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Postoperative brain metastases in soft tissue sarcomas

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Abstract

Brain metastases (BMs) from soft tissue sarcoma (STS) are rare but lethal. We reviewed 187 consecutive patients with STS treated with definitive surgery in Nagoya University Hospital from 2004 to 2014. There were 10 patients with neurofibromatosis-1 (NF-1). We investigated estimated brain metastasis free survival (BMFS) after surgery and overall survival (OS) after BMs in STS. The factors that affected BMFS were also investigated. Eight of 187 patients (4.3 %) developed BM with a median period of 18.2 (range 8.8–42.6) months after surgery. Seven of 8 BM patients had metastases at other sites. Estimated 5 year BMFS rate after surgery was 95.2 %, and 3 month OS rate after BM was 25.0 %. NF-1 (p < 0.0001), histological subtype of MPNST (p = 0.008), and primary tumor size ≥5 cm (p = 0.021) were significantly associated with increasing incidence of BM. In this study, postoperative BMs were common in patients with NF-1, MPNST, and large tumors. Considering the impact of NF-1 on BMFS, careful follow up for BM is necessary for NF-1 patients with metastases at other sites.

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Abbreviations

BM:

Brain metastases

STS:

Soft tissue sarcoma

NF-1:

Neurofibromatosis-1

BMFS:

Brain metastasis free survival

OS:

Overall survival

MRI:

Magnetic resonance image

CT:

Computed tomography

MFH:

Malignant fibrous histiocytoma

MPNST:

Malignant peripheral nerve sheath tumor

ASPS:

Alveolar soft part sarcoma

PNET:

Primitive neuroectodermal tumor

DFS:

Disease free survival

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Acknowledgment

We thank Miss Eri Ishihara for secretarial assistance.

Conflict of interest

All the authors declare that they have no financial and personal relationships with any other persons or organizations that could potentially and inappropriately influence their work and conclusion.

Funding

One or more of the authors (H.U.) has received research funding from the Ministry of Education, Culture, Sports, Science and Technology of Japan [Grant-in-Aid 24791533 for Scientific Research (C)].

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan

    Hiroshi Urakawa, Satoshi Tsukushi, Eiji Kozawa, Kunihiro Ikuta, Shunsuke Hamada, Naoki Ishiguro & Yoshihiro Nishida

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  1. Hiroshi Urakawa
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  2. Satoshi Tsukushi
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  3. Eiji Kozawa
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  4. Kunihiro Ikuta
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  5. Shunsuke Hamada
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  6. Naoki Ishiguro
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  7. Yoshihiro Nishida
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Correspondence to Hiroshi Urakawa.

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Urakawa, H., Tsukushi, S., Kozawa, E. et al. Postoperative brain metastases in soft tissue sarcomas. Clin Exp Metastasis 32, 345–351 (2015). https://doi.org/10.1007/s10585-015-9713-6

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  • DOI: https://doi.org/10.1007/s10585-015-9713-6

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