Prognostic Factors for Survival in Patients with Epithelioid Sarcoma: 441 Cases from the SEER Database.
Jawad MU, Extein J, Min ES, Scully SP.
Department of Orthopaedics, University of Miami Miller School of Medicine, University of Miami Hospital, 4th Floor, 1400 NW, 12th Avenue, Miami, FL, 33136, USA.
Current stratification of prognosis in patients with epithelioid sarcoma (ES) is based largely on data reported by individual centers with a limited number of patients. We sought to identify the important prognostic parameters using the Surveillance, Epidemiology, and End Results (SEER) database. We identified 441 patients with ES in the database and extracted information regarding patient demographics and clinical characteristics. Kaplan-Meier, log-rank, and Cox regression were used for analysis. Disease-specific survival declined until 100 months after diagnosis after which survival was unrelated to epithelioid sarcoma. The overall incidence of ES during 2005 was 0.041 per 100,000 [something like 1 in more than two million; lucky us!]. The reported incidence has increased since 1973, with an annual percentage change of 5.217%. On multivariate analysis, only age younger than 16 years, local stage of disease, or negative nodes and surgical resection of the tumor predicted better disease-specific survival. We observed no increase in survival by comparing decades of diagnosis since 1986. [This implies to me that treatment isn't getting meaningfully better, which I find tough to accept. Hope I'm wrong.] The SEER database shows only age younger than 16 years, negative nodes, or local stage of disease and operability of primary disease independently predict survival in patients with ES. Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Jawad MU, Extein J, Min ES, Scully SP.
Department of Orthopaedics, University of Miami Miller School of Medicine, University of Miami Hospital, 4th Floor, 1400 NW, 12th Avenue, Miami, FL, 33136, USA.
Current stratification of prognosis in patients with epithelioid sarcoma (ES) is based largely on data reported by individual centers with a limited number of patients. We sought to identify the important prognostic parameters using the Surveillance, Epidemiology, and End Results (SEER) database. We identified 441 patients with ES in the database and extracted information regarding patient demographics and clinical characteristics. Kaplan-Meier, log-rank, and Cox regression were used for analysis. Disease-specific survival declined until 100 months after diagnosis after which survival was unrelated to epithelioid sarcoma. The overall incidence of ES during 2005 was 0.041 per 100,000 [something like 1 in more than two million; lucky us!]. The reported incidence has increased since 1973, with an annual percentage change of 5.217%. On multivariate analysis, only age younger than 16 years, local stage of disease, or negative nodes and surgical resection of the tumor predicted better disease-specific survival. We observed no increase in survival by comparing decades of diagnosis since 1986. [This implies to me that treatment isn't getting meaningfully better, which I find tough to accept. Hope I'm wrong.] The SEER database shows only age younger than 16 years, negative nodes, or local stage of disease and operability of primary disease independently predict survival in patients with ES. Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
1 comment:
Part of the problem is funding clinical trials for Sarcomas. Sarcoma USED to be the prototype cell for cancer therapy. That changed somewhere along the line with money being allocated for research based on population incidence. We are choking on breast cancer, prostate cancer and colon cancer research. Not that these aren't nasty diseases but our subtype is far behind in new treatments and therapies. There are some grassroots efforts. I support any and all that I can. I also refuse to read anything dealing with prognosis because it does nothing to help me. I can find 100 ways to die on the internet when it comes to cancer. I want research and compatriots that show me how to live with it, survive with it, and squash it.
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