Brain, the Last Fortress of Sarcoma: Similar Dismal Outcome But Discrepancy of Timing of Brain Metastasis in Bone and Soft Tissue Sarcoma

作者：Chou Yi Sheng; Liu Chun Yu; Chen Wei Ming; Chen Tain Hsiung; Chen Paul Chih Hsueh; Wu Hung Ta Hondar; Shiau Cheng Ying; Wu Yu Chung; Liu Chien Lin; Chao Ta Chung; Tzeng Cheng Hwai; Wong Tai Tong; Yen Chueh Chuan^*

来源：Journal of Surgical Oncology, 2011, 104(7): 765-770.

DOI：10.1002/jso.22011

• alveolar soft part sarcoma
• brain metastasis
• osteosarcoma
• soft tissue sarcoma

Background and Objective: Brain metastasis is a rare but dismal event in sarcomas. However, the pattern of occurrence and the prognostic factors associated with post-brain metastasis survival (PBMS) are not yet well-characterized.
Methods: Sarcoma patients treated at one institute within 10-year period were retrospectively reviewed and those with brain metastasis were identified. The incidence of brain metastasis was demonstrated by case per person-years and cumulative incidence curves. Univariate factors associated with PBMS were analyzed.
Results: Among 611 sarcoma patients, 20 (3.3%) developed brain metastasis. Alveolar soft part sarcoma (ASPS) and osteosarcoma were the most common subtypes. Overall, the cumulative incidence was 3.9% at 5 years and 8.4% at 10 years. However, the incidence in STS patients continued to rise up to 10 years after primary diagnosis, whereas it reached a plateau in bone sarcoma patients at 3 years. Median PBMS was 1.67 months. Univariate factors associated with better PBMS included ASPS histology, initial surgical treatment, and brain irradiation for non-surgically treated patients.
Conclusion: Our study revealed a discrepancy in the timing of occurrence of brain metastasis between STS and bone sarcoma. However, patients with brain metastasis had a poor prognosis, implicating the brain as the last fortress of sarcoma. J. Surg. Oncol. 2011;104:765-770.

• 出版日期2011-12