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Undifferentiated Pleomorphic Sarcoma: Long-Term Follow-Up from a Large Institution

Authors Chen S, Huang W, Luo P, Cai W, Yang L, Sun Z, Zheng B, Yan W, Wang C

Received 12 August 2019

Accepted for publication 12 November 2019

Published 27 November 2019 Volume 2019:11 Pages 10001—10009


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Seema Singh

Shiqi Chen,1,2 Wending Huang,1,2 Peng Luo,1,2 Weiluo Cai,1,2 Lingge Yang,1,2 Zhengwang Sun,1,2 Biqiang Zheng,1,2 Wangjun Yan,1,2 Chunmeng Wang1,2

1Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, People’s Republic of China; 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, People’s Republic of China

Correspondence: Chunmeng Wang; Wangjun Yan
Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, 270 Dong’an Road, Xuhui District, Shanghai 200032, People’s Republic of China

Purpose: Our study aimed to describe the clinical features of undifferentiated pleomorphic sarcoma (UPS) and identify the predictors of poor outcomes.
Patients and methods: The clinicopathological variables and treatment strategies of 100 UPS patients who underwent surgical resections at a single institution between November 2004 and July 2016 were reviewed. Kaplan–Meier and Cox regression method were conducted for survival analysis.
Results: The median follow-up time was 94 months (range, 1.5–154 months). R0 resection was applied for 72 cases, and the median tumor size was 5.75cm (range, 1–30cm). Tumor grades of 45 patients were intermediate grade (G2), and 54 patients were with advanced stage (stage III/IV). Twenty-seven patients presented with tumors involving important structures, in which the nerve was the most frequently invaded structure (n=12). During the follow-up, 40 patients suffered from postoperative local recurrence, and distant metastasis was observed in 25 patients which mainly metastasized to the lung (n=14). The 5-year OS rate, 5-year LRFS rate, and 5-year MFS rate was 53%, 55%, and 70%, respectively. Multivariate analysis revealed that tumor presentation, tumor size, and important structures involved (p=0.033, p=0.004, and p=0.033, respectively) were independent prognostic factors associated with OS. Meanwhile, age, resection quality and tumor grade were independent prognostic factors for LRFS (p=0.033, p=0.045, and p=0.007, respectively) and tumor depth was significantly associated with MFS (p=0.050) in multivariate analysis.
Conclusion: Primary treatment of UPS should be conducted by experts in large sarcoma center. Wide surgical margin provides sufficient control of the disease recurrence.

Keywords: undifferentiated pleomorphic sarcoma, Asian, long-term follow-up, prognostic factor

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