Abstract
BackgroundThe objective of this retrospective study was to evaluate the prognostic value of various factors in clear cell sarcoma patients after radical surgery.MethodsForty-two clear cell sarcoma patients from August 2006 to March 2018 were included in the study. Curves of disease-free survival and overall survival were calculated using the Kaplan–Meier method, and univariate and multivariate analyses of various prognostic factors were performed using a Cox proportional hazard regression model. Laboratory test of peripheral blood was recorded before surgery. The optimal cutoff value of systemic inflammatory markers was defined by receiver-operating curve analysis.ResultsThe 5-year DFS and 5-year OS rate were 22% and 46%, respectively. The median DFS and OS times were 12 and 41.5 months, respectively. In univariate analysis, there was a significant association between shorter DFS and tumor size larger than 5 cm (p = 0.0043), positive surgical margin (p = 0.0233), and the neutrophil-to-lymphocyte ratio (NLR) higher than 2.73 (p = 0.0009). Furthermore, we observed a significant association between shorter OS and tumor size larger than 5 cm (p = 0.0075), positive surgical margin (p = 0.0101), NLR higher than 2.73 (p = 0.0126), the platelet-to-lymphocyte ratio (PLR) higher than 103.89 (p = 0.0147) and the lymphocyte-to-monocyte ratio (LMR) lower than 4.2 (p = 0.0445). A multivariate analysis demonstrated that the surgical margin (p = 0.013) and NLR (p = 0.001) were significantly associated with DFS. Tumor size (p = 0.010) and NLR (p = 0.013) were independent prognostic factors for OS.ConclusionsThis study had the second largest sample around the world and preoperative NLR may be a useful prognostic factor in CCS patients after radical surgery.
Highlights
Clear cell sarcoma (CCS), which was first described by Enzinger in 1965 [1], is a rare malignant tumor mainly involving tendons and aponeuroses in young adults
The neutrophil-to-lymphocyte ratio (NLR) was derived by dividing the neutrophil count by the lymphocyte count; the platelet-to-lymphocyte ratio (PLR) was derived by dividing the platelet count by the lymphocyte count; the lymphocyte-to-monocyte ratio (LMR) was derived by dividing the lymphocyte count by the monocyte count
There were 30 (71.4%) patients whose tumors were in the extremities and 12 (28.6%) patients whose tumors were in the trunk
Summary
Clear cell sarcoma (CCS), which was first described by Enzinger in 1965 [1], is a rare malignant tumor mainly involving tendons and aponeuroses in young adults. We conducted this study to explore the prognostic value of NLR, PLR, and LMR in CCS patients after radical resection. The objective of this retrospective study was to evaluate the prognostic value of various factors in clear cell sarcoma patients after radical surgery. There was a significant association between shorter DFS and tumor size larger than 5 cm (p = 0.0043), positive surgical margin (p = 0.0233), and the neutrophil-to-lymphocyte ratio (NLR) higher than 2.73 (p = 0.0009). We observed a significant association between shorter OS and tumor size larger than 5 cm (p = 0.0075), positive surgical margin (p = 0.0101), NLR higher than 2.73 (p = 0.0126), the platelet-to-lymphocyte ratio (PLR) higher than 103.89 (p = 0.0147) and the lymphocyte-to-monocyte ratio (LMR) lower than 4.2 (p = 0.0445). Conclusions This study had the second largest sample around the world and preoperative NLR may be a useful prognostic factor in CCS patients after radical surgery
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