Prognostic factors in alveolar soft part sarcoma: A SEER analysis

• Published in: Journal of surgical oncology Vol. 113; no. 5; pp. 581 - 586
• Main Authors: Wang, Haotong, Jacobson, Alex, Harmon, David C., Choy, Edwin, Hornicek, Francis J., Raskin, Kevin A., Chebib, Ivan A., DeLaney, Thomas F., Chen, Yen-Lin E.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.04.2016; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Aged; ASPS; Cancer surgery; Child; Child, Preschool; Female; Humans; Infant; Kaplan-Meier Estimate; Male; Medical prognosis; Middle Aged; Multivariate analysis; Prognosis; Proportional Hazards Models; Retrospective Studies; Sarcoma; Sarcoma, Alveolar Soft Part - mortality; Sarcoma, Alveolar Soft Part - pathology; Sarcoma, Alveolar Soft Part - therapy; SEER Program; soft tissue sarcoma; Surgery; surgical treatment; survival; Survival Rate; United States - epidemiology; Young Adult; surgical treatment; ASPS; soft tissue sarcoma; survival
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.24183

Objectives We reviewed the clinical characteristics and outcomes of patients treated for alveolar soft part sarcoma (ASPS) and analyzed the effect of surgery for patients presenting with and without metastatic disease (DM). Methods The SEER Registry was queried for patients with ASPS from 1973–2012. The Kaplan–Meier estimate and Cox proportional hazards were used to analyze survival outcomes and risk variables. Results Among 251 patients, 43% had DM and 67% locoregional disease (LR) on presentation. The 5‐year overall survival (OS) for all patients was 56% (82% and 27% for LR and DM, respectively). Multivariate analysis identified older age (hazard ratio [HR] = 1.03 per year, P < 0.001), tumor size >10 cm (HR = 2.76, P = 0.013), DM at diagnosis (HR = 3.79, P < 0.001), and truncal primary site (HR = 1.63, P = 0.035) as independent factors predicting worse OS. For LR patients, surgery plus radiotherapy (RT) resulted in better OS compared to surgery alone P = 0.014. For DM patients, primary site surgery significantly improved survival (P < 0.001). Conclusion ASPS presents with high metastasis rate but has a relatively indolent clinical course and a favorable prognosis with prolonged survival. Aggressive treatment using adjuvant RT with surgery is indicated in patients with LR disease and surgery is indicated in patients presenting with DM. J. Surg. Oncol. 2016;113:581–586. © 2016 Wiley Periodicals, Inc.