Individual prognostic system for prediction of soft tissue sarcoma recurrence

Abstract

Aim. To investigate risk factors for the development of soft tissue sarcoma recurrence.
Materials and methods. We analyzed treatment results of 168 patients (86 men and 82 women, age – 22 to 85 years, average age was 41 years) with primary soft tissue sarcomas (STS) of extremities and trunk. All patients with STS underwent surgical treatment, mainly wide excisions and 17 amputations were performed. Local relapses developed 39 patients. Multifactor analysis was performed to evaluate combined influence of the selected risk factors on the occurrence of the relapse. A prognostic scoring scale has been developed to provides an integral assessment of the possibility of the relapse taking into account all analyzed factors.
Results. On the basis of own and published data, a number of risk factors were selected to calculate prognostic factors (PF), with a maximum PC amount of 56, a minimum of 26, and a scale of 82 points. On the basis of nomographs by Gubler E.V. (1973), the upper (14) and lower (–9) thresholds were selected, dividing the entire scale into 3 distribution zones of forecasts in accordance with the values of the PF. The analysis of 39 STS relapse cases showed that only in 2 (5%) patients the prognosis outcome with this scale was qualified as «unclear», in the remaining 37 cases relapses were confirmed. In 129 patients without tumor recurrence, the prognosis was assessed as «unclear» in 12 patients, in other cases the prognosis was correct.
Conclusion. The conducted study showed the effectiveness of the developed approach for the prediction of sarcoma recurrence. An algorithm of individualized approach of postoperative followup is proposed and its implementation in a daily practice allows early detection of early recurrence in STS patients.