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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Smolle, MA; Sande, MV; Callegaro, D; Wunder, J; Hayes, A; Leitner, L; Bergovec, M; Tunn, PU; van Praag, V; Fiocco, M; Panotopoulos, J; Willegger, M; Windhager, R; Dijkstra, SPD; van Houdt, WJ; Riedl, JM; Stotz, M; Gerger, A; Pichler, M; Stöger, H; Liegl-Atzwanger, B; Smolle, J; Andreou, D; Leithner, A; Gronchi, A; Haas, RL; Szkandera, J.
Individualizing Follow-Up Strategies in High-Grade Soft Tissue Sarcoma with Flexible Parametric Competing Risk Regression Models.
Cancers (Basel). 2019; 12(1): Doi: 10.3390/cancers12010047 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz

Smolle Maria Anna

Szkandera Joanna

Co-Autor*innen der Med Uni Graz

Andreou Dimosthenis

Bergovec Marko

Gerger Armin

Leithner Andreas

Leitner Lukas

Liegl-Atzwanger Bernadette

Pichler Martin

Riedl Jakob

Smolle Josef

Stöger Herbert

Stotz Michael

Windhager Reinhard

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Abstract:

Currently, patients with extremity soft tissue sarcoma (eSTS) who have undergone curative resection are followed up by a heuristic approach, not covering individual patient risks. The aim of this study was to develop two flexible parametric competing risk regression models (FPCRRMs) for local recurrence (LR) and distant metastasis (DM), aiming at providing guidance on how to individually follow-up patients. Three thousand sixteen patients (1931 test, 1085 validation cohort) with high-grade eSTS were included in this retrospective, multicenter study. Histology (9 categories), grading (time-varying covariate), gender, age, tumor size, margins, (neo)adjuvant radiotherapy (RTX), and neoadjuvant chemotherapy (CTX) were used in the FPCRRMs and performance tested with Harrell-C-index. Median follow-up was 50 months (interquartile range: 23.3-95 months). Two hundred forty-two (12.5%) and 603 (31.2%) of test cohort patients developed LR and DM. Factors significantly associated with LR were gender, size, histology, neo- and adjuvant RTX, and margins. Parameters associated with DM were margins, grading, gender, size, histology, and neoadjuvant RTX. C-statistics was computed for internal (C-index for LR: 0.705, for DM: 0.723) and external cohort (C-index for LR: 0.683, for DM: 0.772). Depending on clinical, pathological, and patient-related parameters, LR- and DM-risks vary. With the present model, implemented in the updated Personalised Sarcoma Care (PERSARC)-app, more individualized prediction of LR/DM-risks is made possible.

Find related publications in this database (Keywords)

soft tissue sarcoma

follow-up

flexible parametric competing risk regression model

local recurrence

distant metastasis

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