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Epithelioid Sarcoma: Prognostic Factors and Survival in a Series of Patients Treated at a Single Institution

  • Bone and Soft Tissue Sarcomas
  • Original Paper
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Epithelioid sarcoma (ES) is a rare subtype of soft-tissue sarcoma of unknown histogenesis. Typically, it occurs superficially as single/multiple nodules (nodular ES), or in deeper tissues as a mass. The correlation between initial presentation and clinical outcome was investigated.

Methods

Fifty-four consecutive patients surgically treated at a single referral center were retrospectively reviewed. Thirty-six patients presented with a primary and 18 with a recurrent tumor. Potential prognostic clinicopathological variables, including macroscopic features at first presentation, were tested by univariable and multivariable analysis with respect to overall (OS), metastasis-free (MFS), and local recurrence-free survival (LRFS).

Results

The 10-year OS was 61.8% for the whole series. Thirty patients relapsed; in detail, local and distant failure occurred in 14 (25.9%) and 24 (44.4%) patients, respectively. The lymph node involvement rate was 16/54 (29.6%). In both the whole series and the subset of patient with primary ES, single localized tumor correlated with increased OS at multivariable analysis; occurrence of nodal involvement during postoperative follow-up correlated to worse OS and MFS. Nodular ES was an independent predictor of worse LRFS. In univariable analysis, nodular ES was associated with smaller tumor size, distal limb locations, earlier classification of malignant tumor (TNM) stage, and higher amputation rate. A statistical difference in the pattern of failure between nodular and mass ES was found.

Conclusions

Primary tumor macroscopic features seem to correlate to different local aggressiveness and failure patterns. Better prognosis is associated with single localized disease stage and no occurrence of locoregional spread.

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Acknowledgments

The authors are indebted to Cristiana Carniti, PhD, for assistance in preparing the manuscript. The authors declare no conflict of interest in the subject discussed in the manuscript. All the patients involved in the present study signed a written informed consent.

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Authors and Affiliations

  1. Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy

    Dario Baratti MD, Elisabetta Pennacchioli MD, Stefano Radaelli MD, Marco Fiore MD & Alessandro Gronchi MD

  2. Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy

    Paolo G. Casali MD & Rossella Bertulli MD

  3. Department of Radiotherapy, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy

    Laura Lozza MD & Patrizia Olmi MD

  4. Department of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy

    Paola Collini MD

Authors
  1. Dario Baratti MD
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  2. Elisabetta Pennacchioli MD
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  3. Paolo G. Casali MD
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  4. Rossella Bertulli MD
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  5. Laura Lozza MD
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  6. Patrizia Olmi MD
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  7. Paola Collini MD
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  8. Stefano Radaelli MD
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  9. Marco Fiore MD
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  10. Alessandro Gronchi MD
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Corresponding author

Correspondence to Alessandro Gronchi MD.

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Baratti, D., Pennacchioli, E., Casali, P.G. et al. Epithelioid Sarcoma: Prognostic Factors and Survival in a Series of Patients Treated at a Single Institution. Ann Surg Oncol 14, 3542–3551 (2007). https://doi.org/10.1245/s10434-007-9628-9

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  • DOI: https://doi.org/10.1245/s10434-007-9628-9

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