Patterns of Extrapulmonary Metastases in Sarcoma Surveillance

Soft tissue sarcomas (STS) most commonly metastasize to the lungs. Current surveillance guidelines variably recommend abdominal and pelvic imaging, but there is little evidence to support this. We sought to determine the proportion of initial pulmonary versus extrapulmonary metastases, the time to d...

Full description

Saved in:
Bibliographic Details
Published inCancers Vol. 13; no. 18; p. 4669
Main Authors Hong, Zachery, England, Patrick, Rhea, Lee, Hirbe, Angela, McDonald, Douglas, Cipriano, Cara A.
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 17.09.2021
MDPI
Subjects
Abdomen
Age
Biopsy
Body mass index
extrapulmonary
Gender
Lung diseases
Lungs
Magnetic resonance imaging
Medical prognosis
Metastases
Metastasis
Multivariate analysis
Orthopedics
Patients
Pelvis
Radiation therapy
Sarcoma
Soft tissue sarcoma
Surveillance
Tumors
Variables
Online AccessGet full text

Cover

More Information
Summary:Soft tissue sarcomas (STS) most commonly metastasize to the lungs. Current surveillance guidelines variably recommend abdominal and pelvic imaging, but there is little evidence to support this. We sought to determine the proportion of initial pulmonary versus extrapulmonary metastases, the time to development of each, and factors to identify patients that would benefit from abdominopelvic surveillance. We retrospectively reviewed 382 patients who underwent surgical treatment for STS at a single institution. Of the 33% (126/382) of patients who developed metastases, 72% (90/126) were pulmonary, 22% (28/126) were extrapulmonary, and 6% (8/126) developed both simultaneously. Initial extrapulmonary metastases occurred later (log rank p = 0.049), with median 11 months (IQR, 5 to 19) until pulmonary disease and 22 months (IQR, 6 to 45) until extrapulmonary disease. Pulmonary metastases were more common in patients with high grade tumors (p = 0.0201) and larger tumors (p < 0.0001). Our multivariate analysis did not identify any factors associated with initial extrapulmonary metastases. A substantial minority of initial metastases were extrapulmonary; these occurred later and over a broader time range than initial pulmonary metastases. Moreover, extrapulmonary metastases are more difficult to predict than pulmonary metastases, adding to the challenge of creating targeted surveillance protocols.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers13184669