Abstract 1518P
Background
Patients (pts) with high-grade STS>5cm are at high risk of disease recurrence and death. Adjuvant chemotherapy (CHT) aims to decrease the risk. This study investigated factors impacting the outcome of pts receiving multimodal treatment.
Methods
Among 864 pts treated in 2013-2020, who underwent treatment for extremity/trunk wall STS with radical intent, pts qualified for neoadjuvant chemotherapy with 3 cycles of doxorubicin and ifosfamide were selected (n = 133). We’ve collected detailed data on tumor and pts characteristics. All pts were additionally evaluated using a SARCULATOR nomogram. The results were analyzed using Cox’s proportional hazard model.
Results
Mean age was 52 years. The median follow-up was 30 months (95%CI: 27-34). The most common subtypes were pleomorphic sarcoma, liposarcoma, and myxofibrosarcoma. 81% of the pts had primary tumors; Mean tumor size was 12cm. All but two had high-grade tumors. The most common tumor localization was lower limbs (67%). The median OS (overall survival) was not reached. Among all factors, ECOG status and the ones included in the SARCULATOR were connected with OS in the univariate analysis. The SARCULATOR 10-year score was the best predictor for the OS, with HR 1.04 per percentage point change (95%CI: 1.01-1.06, p=0.004, c-index=0.66). In multivariate analysis, after adjusting for SARCULATOR score, ECOG performance status (0 vs. >0) was predictive for OS, HR = 2.53 (95%CI: 1.02-6.27, p = 0.04) with c-index=0.71. The DFS (disease free-survival) univariate analysis showed significance of SARCULATOR-related variables, initial albumin and hemoglobin concentration below lower limit normal, and ECOG score. The multivariate model for DFS is presented in the table. Table: 1518P
Multivariate model for DFS
| HR | lower .95 | upper .95 | p | |
| Albumin level at start < 35 | 2.163 | 1.119 | 4.181 | 0.022 |
| ECOG > 0 | 1.729 | 1.007 | 2.966 | 0.047 |
| Sarculator per 1% | 1.017 | 1.001 | 1.034 | 0.041 |
Conclusions
SARCULATOR nomogram provides a practical guide in planning adjuvant treatment in STS. Also, additional clinical data on pts general conditions should be taken into account.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.