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Tumor size, invasion beyond subcutaneous fat predict adverse outcomes in undifferentiated pleomorphic sarcoma

Winchester D et al. J Am Acad Dermatol. Available online 19 May 2018 https://doi.org/10.1016/j.jaad.2018.05.022

Key clinical point: The behavior of undifferentiated pleomorphic sarcomas is most reliably predicted by the presence of invasion beyond subcutaneous fat, preoperative tumor size larger than 2 cm, immunosuppression, and the presence of lymphovascular invasion. These tumors should be subcategorized as superficial versus deep, consistent with the American Joint Committee on Cancer staging of soft-tissue sarcomas.

Major finding: Among the 319 patients, 45 had recurrences, 33 had metastases, and 96 died of any cause. Risk factors for recurrence were tumor size larger than 5 cm and invasion beyond the subcutaneous fat. Risk factors for distant metastases were tumor site, tumor size larger than 2 cm, invasion beyond subcutaneous fat, and lymphovascular invasion. Risk factors for overall mortality were age, immunosuppression, tumor size larger than 2 cm, and lymphovascular invasion. A history of skin cancer was associated with a lower risk of recurrence and metastasis.

Study details: A retrospective evaluation of 319 available cases of undifferentiated pleomorphic sarcoma, including atypical fibroxanthoma, malignant fibrous histiocytoma, pleomorphic dermal sarcoma, and subfascial undifferentiated pleomorphic sarcoma across 3 tertiary care centers.

Disclosures:

Source: Winchester D et al. J Am Acad Dermatol. Available online 19 May 2018 https://doi.org/10.1016/j.jaad.2018.05.022

Citation:

Winchester D et al. J Am Acad Dermatol. Available online 19 May 2018 https://doi.org/10.1016/j.jaad.2018.05.022

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