Prognoses of superficial soft tissue sarcoma: The importance of fascia-tumor relationship on MRI

Abstract

BackgroundSuperficial soft tissue sarcoma (S-STS) has been reported to have more favorable prognoses than deep-seated STS. However, for some patients, poor prognoses have been observed and there is a need for better prognostication. The deep peripheral fascia lies in the border of the S-STS and can be consistently detected using magnetic resonance imaging (MRI). The relationship of the subcutaneous tumor with the fascia on MRI scan was reported to be useful in classifying the tumor as benign or malignant; this in turn, may reflect the biological aggressiveness of STS. This study was performed to evaluate the oncologic outcomes and to identify the prognostic factors of S-STS by focusing on the relationship of S-STS with the underlying fascia on MRI. Material and methodsWe retrospectively reviewed data on 253 patients who underwent resection of localized S-STS. Potential factors that might influence the oncologic outcomes were identified. The fascia-tumor relationship on MRI was classified into three groups: no fascial contact group (n = 46), fascial contact group (n = 77), and fascial invasion group (n = 84). ResultsOverall, 39 patients (16.5%) died due to S-STS; the 5- and 10-year survival rates were 82.6 ± 2.9% and 73.2 ± 4.5%, respectively. Fascial invasion detected on MRI scans (OR = 2.190, p = 0.034) and advanced age (OR = 2.408, p = 0.034) were found to be independent factors for worse disease specific survival. The fascia-tumor relationship on MRI scan was not associated with local recurrence of S-STS. ConclusionThe fascia-tumor relationship on MRI scan reflects the biological aggressiveness of S-STS and can serve as a prognostic factor.