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.
Source: Winchester D et al. J Am Acad Dermatol. Available online 19 May 2018 https://doi.org/10.1016/j.jaad.2018.05.022
Winchester D et al. J Am Acad Dermatol. Available online 19 May 2018 https://doi.org/10.1016/j.jaad.2018.05.022
This Week's Must Reads
PFS superior with avelumab and axitinib in advanced RCC, Motzer RJ et al. ESMO 2018. Abstract LBA6_PR
Adjuvant axitinib may benefit highest risk RCC patients, Quinn DI et al. Ann Oncol. 2018 Oct 20. doi: 10.1093/annonc/mdy454
High KPNA2 signals poor outcomes for RCC, Kristiansen G et al. Clin Genitourin Cancer. 2018 Oct 22. doi: 10.1016/j.clgc.2018.10.008
RCC patient and disease characteristics differ by race/ethnicity, Batai K et al. Clin Genitourin Cancer. 2018 Oct 26. doi: 10.1016/j.clgc.2018.10.012
Change in tumor burden signals treatment needs in mRCC, Bimbatti D et al. Urol Oncol. 2018 Oct 6. doi: 10.1016/j.urolonc.2018.08.018
Must Reads in Sarcoma & GIST
Nivolumab, pembrolizumab successfully used in Kaposi sarcoma, Galanina et al. Cancer Immunol Res. 2018 Sept 7. doi: 10.1158/2326-6066.CIR-18-0121.
Perioperative radiation therapy underused in elderly patients with soft tissue sarcomas, Venigalla S et al. Intl J Rad Oncology*Biology*Physics; September (102) 2018: 155-165. https://doi.org/10.1016/j.ijrobp.2018.05.019
Age, R0 resection, and adjuvant radiotherapy boost outcomes in myxofibrosarcoma, Boughzala-Bennadji R et al. Intl J Rad Oncology*Biology*Physics; October (102) 2018: 399-406. https://doi.org/10.1016/j.ijrobp.2018.05.055
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
High recurrence rate after pancreaticoduodenectomy for primary retroperitoneal sarcoma, Tseng W et al. European Journal of Surgical Oncology 2018 (44): June; 810-815.