sarcoma (ES) is an extremely rare soft tissue sarcoma. Recently, the proximal variant has been reported to be a more aggressive subtype; however, as most reports of ES have involved small case series, the actual prognostic implications remain unclear. We investigated the clinicopathological features of patients with ES to identify the prognostic factors that influence survival. Methods: We retrospectively analyzed the clinicopathological features of 44 patients with ES who had been treated at our institutions between 1991 and 2011. Among these patients, 26 were diagnosed histologically as having classic-type ES, whereas the remaining 18 had proximal-type ES. Thirty-three of the patients, all without distant metastases, underwent curative surgery, and the remaining 11 with distant metastases (M1) received palliative treatment. Results: The proximal subtype was significantly correlated with a proximal tumor location, distant metastases at presentation, presence of rhabdoid cells, a higher tumor grade, and vascular invasion. The overall survival (OS) rate at 5 years for the 44 patients was 45 %. A superficial tumor location and lymph node metastases (N1) at presentation were independently predictive of local recurrence-free survival (LRFS), and N1 and M1 tumors were independently predictive of distant metastasis-free survival and OS, respectively. The proximal subtype was associated with unfavorable LRFS and OS, although not to a statistically significant degree. Conclusions: Proximal-type ES has significantly more aggressive clinicopathological features than classic-type ES, and lymph node or distant metastasis has the most critical impact on prognosis.

AB - Background: Epithelioid sarcoma (ES) is an extremely rare soft tissue sarcoma. Recently, the proximal variant has been reported to be a more aggressive subtype; however, as most reports of ES have involved small case series, the actual prognostic implications remain unclear. We investigated the clinicopathological features of patients with ES to identify the prognostic factors that influence survival. Methods: We retrospectively analyzed the clinicopathological features of 44 patients with ES who had been treated at our institutions between 1991 and 2011. Among these patients, 26 were diagnosed histologically as having classic-type ES, whereas the remaining 18 had proximal-type ES. Thirty-three of the patients, all without distant metastases, underwent curative surgery, and the remaining 11 with distant metastases (M1) received palliative treatment. Results: The proximal subtype was significantly correlated with a proximal tumor location, distant metastases at presentation, presence of rhabdoid cells, a higher tumor grade, and vascular invasion. The overall survival (OS) rate at 5 years for the 44 patients was 45 %. A superficial tumor location and lymph node metastases (N1) at presentation were independently predictive of local recurrence-free survival (LRFS), and N1 and M1 tumors were independently predictive of distant metastasis-free survival and OS, respectively. The proximal subtype was associated with unfavorable LRFS and OS, although not to a statistically significant degree. Conclusions: Proximal-type ES has significantly more aggressive clinicopathological features than classic-type ES, and lymph node or distant metastasis has the most critical impact on prognosis.

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