Abstract
BackgroundExtremity liposarcoma represents 25% of extremity soft tissue sarcoma and has a better prognosis than liposarcoma occurring in other anatomic sites. The purpose of this study was to develop two nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) of patients with extremity liposarcoma.MethodsA total of 2170 patients diagnosed with primary extremity liposarcoma between 2004 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox analyses were performed to explore the independent prognostic factors and establish two nomograms. The area under the curve (AUC), C-index, calibration curve, decision curve analysis (DCA), Kaplan-Meier analysis, and subgroup analyses were used to evaluate the nomograms.ResultsSix variables were identified as independent prognostic factors for both OS and CSS. In the training cohort, the AUCs of the OS nomogram were 0.842, 0.841, and 0.823 for predicting 3-, 5-, and 8-year OS, respectively, while the AUCs of the CSS nomogram were 0.889, 0.884, and 0.859 for predicting 3-, 5-, and 8-year CSS, respectively. Calibration plots and DCA revealed that the nomogram had a satisfactory ability to predict OS and CSS. The above results were also observed in the validation cohort. In addition, the C-indices of both nomograms were significantly higher than those of all independent prognostic factors in both the training and validation cohorts. Stratification of the patients into high- and low-risk groups highlighted the differences in prognosis between the two groups in the training and validation cohorts.ConclusionAge, sex, tumor size, grade, M stage, and surgery status were confirmed as independent prognostic variables for both OS and CSS in extremity liposarcoma patients. Two nomograms based on the above variables were established to provide more accurate individual survival predictions for extremity liposarcoma patients and to help physicians make appropriate clinical decisions.
Highlights
Extremity liposarcoma represents 25% of extremity soft tissue sarcoma and has a better prognosis than liposarcoma occurring in other anatomic sites
Based on the Surveillance, Epidemiology, and End Results (SEER) program database, this study aimed to identify the prognostic factors of extremity liposarcoma patients and develop two nomograms to predict overall survival (OS) and cancer-specific survival (CSS)
Tumor size was divided into < 11.1 cm, 11.1–23.5 cm, and > 23.5 cm based on OS information, while it was grouped as < 7.4 cm, 7.4–12.4 cm, and > 12.4 cm based on CSS information (Fig. S1B and D)
Summary
Extremity liposarcoma represents 25% of extremity soft tissue sarcoma and has a better prognosis than liposarcoma occurring in other anatomic sites. The purpose of this study was to develop two nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) of patients with extremity liposarcoma. Liposarcoma is a rare malignant tumor accounting for approximately 15 to 20% of soft tissue sarcoma (STS) [1]. Liposarcoma can occur in any site but is usually located in the retroperitoneum and extremities [3]. Extremity liposarcoma represents 25% of extremity STS and has a better prognosis than that liposarcoma other locations [4, 5]. Surgical resection with adjuvant radiation therapy is one of the main treatment strategies for extremity STS patients [6]. Chemotherapy may be considered for patients with localized disease but at high risk of developing distant metastasis and patients with metastatic disease amenable to surgery at the initial diagnosis [7,8,9]
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