1499P - Undifferentiated pleomorphic sarcoma (UPS): an analysis of 135 patients (pts) with this clinically unique subtype of high-grade soft tissue sarcoma...

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Soft Tissue Sarcomas
Presenter Mohamad Farid Harunal Rashid
Authors M.F. Harunal Rashid1, S. Pan2, T. Mann Hong3, L. Foo Siang Sheng3, K. Sittampalam4, A. Sairi5, K. Adam5, F. Chin6, M. Teo7, R. Quek5
  • 1Dept. Medical Oncology, National Cancer Centre Singapore, 169610 - Singapore/SG
  • 2Division Of Clinical Trials And Biostatisics, National Cancer Centre Singapore, 169610 - Singapore/SG
  • 3Orthopaedic Surgery, Singapore General Hospital, 169610 - Singapore/SG
  • 4Pathology, Singapore General Hospital, 169610 - Singapore/SG
  • 5Medical Oncology, National Cancer Centre Singapore, 169610 - Singapore/SG
  • 6Radiation Oncology, National Cancer Centre Singapore, 169610 - Singapore/SG
  • 7Surgical Oncology, National Cancer Centre Singapore, 169610 - Singapore/SG

Abstract

Background

UPS represents one of the largest subsets of HG-STS but is often reported together with other STS histologic types limiting the value of such data in clinical practice. We sought to define clinical characteristics, prognostic factors and treatment outcomes in UPS.

Methods

Single institution retrospective study of 135 consecutive UPS pts with complete medical records representing 18% of all STS cases seen at our center from 2002-2011.

Results

Median age was 57 years; 73% presented with localized disease. Distribution according to primary site: 44% vs 44% vs 11% originating from extremities, axial, head and neck regions respectively. In pts with localized disease, 91% underwent curative surgery with 64% of evaluable pts achieving microscopically negative surgical margins; no correlation between margin status and primary site was noted. Notably 59% received adjuvant therapy, of whom 81% received radiotherapy (RT), 6% chemotherapy, 13% both. At a median follow-up of 20.7 months (mths), median overall survival (OS) for the entire cohort was 28.6 mths, 57.9 mths vs 5.2 mths in pts presenting with localized vs metastatic disease, respectively (p <0.0001). In localized disease, median relapse-free survival (RFS) was 21.6 mths. In univariate analysis, use of adjuvant RT significantly improved RFS (p = 0.0038) and OS (borderline significance, p = 0.051); margin status did not influence RFS. In 63 pts who developed metastases either at diagnosis or relapse, 41% received palliative chemotherapy of whom 65% received an anthracycline and/or ifosfamide in first line, with an objective response rate of 24% in evaluable pts; median OS was 6.3 mths. In univariate analysis, palliative chemotherapy significantly improved OS (p = 0.0002) while metastasectomy was of borderline significance (p = 0.058).

Conclusions

This study reinforces the value of adjuvant RT in UPS. The survival benefit of palliative chemotherapy in advanced UPS is noteworthy. However survival in metastatic UPS appears inferior to advanced HG-STS as a whole (typically 12 mths) calling for further improvements in molecular characterization and therapy in this narrowly defined subset of STS.

Disclosure

All authors have declared no conflicts of interest.