A Prognostic Model for Soft Tissue Sarcoma of the Extremities and Trunk Wall Based on Size, Vascular Invasion, Necrosis, and Growth Pattern

作者：Carneiro Ana^*; Bendahl Par Ola; Engellau Jacob; Domanski Henryk A; Fletcher Christopher D; Rissler Pehr; Rydholm Anders; Nilbert Mef

来源：Cancer, 2011, 117(6): 1279-1287.

DOI：10.1002/cncr.25621

• grade
• infiltrative growth
• high-risk
• prognostic model

BACKGROUND: In soft tissue sarcoma, better distinction of high-risk and low-risk patients is needed to individualize treatment and improve survival. Prognostic systems used in clinical practice identify high-risk patients based on various factors, including age, tumor size and depth, histological type, necrosis, and grade. METHODS: Whole-tumor sections from 239 soft tissue sarcomas of the extremities were reviewed for the following prognostic factors: size, vascular invasion, necrosis, and growth pattern. A new prognostic model, referred to as SING (Size, Invasion, Necrosis, Growth), was established and compared with other clinically applied systems. RESULTS: Size, vascular invasion, necrosis, and peripheral tumor growth pattern provided independent prognostic information with hazard ratios of 2.2-2.6 for development of metastases in multivariate analysis. When these factors were combined into the prognostic model SING, high risk of metastasis was predicted with a sensitivity of 74% and a specificity of 85%. Moreover, the prognostic performance of SING compared favorably with other widely used systems. CONCLUSIONS: SING represents a promising prognostic model, and vascular invasion and tumor growth pattern should be considered in soft tissue sarcoma prognostication. Cancer 2011;117:1279-87.

• 出版日期2011-3-15