Title
Brain Metastases in Patients With Soft-Tissue Sarcomas: Management and Survival-A SEER Population-Based Cohort Study
Date Issued
07 October 2021
Access level
open access
Resource Type
journal article
Author(s)
Universidad Peruana Cayetano Heredia
Publisher(s)
Wolters Kluwer Health
Abstract
INTRODUCTION: Brain metastases (BM) in soft-tissue sarcomas (STS) is associated with poor prognosis. This large population analysis presents (1) demographic and clinical variables of these patients, (2) potential risk factors, (3) impact of BM on overall survival, and (4) treatment strategies. METHODS: Patients with STS and BM were identified from the Surveillance, Epidemiology, and End Results database. Demographic and clinical variables, as well as treatment modalities, were analyzed. Overall 5-year survival was calculated using the Kaplan-Meier method, and the survival difference was assessed using the log-rank test. A multivariate analysis was performed using the Cox proportional hazard regression to determine the risk factors. RESULTS: Twenty-two patients (22/8,433) with STS presented BM at diagnosis. A multivariate analysis showed that women and American Indians/Alaska Natives had a greater risk of presenting BM. The most common histological subtype to metastasize to the brain was alveolar soft part sarcoma (4/22). In 54.5% of patients with BM, the tumor had also metastasized to the lung, although having synchronous bone, liver, and lung metastases showed the greatest increase in risk for presenting BM (odd ratio [OR] = 1,857.7, confidence interval [CI] 95%, 88.4 to 3,9046.6, P < 0.0001). Individually, bone metastasis increased the risk of presenting BM the most (OR = 205.0, CI 95%, 30.5 to 1,379.6, P < 0.0001). The mean survival of patients with BM was 10.22 months. The standard treatment approach included surgery, radiation therapy, and chemotherapy. CONCLUSION: BM in patients with STS represents an infrequent but lethal event. Women and American Indians/Alaska Natives are at a higher risk of presenting BM, as well as patients with synchronous metastases. Patients are mainly managed with systemic therapy.
Volume
5
Issue
10
Language
English
OCDE Knowledge area
Epidemiología
Ortopedía
Scopus EID
2-s2.0-85117980007
PubMed ID
Source
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
ISSN of the container
24747661
Sources of information:
Directorio de Producción Científica
Scopus