Abstract
BackgroundThe French EMS study prospectively collected exhaustive data from STS patients diagnosed in the Rhone-Alpes region from 2005 to 07.MethodsThe database included diagnosis/histology, surgery, radiotherapy, systemic treatments and treatment response. Treatment patterns and outcomes of patients with metastatic disease, excluding adipocytic sarcoma and GIST were analyzed.ResultsOf 888 total patients, 145 were included based on having metastatic disease and appropriate subtypes. All patients received treatment with systemic therapy being most common (74%, n = 107), followed by radiotherapy (30%, n = 44) and surgery (23%, n = 33). Doxorubicin, alone or in combination, was the most common first line systemic therapy (65%, n = 46). Drugs without license in sarcoma were used in 38–83% of treatments depending on treatment line. 24% of frontline patients demonstrated an objective response, decreasing to 11% objective responses in second line but no responses were documented beyond second line, with median PFS declining with each additional line. Median PFS also declined in patients receiving surgery compared to those receiving no surgery (8–15 m vs 5 m). Median OS from metastatic diagnosis for patients receiving systemic therapy was double that of patients without systemic treatment (24 m vs 12 m, p = 0.007).ConclusionsOutcomes in this population were poor and declined with successive treatment. However, results suggest that further anticancer therapies in recurrent sarcoma might be beneficial.
Highlights
The French EMS study prospectively collected exhaustive data from Soft tissue sarcomas (STS) patients diagnosed in the Rhone-Alpes region from 2005 to 07
Patients A total of 888 patients with a primary diagnosis of sarcoma were available for analysis
A further 76 (21.2%) patients with initially localised disease progressed to metastatic disease during the observation period (2005–2012)
Summary
The French EMS study prospectively collected exhaustive data from STS patients diagnosed in the Rhone-Alpes region from 2005 to 07. In France, the incidence of STS is estimated at 6 per 100,000 per year with 4000 new cases diagnosed each year [2]. Non-concordance in diagnosis occurs in 30% of cases [6], potentially resulting in delayed or inappropriate treatment. Half of all STS patients with intermediate or highgrade tumors develop metastases [7]. Median survival is approximately 12 to 18 months from the time of metastatic diagnosis [8, 9], and has changed little in the past two decades. Five-year survival is no more than 8% in metastatic patients [8]
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