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  • 1
    In: Journal of Surgical Oncology, Wiley, Vol. 124, No. 5 ( 2021-10), p. 829-837
    Abstract: Prognostic nomograms for patients undergoing resection of retroperitoneal sarcoma (RPS) include the Sarculator and Memorial Sloan Kettering (MSK) sarcoma nomograms. We sought to validate the Sarculator and MSK nomograms within a large, modern multi‐institutional cohort of patients with primary RPS undergoing resection. Methods Patients who underwent resection of primary RPS between 2000 and 2017 across nine high‐volume US institutions were identified. Predicted 7‐year disease‐free (DFS) and overall survival (OS) and 4‐, 8‐, and 12‐year disease‐specific survival (DSS) were calculated from the Sarculator and MSK nomograms, respectively. Nomogram‐predicted survival probabilities were stratified in quintiles and compared in calibration plots to observed survival outcomes assessed by Kaplan–Meier estimates. Discriminative ability of nomograms was quantified by Harrell's concordance index (C‐index). Results Five hundred and two patients underwent resection of primary RPS. Histologies included leiomyosarcoma (30%), dedifferentiated liposarcoma (23%), and well‐differentiated liposarcoma (15%). Median tumor size was 14.0 cm (interquartile range [IQR], 8.5–21.0 cm). Tumor grade distribution was: Grade 1 (27%), Grade 2 (17%), and Grade 3 (56%). Median DFS was 31.5 months; 7‐year DFS was 29%. Median OS was 93.8 months; 7‐year OS was 51%. C‐indices for 7‐year DFS, and OS by the Sarculator nomogram were 0.65 (95% confidence interval [CI] : 0.62–0.69) and 0.69 (95%CI: 0.65–0.73); plots demonstrated good calibration for predicting 7‐year outcomes. The C‐index for 4‐, 8‐, and 12‐year DSS by the MSK nomogram was 0.71 (95%CI: 0.67–0.75); plots demonstrated similarly good calibration ability. Conclusions In a diverse, modern validation cohort of patients with resected primary RPS, both Sarculator and MSK nomograms demonstrated good prognostic ability, supporting their ongoing adoption into clinical practice.
    Type of Medium: Online Resource
    ISSN: 0022-4790 , 1096-9098
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 1475314-5
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  • 2
    In: Cancer Medicine, Wiley, Vol. 12, No. 6 ( 2023-03), p. 7029-7038
    Abstract: Patients with unresectable dedifferentiated liposarcoma (DDLPS) have poor overall outcomes. Few genomic alterations have been identified with limited therapeutic options. Experimental Design Patients treated at Levine Cancer Institute with DDLPS were identified. Next generation sequencing (NGS), immunohistochemistry (IHC), and fluorescence in situ hybridization (FISH) testing were performed on tumor tissue collected at diagnosis or recurrence/progression. Confirmation of genomic alterations was performed by orthologous methods and correlated with clinical outcomes. Univariate Cox regression was used to identify genomic alterations associated with clinical outcomes. Results Thirty‐eight DDLPS patients with adequate tissue for genomic profiling and clinical data were identified. Patient characteristics included: median age at diagnosis (66 years), race (84.2% Caucasian), and median follow‐up time for the entire cohort was 12.1 years with a range from approximately 3.5 months to 14.1 years. Genes involved in cell cycle regulation, including MDM2 (74%) CDK4 (65%), and CDKN2A (23%), were amplified along with WNT/Notch pathway markers: HMGA2, LGR5, MCL1, and CALR (19%–29%). While common gene mutations were identified, PDE4DIP and FOXO3 were also mutated in 47% and 34% of patients, respectively, neither of which have been previously reported. FOXO3 was associated with improved overall survival (OS) (HR 0.37; p  = 0.043) along with MAML2 (HR 0.30; p  = 0.040). Mutations that portended worse prognosis included RECQL4 (disease‐specific survival HR 4.67; p  = 0.007), MN1 (OS HR = 3.38; p  = 0.013), NOTCH1 (OS HR 2.28, p  = 0.086), and CNTRL (OS HR 2.42; p  = 0.090). Conclusions This is one of the largest retrospective reports analyzing genomic aberrations in relation to clinical outcomes for patients with DDLPS. Our results suggest therapies targeting abnormalities should be explored and confirmation of prognostic markers is needed. Dedifferentiated liposarcoma is one of the most common subtypes of soft tissue sarcoma yet little is known of its molecular aberrations and possible impact on outcomes. The work presented here is an evaluation of genetic abnormalities among a population of patients with dedifferentiated liposarcoma and how they corresponded with survival and risk of metastases. There were notable gene mutations and amplifications commonly found, some of which had interesting prognostic implications.
    Type of Medium: Online Resource
    ISSN: 2045-7634 , 2045-7634
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2659751-2
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