Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions

Sean P. Dineen, Christina L. Roland, Rachel Feig, Caitlin May, Shouhao Zhou, Elizabeth Demicco, Ghadah Al Sannaa, Davis Ingram, Wei Lein Wang, Vinod Ravi, Ashleigh Guadagnolo, Dina Lev, Raphael E. Pollock, Kelly Hunt, Janice Cormier, Alex Lazar, Barry Feig, Keila E. Torres

Research output: Contribution to journalArticle

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Abstract

Background: Radiation therapy is used increasingly as a component of multidisciplinary treatment for many solid tumors. One complication of such treatment is the development of radiation-associated sarcoma (RAS). Undifferentiated pleomorphic sarcoma (UPS), previously termed “malignant fibrous histiocytoma” (MFH) is the most common histologic subtype of RAS. This study investigated the clinical outcomes for patients with radiation-associated UPS (RA-UPS/MFH). Methods: The study identified 1068 patients with UPS/MFH treated at the authors’ institution. Patient and tumor factors were collected and compared. Regression analysis was performed to identify independent predictors of survival. A matched-cohort survival and recurrence analysis was performed for radiation-associated and sporadic UPS/MFH. Results: The findings showed that RA-UPS/MFH comprised 5.1 % of the UPS population. The median latency to the development of RA-UPS/MFH was 9.3 years. The 5-year disease-specific survival (DSS) was 52.2 % for patients identified with RA-UPS/MFH (n = 55) compared with 76.4 % for patients with unmatched sporadic UPS/MFH (n = 1,013; p < 0.001). A matched-cohort analysis also demonstrated that the 5-year DSS was significantly worse for RA-UPS/MFH (52.2 vs 73.4 %; p = 0.002). Furthermore, higher local recurrence rates were observed for patients with RA-UPS/MFH than for patients with sporadic lesions (54.5 vs 23.5 %; p < 0.001). Radiation-associated status and incomplete resection were identified as independent predictors of local recurrence. Conclusion: This study demonstrated worse clinical outcomes for patients with RA-UPS/MFH than for patients with sporadic UPS/MFH. Local recurrence was significantly higher for patients with RA-UPS/MFH, suggesting a unique tumor biology for this challenging disease.

Original languageEnglish (US)
Pages (from-to)3913-3920
Number of pages8
JournalAnnals of Surgical Oncology
Volume22
Issue number12
DOIs
StatePublished - Nov 1 2015

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Malignant Fibrous Histiocytoma
Sarcoma
Radiation
Recurrence
Survival
Background Radiation
Neoplasms
Survival Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Dineen, Sean P. ; Roland, Christina L. ; Feig, Rachel ; May, Caitlin ; Zhou, Shouhao ; Demicco, Elizabeth ; Sannaa, Ghadah Al ; Ingram, Davis ; Wang, Wei Lein ; Ravi, Vinod ; Guadagnolo, Ashleigh ; Lev, Dina ; Pollock, Raphael E. ; Hunt, Kelly ; Cormier, Janice ; Lazar, Alex ; Feig, Barry ; Torres, Keila E. / Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions. In: Annals of Surgical Oncology. 2015 ; Vol. 22, No. 12. pp. 3913-3920.
@article{86373dc51be741aaa6fd367f19e2d88f,
title = "Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions",
abstract = "Background: Radiation therapy is used increasingly as a component of multidisciplinary treatment for many solid tumors. One complication of such treatment is the development of radiation-associated sarcoma (RAS). Undifferentiated pleomorphic sarcoma (UPS), previously termed “malignant fibrous histiocytoma” (MFH) is the most common histologic subtype of RAS. This study investigated the clinical outcomes for patients with radiation-associated UPS (RA-UPS/MFH). Methods: The study identified 1068 patients with UPS/MFH treated at the authors’ institution. Patient and tumor factors were collected and compared. Regression analysis was performed to identify independent predictors of survival. A matched-cohort survival and recurrence analysis was performed for radiation-associated and sporadic UPS/MFH. Results: The findings showed that RA-UPS/MFH comprised 5.1 {\%} of the UPS population. The median latency to the development of RA-UPS/MFH was 9.3 years. The 5-year disease-specific survival (DSS) was 52.2 {\%} for patients identified with RA-UPS/MFH (n = 55) compared with 76.4 {\%} for patients with unmatched sporadic UPS/MFH (n = 1,013; p < 0.001). A matched-cohort analysis also demonstrated that the 5-year DSS was significantly worse for RA-UPS/MFH (52.2 vs 73.4 {\%}; p = 0.002). Furthermore, higher local recurrence rates were observed for patients with RA-UPS/MFH than for patients with sporadic lesions (54.5 vs 23.5 {\%}; p < 0.001). Radiation-associated status and incomplete resection were identified as independent predictors of local recurrence. Conclusion: This study demonstrated worse clinical outcomes for patients with RA-UPS/MFH than for patients with sporadic UPS/MFH. Local recurrence was significantly higher for patients with RA-UPS/MFH, suggesting a unique tumor biology for this challenging disease.",
author = "Dineen, {Sean P.} and Roland, {Christina L.} and Rachel Feig and Caitlin May and Shouhao Zhou and Elizabeth Demicco and Sannaa, {Ghadah Al} and Davis Ingram and Wang, {Wei Lein} and Vinod Ravi and Ashleigh Guadagnolo and Dina Lev and Pollock, {Raphael E.} and Kelly Hunt and Janice Cormier and Alex Lazar and Barry Feig and Torres, {Keila E.}",
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month = "11",
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doi = "10.1245/s10434-015-4453-z",
language = "English (US)",
volume = "22",
pages = "3913--3920",
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Dineen, SP, Roland, CL, Feig, R, May, C, Zhou, S, Demicco, E, Sannaa, GA, Ingram, D, Wang, WL, Ravi, V, Guadagnolo, A, Lev, D, Pollock, RE, Hunt, K, Cormier, J, Lazar, A, Feig, B & Torres, KE 2015, 'Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions', Annals of Surgical Oncology, vol. 22, no. 12, pp. 3913-3920. https://doi.org/10.1245/s10434-015-4453-z

Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions. / Dineen, Sean P.; Roland, Christina L.; Feig, Rachel; May, Caitlin; Zhou, Shouhao; Demicco, Elizabeth; Sannaa, Ghadah Al; Ingram, Davis; Wang, Wei Lein; Ravi, Vinod; Guadagnolo, Ashleigh; Lev, Dina; Pollock, Raphael E.; Hunt, Kelly; Cormier, Janice; Lazar, Alex; Feig, Barry; Torres, Keila E.

In: Annals of Surgical Oncology, Vol. 22, No. 12, 01.11.2015, p. 3913-3920.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions

AU - Dineen, Sean P.

AU - Roland, Christina L.

AU - Feig, Rachel

AU - May, Caitlin

AU - Zhou, Shouhao

AU - Demicco, Elizabeth

AU - Sannaa, Ghadah Al

AU - Ingram, Davis

AU - Wang, Wei Lein

AU - Ravi, Vinod

AU - Guadagnolo, Ashleigh

AU - Lev, Dina

AU - Pollock, Raphael E.

AU - Hunt, Kelly

AU - Cormier, Janice

AU - Lazar, Alex

AU - Feig, Barry

AU - Torres, Keila E.

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background: Radiation therapy is used increasingly as a component of multidisciplinary treatment for many solid tumors. One complication of such treatment is the development of radiation-associated sarcoma (RAS). Undifferentiated pleomorphic sarcoma (UPS), previously termed “malignant fibrous histiocytoma” (MFH) is the most common histologic subtype of RAS. This study investigated the clinical outcomes for patients with radiation-associated UPS (RA-UPS/MFH). Methods: The study identified 1068 patients with UPS/MFH treated at the authors’ institution. Patient and tumor factors were collected and compared. Regression analysis was performed to identify independent predictors of survival. A matched-cohort survival and recurrence analysis was performed for radiation-associated and sporadic UPS/MFH. Results: The findings showed that RA-UPS/MFH comprised 5.1 % of the UPS population. The median latency to the development of RA-UPS/MFH was 9.3 years. The 5-year disease-specific survival (DSS) was 52.2 % for patients identified with RA-UPS/MFH (n = 55) compared with 76.4 % for patients with unmatched sporadic UPS/MFH (n = 1,013; p < 0.001). A matched-cohort analysis also demonstrated that the 5-year DSS was significantly worse for RA-UPS/MFH (52.2 vs 73.4 %; p = 0.002). Furthermore, higher local recurrence rates were observed for patients with RA-UPS/MFH than for patients with sporadic lesions (54.5 vs 23.5 %; p < 0.001). Radiation-associated status and incomplete resection were identified as independent predictors of local recurrence. Conclusion: This study demonstrated worse clinical outcomes for patients with RA-UPS/MFH than for patients with sporadic UPS/MFH. Local recurrence was significantly higher for patients with RA-UPS/MFH, suggesting a unique tumor biology for this challenging disease.

AB - Background: Radiation therapy is used increasingly as a component of multidisciplinary treatment for many solid tumors. One complication of such treatment is the development of radiation-associated sarcoma (RAS). Undifferentiated pleomorphic sarcoma (UPS), previously termed “malignant fibrous histiocytoma” (MFH) is the most common histologic subtype of RAS. This study investigated the clinical outcomes for patients with radiation-associated UPS (RA-UPS/MFH). Methods: The study identified 1068 patients with UPS/MFH treated at the authors’ institution. Patient and tumor factors were collected and compared. Regression analysis was performed to identify independent predictors of survival. A matched-cohort survival and recurrence analysis was performed for radiation-associated and sporadic UPS/MFH. Results: The findings showed that RA-UPS/MFH comprised 5.1 % of the UPS population. The median latency to the development of RA-UPS/MFH was 9.3 years. The 5-year disease-specific survival (DSS) was 52.2 % for patients identified with RA-UPS/MFH (n = 55) compared with 76.4 % for patients with unmatched sporadic UPS/MFH (n = 1,013; p < 0.001). A matched-cohort analysis also demonstrated that the 5-year DSS was significantly worse for RA-UPS/MFH (52.2 vs 73.4 %; p = 0.002). Furthermore, higher local recurrence rates were observed for patients with RA-UPS/MFH than for patients with sporadic lesions (54.5 vs 23.5 %; p < 0.001). Radiation-associated status and incomplete resection were identified as independent predictors of local recurrence. Conclusion: This study demonstrated worse clinical outcomes for patients with RA-UPS/MFH than for patients with sporadic UPS/MFH. Local recurrence was significantly higher for patients with RA-UPS/MFH, suggesting a unique tumor biology for this challenging disease.

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U2 - 10.1245/s10434-015-4453-z

DO - 10.1245/s10434-015-4453-z

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JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

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