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Surgical resection of primary tumor in the extremities improves survival for metastatic soft-tissue sarcoma patients: a population-based study of the SEER database

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Abstract

Purpose

The objectives of this study were to clarify whether resection of primary tumor in the extremities for patients with metastatic soft-tissue sarcoma (STS) improves survival, and to clarify patient groups for whom primary tumor resection should be considered.

Methods/patients

Using the surveillance, epidemiology, and end results database, we identified 1453 patients with metastatic STS of the extremities at initial presentation between 1983 and 2016. Of these 1453 patients, 898 patients underwent primary tumor resection (Surgery group), and 555 patients did not (No-surgery group).

Results

After adjusting for patient background by propensity score matching, a total of 804 patients were included for analysis. Patients in the Surgery group showed improved survival (cancer-specific survival (CSS) hazard ratio (HR) = 0.59, 95% confidence interval (CI) 0.50–0.71 overall survival rate (OS) HR = 0.60, 95% CI 0.51–0.70). In subclass analysis, patients with high-grade STS, undifferentiated pleomorphic sarcoma, leiomyosarcoma, or synovial sarcoma showed improved survival in the Surgery group (high grade—CSS HR = 0.57, 95% CI 0.45–0.72, OS HR = 0.58, 95% CI 0.48–0.71; undifferentiated pleomorphic sarcoma—CSS HR = 0.60, 95% CI 0.42–0.84, OS HR = 0.61, 95% CI 0.46–0.82; leiomyosarcoma—CSS HR = 0.50, 95% CI 0.33–0.75, OS HR = 0.50, 95% CI 0.35–0.72; synovial sarcoma—CSS HR = 0.46, 95% CI 0.31–0.68, OS HR = 0.43, 95% CI 0.30–0.62).

Conclusions

Our results indicated that primary tumor resection in metastatic STS exerts positive impacts on survival. Further clinical research is needed to confirm these results.

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Funding

We have received no specific funding from any funding bodies to carry out this work.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15 West 7, Kita-Ku, Hokkaido, Sapporo, 060-8638, Japan

    M. Matsuoka, T. Onodera, S. Matsubara, R. Hishimura & N. Iwasaki

  2. Department of Biostatistics, Graduate School of Medicine, Hokkaido University, North 15 West 7, Kita-Ku, Hokkaido, Sapporo, 060-8638, Japan

    I. Yokota

  3. Department of Functional Reconstruction for the Knee Joint, Hokkaido University, Kita-15, Nish-7, Kita-ku, Hokkaido, Sapporo, 060-8638, Japan

    K. Iwasaki

  4. Centre for Sports Medicine, Hokkaido University Hospital, North 15 West 7, Kita-Ku, Hokkaido, Sapporo, 060-8638, Japan

    E. Kondo

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  1. M. Matsuoka
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  2. T. Onodera
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Contributions

MM was involved in the design of the study performed the clinical assessment, analysis, and interpretation of data and drafted and revised the manuscript. TO and IY assisted with data interpretation and revised the manuscript for important intellectual content. KI, SM, RH, EK, and NI were involved in data acquisition and revised the manuscript critically for important intellectual content. All authors have read and approved the final manuscript.

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Correspondence to M. Matsuoka.

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Matsuoka, M., Onodera, T., Yokota, I. et al. Surgical resection of primary tumor in the extremities improves survival for metastatic soft-tissue sarcoma patients: a population-based study of the SEER database. Clin Transl Oncol 23, 2474–2481 (2021). https://doi.org/10.1007/s12094-021-02646-1

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  • DOI: https://doi.org/10.1007/s12094-021-02646-1

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