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Br J Cancer. 2012 Jan 17;106(2):297-306. doi: 10.1038/bjc.2011.559. Epub 2011 Dec 15.

Why do patients with radiation-induced sarcomas have a poor sarcoma-related survival?

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  • 1Department of Pathology, Postboks 4953, NO-0424 Oslo, Norway. bodil.bjerkehagen@oslo-universitetssykehus.no

Abstract

BACKGROUND:

This study aims to provide reasons for the poor sarcoma-related survival in patients with radiation-induced sarcoma (RIS).

METHODS:

We performed a case-control study comparing sarcoma-related survival of 98 patients with RIS to that of 239 sporadic high-grade malignant sarcomas.

RESULTS:

The cumulative sarcoma-related 5-year survival was 32% (95% confidence interval (CI): 22-42) for patients with RIS vs 51% (95% CI: 44-58) for controls (P<0.001). Female gender, central tumour site and incomplete surgical remission were significantly more frequent among RIS patients than in controls. In multivariate analysis incomplete surgical remission (hazard ratio (HR) 4.48, 95% CI: 3.08-6.52), metastases at presentation (HR 2.93, 95% CI: 1.95-4.41), microscopic tumour necrosis (HR 1.88, 95% CI: 1.27-2.78) and central tumour site (HR 1.71, 95% CI: 1.18-2.47) remained significant adverse prognostic factors, but not sarcoma category (RIS vs sporadic).

CONCLUSION:

The poor prognosis of RIS patients are not due to the previous radiotherapy per se, but related to the unfavourable factors - central tumour site, incomplete surgical remission, microscopic tumour necrosis and the presence of metastases, the two former factors overrepresented in RIS.

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