Abstract
IntroductionAdvanced or metastatic soft tissue sarcoma (a/mSTS) is associated with a dismal prognosis. Patient counseling on treatment aggressiveness is pivotal to avoid over- or undertreatment. Recently, evaluation of body composition markers like the skeletal muscle index (SMI) became focus of interest in a variety of cancers. This study focuses on the prognostic impact of SMI in a/mSTS, retrospectively.Methods181 a/mSTS patients were identified, 89 were eligible due to prespecified criteria for SMI assessment. Baseline CT-Scans were analyzed using an institutional software solution. Sarcopenia defining cut-off values for the SMI were established by optimal fitting method. Primary end point was overall survival (OS) and secondary endpoints were progression free survival (PFS), disease control rate (DCR), overall response rate (ORR). Descriptive statistics as well as Kaplan Meier- and Cox regression analyses were administered.Results28/89 a/mSTS patients showed sarcopenia. Sarcopenic patients were significantly older, generally tended to receive less multimodal therapies (62 vs. 57 years, P = 0.025; respectively median 2.5 vs. 4, P = 0.132) and showed a significantly lower median OS (4 months [95%CI 1.9–6.0] vs. 16 months [95%CI 8.8–23.2], Log-rank P = 0.002). Sarcopenia was identified as independent prognostic parameter of impaired OS (HR 2.40 [95%-CI 1.4–4.0], P < 0.001). Moreover, DCR of first palliative medical treatment was superior in non-sarcopenic patients (49.2% vs. 25%, P = 0.032).ConclusionThis study identifies sarcopenia as a prognostic parameter in a/mSTS. Further on, the data suggest that sarcopenia shows a trend of being associated with first line therapy response. SMI is a promising prognostic parameter, which needs further validation.
Highlights
Advanced or metastatic soft tissue sarcoma (a/mSTS) is associated with a dismal prognosis
89 (49%) of 181 a/mSTS patients were eligible for this retrospective analysis, according to predefined in- and exclusion criteria
At initial diagnosis 81 (91.0%) sarcomas were classified as deep according to TNM rules and 69 (77.5%) sarcomas had a diameter of > 5 cm [21]
Summary
Advanced or metastatic soft tissue sarcoma (a/mSTS) is associated with a dismal prognosis. Conclusion This study identifies sarcopenia as a prognostic parameter in a/mSTS. Despite improvements in surgical techniques, pathological understanding and medical treatment, patients with advanced or metastatic soft tissue sarcomas (a/mSTS) are mostly considered incurable [1]. Clinical parameters like tumor localization or histopathological grade have been identified to significantly impact outcome and reflect critical parameters once counseling patients [9, 10]. Once a patient enters the setting of a/mSTS disease stage, the prognosis becomes dismal and risk benefit evaluation of therapeutic aggressiveness is crucial to ensure optimal palliative benefit. Hardly any valid tool is established for prognostication for therapy aggressiveness in a/mSTS patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
