Journal
JOURNAL OF SURGICAL ONCOLOGY
Volume 104, Issue 7, Pages 765-770Publisher
WILEY
DOI: 10.1002/jso.22011
Keywords
alveolar soft part sarcoma; brain metastasis; osteosarcoma; soft tissue sarcoma
Funding
- Department of Health, Taiwan (Center of Excellence for Cancer Research at Taipei Veterans General Hospital) [DOH99-TD-C-111-007, DOH100-TD-C-111-007]
- Taiwan Clinical Oncology Research Foundation
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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. (C) 2011 Wiley Periodicals, Inc.
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