Gootee J

Background: Myxoid liposarcomas (MLS) are intermediate to high grade liposarcomas, which are the most common type of soft tissue sarcoma. Although MLS most frequently develops in the legs, it can arise in any of the body’s soft tissue adipose. Previous studies of MLS survival have been limited in terms of geography, cohort size, variety of treatment settings, and assessment of primary site role. We retrospectively studied survival data for a nationwide cohort of MLS patients to identify prognostic factors and assess their effects on survival.

Methods: Using the National Cancer Database, we obtained data on 4636 patients diagnosed with MLS (ICD-O-3 8852) between 2004 and 2016. 5- and 10-year survival curves were estimated with Kaplan-Meier analysis and compared with log-rank analysis. Cox hazard regression was also used to compare multiple variables’ effects on survival.

Results: Approximately 59.2% of the cohort was male with a median age of presentation of 49 years. The most common site of metastasis was the bone followed by lung, liver, and brain. The majority (46.8%) of patients were stage I at time of diagnosis, followed by stage II with 18.1%, stage III with 13.1%, and stage IV at 5.3%. Overall 5- and 10-year survival probabilities for the cohort were 76.1% and 62.0%. Female patients (5-year: 79.6% and 10-year: 65.5%) had better survivals than male patients (5-year: 73.8% and 10-years: 59.6%). As stage increased, overall survival decreased with stage IV patients having 5- and 10-year survival probabilities of 21.2% and 9.4%, respectively. Patients with tumors localized to the extremities (5-year: 81.2%) had the best overall survival followed by tumors in the head or neck (5-year: 79.9%), pelvis (5-year: 77.3%), pelvis (5-year: 78.0%), thorax or trunk (5-year: 66.5%), and the retroperitoneum or abdomen (5-year: 53.1%). Finally, adjuvant radiation treatment correlated with decreased mortality to surgical resection of primary tumor alone (HR: 0.847; 95% CI: 0.726-0.989), whereas adjuvant chemotherapy correlated with increased mortality (HR: 2.769; 95% CI: 1.995-3.841).

Conclusion: Primary anatomical site was determined to be a major prognostic factor along with treatment facility type, sex, stage, and surgical margins for patients with myxoid liposarcoma.

Background: Myxoid liposarcomas (MLS) are intermediate to high grade liposarcomas, which are the most common type of soft tissue sarcoma. Although MLS most frequently develops in the legs, it can arise in any of the body’s soft tissue adipose. Previous studies of MLS survival have been limited in terms of geography, cohort size, variety of treatment settings, and assessment of primary site role. We retrospectively studied survival data for a nationwide cohort of MLS patients to identify prognostic factors and assess their effects on survival.

Methods: Using the National Cancer Database, we obtained data on 4636 patients diagnosed with MLS (ICD-O-3 8852) between 2004 and 2016. 5- and 10-year survival curves were estimated with Kaplan-Meier analysis and compared with log-rank analysis. Cox hazard regression was also used to compare multiple variables’ effects on survival.

Results: Approximately 59.2% of the cohort was male with a median age of presentation of 49 years. The most common site of metastasis was the bone followed by lung, liver, and brain. The majority (46.8%) of patients were stage I at time of diagnosis, followed by stage II with 18.1%, stage III with 13.1%, and stage IV at 5.3%. Overall 5- and 10-year survival probabilities for the cohort were 76.1% and 62.0%. Female patients (5-year: 79.6% and 10-year: 65.5%) had better survivals than male patients (5-year: 73.8% and 10-years: 59.6%). As stage increased, overall survival decreased with stage IV patients having 5- and 10-year survival probabilities of 21.2% and 9.4%, respectively. Patients with tumors localized to the extremities (5-year: 81.2%) had the best overall survival followed by tumors in the head or neck (5-year: 79.9%), pelvis (5-year: 77.3%), pelvis (5-year: 78.0%), thorax or trunk (5-year: 66.5%), and the retroperitoneum or abdomen (5-year: 53.1%). Finally, adjuvant radiation treatment correlated with decreased mortality to surgical resection of primary tumor alone (HR: 0.847; 95% CI: 0.726-0.989), whereas adjuvant chemotherapy correlated with increased mortality (HR: 2.769; 95% CI: 1.995-3.841).

Conclusion: Primary anatomical site was determined to be a major prognostic factor along with treatment facility type, sex, stage, and surgical margins for patients with myxoid liposarcoma.

Background: Myxoid liposarcomas (MLS) are intermediate to high grade liposarcomas, which are the most common type of soft tissue sarcoma. Although MLS most frequently develops in the legs, it can arise in any of the body’s soft tissue adipose. Previous studies of MLS survival have been limited in terms of geography, cohort size, variety of treatment settings, and assessment of primary site role. We retrospectively studied survival data for a nationwide cohort of MLS patients to identify prognostic factors and assess their effects on survival.

Methods: Using the National Cancer Database, we obtained data on 4636 patients diagnosed with MLS (ICD-O-3 8852) between 2004 and 2016. 5- and 10-year survival curves were estimated with Kaplan-Meier analysis and compared with log-rank analysis. Cox hazard regression was also used to compare multiple variables’ effects on survival.

Results: Approximately 59.2% of the cohort was male with a median age of presentation of 49 years. The most common site of metastasis was the bone followed by lung, liver, and brain. The majority (46.8%) of patients were stage I at time of diagnosis, followed by stage II with 18.1%, stage III with 13.1%, and stage IV at 5.3%. Overall 5- and 10-year survival probabilities for the cohort were 76.1% and 62.0%. Female patients (5-year: 79.6% and 10-year: 65.5%) had better survivals than male patients (5-year: 73.8% and 10-years: 59.6%). As stage increased, overall survival decreased with stage IV patients having 5- and 10-year survival probabilities of 21.2% and 9.4%, respectively. Patients with tumors localized to the extremities (5-year: 81.2%) had the best overall survival followed by tumors in the head or neck (5-year: 79.9%), pelvis (5-year: 77.3%), pelvis (5-year: 78.0%), thorax or trunk (5-year: 66.5%), and the retroperitoneum or abdomen (5-year: 53.1%). Finally, adjuvant radiation treatment correlated with decreased mortality to surgical resection of primary tumor alone (HR: 0.847; 95% CI: 0.726-0.989), whereas adjuvant chemotherapy correlated with increased mortality (HR: 2.769; 95% CI: 1.995-3.841).

Conclusion: Primary anatomical site was determined to be a major prognostic factor along with treatment facility type, sex, stage, and surgical margins for patients with myxoid liposarcoma.

Background: Pleomorphic liposarcomas is an aggressive, high grade subtype of soft tissue sarcoma representing < 15% of liposarcomas. It most commonly arises in the retroperitoneum and proximal upper extremities. Current prognostic factors are centered around staging, which accounts for the grade, size, and location of the tumor in relation to the superficial fascia.

Methods: A total of 1778 patients diagnosed with pleomorphic liposarcoma were identified in the National Cancer Database and stratified by primary anatomical site: head/neck, upper limb, lower limb/hip, thorax/lung, pelvis, and retroperitoneum/abdomen. Kaplan-Meier survival tables were produced to estimate 1-, 5-, and 10-year overall survival. Log-rank tests with a Bonferroni correction for multiple comparisons and a multivariable Cox proportional hazards analysis were utilized to compare the primary site groups; P < 0.05 was considered significant.

Results: The most common primary anatomical site was the lower limb/hip. The head/neck primary anatomical site demonstrated the highest 10-year overall survival probability, while retroperitoneum/abdomen had the lowest (50% and 18.4%, respectively). Median survival was 9.19 years for the head/neck group, and 3.08 years for the retroperitoneum/abdomen group. Significant overall survival differences were found between the retroperitoneum/abdomen group and each of the following groups: head/neck (P=0.001), upper limb (P<0.001), lower limb/hip (P<0.001), and pelvis (P=0.001). After adjusting for age, biological sex, race and ethnicity, Charlson-Deyo comorbidity index, and AJCC pathologic stage, a 48.4% increased risk of death was found for retroperitoneum/abdomen vs. lower limb/hip primary site (95% CI: 14.6% to 92.1%; P=0.003). Thorax/lung vs. lower limb/hip was also associated with a 55.1% increased risk of death (95% CI: 8.4% to 121.9%; P=0.016).

Conclusion: The current prognostic modality for pleomorphic liposarcoma is limited. There are statistically significant differences in survival based on primary anatomical sites, which may serve as a useful prognostic indicator. Tumors manifesting in the retroperitoneum/abdomen demonstrated the lowest survival.

Background: Pleomorphic liposarcomas is an aggressive, high grade subtype of soft tissue sarcoma representing < 15% of liposarcomas. It most commonly arises in the retroperitoneum and proximal upper extremities. Current prognostic factors are centered around staging, which accounts for the grade, size, and location of the tumor in relation to the superficial fascia.

Methods: A total of 1778 patients diagnosed with pleomorphic liposarcoma were identified in the National Cancer Database and stratified by primary anatomical site: head/neck, upper limb, lower limb/hip, thorax/lung, pelvis, and retroperitoneum/abdomen. Kaplan-Meier survival tables were produced to estimate 1-, 5-, and 10-year overall survival. Log-rank tests with a Bonferroni correction for multiple comparisons and a multivariable Cox proportional hazards analysis were utilized to compare the primary site groups; P < 0.05 was considered significant.

Results: The most common primary anatomical site was the lower limb/hip. The head/neck primary anatomical site demonstrated the highest 10-year overall survival probability, while retroperitoneum/abdomen had the lowest (50% and 18.4%, respectively). Median survival was 9.19 years for the head/neck group, and 3.08 years for the retroperitoneum/abdomen group. Significant overall survival differences were found between the retroperitoneum/abdomen group and each of the following groups: head/neck (P=0.001), upper limb (P<0.001), lower limb/hip (P<0.001), and pelvis (P=0.001). After adjusting for age, biological sex, race and ethnicity, Charlson-Deyo comorbidity index, and AJCC pathologic stage, a 48.4% increased risk of death was found for retroperitoneum/abdomen vs. lower limb/hip primary site (95% CI: 14.6% to 92.1%; P=0.003). Thorax/lung vs. lower limb/hip was also associated with a 55.1% increased risk of death (95% CI: 8.4% to 121.9%; P=0.016).

Conclusion: The current prognostic modality for pleomorphic liposarcoma is limited. There are statistically significant differences in survival based on primary anatomical sites, which may serve as a useful prognostic indicator. Tumors manifesting in the retroperitoneum/abdomen demonstrated the lowest survival.

Background: Pleomorphic liposarcomas is an aggressive, high grade subtype of soft tissue sarcoma representing < 15% of liposarcomas. It most commonly arises in the retroperitoneum and proximal upper extremities. Current prognostic factors are centered around staging, which accounts for the grade, size, and location of the tumor in relation to the superficial fascia.

Methods: A total of 1778 patients diagnosed with pleomorphic liposarcoma were identified in the National Cancer Database and stratified by primary anatomical site: head/neck, upper limb, lower limb/hip, thorax/lung, pelvis, and retroperitoneum/abdomen. Kaplan-Meier survival tables were produced to estimate 1-, 5-, and 10-year overall survival. Log-rank tests with a Bonferroni correction for multiple comparisons and a multivariable Cox proportional hazards analysis were utilized to compare the primary site groups; P < 0.05 was considered significant.

Results: The most common primary anatomical site was the lower limb/hip. The head/neck primary anatomical site demonstrated the highest 10-year overall survival probability, while retroperitoneum/abdomen had the lowest (50% and 18.4%, respectively). Median survival was 9.19 years for the head/neck group, and 3.08 years for the retroperitoneum/abdomen group. Significant overall survival differences were found between the retroperitoneum/abdomen group and each of the following groups: head/neck (P=0.001), upper limb (P<0.001), lower limb/hip (P<0.001), and pelvis (P=0.001). After adjusting for age, biological sex, race and ethnicity, Charlson-Deyo comorbidity index, and AJCC pathologic stage, a 48.4% increased risk of death was found for retroperitoneum/abdomen vs. lower limb/hip primary site (95% CI: 14.6% to 92.1%; P=0.003). Thorax/lung vs. lower limb/hip was also associated with a 55.1% increased risk of death (95% CI: 8.4% to 121.9%; P=0.016).

Conclusion: The current prognostic modality for pleomorphic liposarcoma is limited. There are statistically significant differences in survival based on primary anatomical sites, which may serve as a useful prognostic indicator. Tumors manifesting in the retroperitoneum/abdomen demonstrated the lowest survival.

Background: Liposarcoma is the most common malignant soft tissue sarcoma (STS). Surgical resection is the most utilized therapeutic option. In this study, we aim to explore the effects of varying degrees of surgical margins on survival in patients with dedifferentiated liposarcoma (DDLPS).

Methods: The National Cancer Database (NCDB) was used to select patients with DDLPS to determine if surgical margins and other variables were associated with decreased overall survival after accounting for age, gender, race, Charlson-Deyo score, anatomic site, treatment approach, tumor size, tumor grade, and presence of metastases through multivariable analysis.

Results: Of the 1004 selected patients, 64.4% were male, 87.0% were white, and the median age was 63 years. About 95% had no metastases at the time of diagnosis, and 91.5% had high grade liposarcoma. For the status of surgical margins, 50.8% had no residual tumors, 26.1% had microscopic residual tumors, 4.3% had macroscopic residual tumors. In general, the risk of death was higher for older males (25.8% increased risk of mortality) and those with metastases (312.9% increased risk of mortality) as well as patients with high grade liposarcoma (112.4% increased risk of mortality). Patients with macroscopic residual tumors in comparison to those with no residual tumors had a 96.7% increased risk of death (HR 95% CI:1.24 to 3.13; P=0.004).

Conclusion: Older age, presence of metastasis, male patients, retroperitoneal/abdomen primary site, highgrade tumors, and macroscopic or residual tumor present after surgery lead to an increased risk of mortality. These outcomes highlight the importance and benefits of negative or complete surgical margins as prognostic indicators for patients with DDLPS, especially considering that resection is the most commonly utilized therapeutic option. The NCDB contains about 70% of cancer incidents within the US, therefore a future study incorporating the Surveillance, Epidemiology, and End Results (SEER) registry could enhance and possibly add to the results brought forth by this study.

Background: Liposarcoma is the most common malignant soft tissue sarcoma (STS). Surgical resection is the most utilized therapeutic option. In this study, we aim to explore the effects of varying degrees of surgical margins on survival in patients with dedifferentiated liposarcoma (DDLPS).

Methods: The National Cancer Database (NCDB) was used to select patients with DDLPS to determine if surgical margins and other variables were associated with decreased overall survival after accounting for age, gender, race, Charlson-Deyo score, anatomic site, treatment approach, tumor size, tumor grade, and presence of metastases through multivariable analysis.

Results: Of the 1004 selected patients, 64.4% were male, 87.0% were white, and the median age was 63 years. About 95% had no metastases at the time of diagnosis, and 91.5% had high grade liposarcoma. For the status of surgical margins, 50.8% had no residual tumors, 26.1% had microscopic residual tumors, 4.3% had macroscopic residual tumors. In general, the risk of death was higher for older males (25.8% increased risk of mortality) and those with metastases (312.9% increased risk of mortality) as well as patients with high grade liposarcoma (112.4% increased risk of mortality). Patients with macroscopic residual tumors in comparison to those with no residual tumors had a 96.7% increased risk of death (HR 95% CI:1.24 to 3.13; P=0.004).

Conclusion: Older age, presence of metastasis, male patients, retroperitoneal/abdomen primary site, highgrade tumors, and macroscopic or residual tumor present after surgery lead to an increased risk of mortality. These outcomes highlight the importance and benefits of negative or complete surgical margins as prognostic indicators for patients with DDLPS, especially considering that resection is the most commonly utilized therapeutic option. The NCDB contains about 70% of cancer incidents within the US, therefore a future study incorporating the Surveillance, Epidemiology, and End Results (SEER) registry could enhance and possibly add to the results brought forth by this study.

Background: Liposarcoma is the most common malignant soft tissue sarcoma (STS). Surgical resection is the most utilized therapeutic option. In this study, we aim to explore the effects of varying degrees of surgical margins on survival in patients with dedifferentiated liposarcoma (DDLPS).

Methods: The National Cancer Database (NCDB) was used to select patients with DDLPS to determine if surgical margins and other variables were associated with decreased overall survival after accounting for age, gender, race, Charlson-Deyo score, anatomic site, treatment approach, tumor size, tumor grade, and presence of metastases through multivariable analysis.

Results: Of the 1004 selected patients, 64.4% were male, 87.0% were white, and the median age was 63 years. About 95% had no metastases at the time of diagnosis, and 91.5% had high grade liposarcoma. For the status of surgical margins, 50.8% had no residual tumors, 26.1% had microscopic residual tumors, 4.3% had macroscopic residual tumors. In general, the risk of death was higher for older males (25.8% increased risk of mortality) and those with metastases (312.9% increased risk of mortality) as well as patients with high grade liposarcoma (112.4% increased risk of mortality). Patients with macroscopic residual tumors in comparison to those with no residual tumors had a 96.7% increased risk of death (HR 95% CI:1.24 to 3.13; P=0.004).

Conclusion: Older age, presence of metastasis, male patients, retroperitoneal/abdomen primary site, highgrade tumors, and macroscopic or residual tumor present after surgery lead to an increased risk of mortality. These outcomes highlight the importance and benefits of negative or complete surgical margins as prognostic indicators for patients with DDLPS, especially considering that resection is the most commonly utilized therapeutic option. The NCDB contains about 70% of cancer incidents within the US, therefore a future study incorporating the Surveillance, Epidemiology, and End Results (SEER) registry could enhance and possibly add to the results brought forth by this study.

Background: Chondrosarcoma (CHS) is the second most common primary malignant solid bone tumor. Present management of CHS is based largely on case series from individual treatment centers. This study summarizes descriptive epidemiologic and prognostic characteristics associated with CHS patients utilizing the National Cancer Database (NCDB).

Methods: We identified 6,559 patients with CHS of the bone, joints, and/or articular cartilage in the NCDB from 2004-2015. Kaplan-Meier analyses were used to estimate 2- and 5-year survival, and median survival. Survival comparisons were made using log-rank tests.

Results: Median age at diagnosis was 53 years. 53.3% of cases were in males, and 86.4% were in white patients. 28.2% of cases were in lower limb long bones and associated joints. The most common NCDB analytic stage at presentation was stage I (60.5%). 6.4% of patients had known metastases at diagnosis. 86.6%, 7%, and 12.5% of patients received surgery, chemotherapy, and radiation, respectively. Overall probability of 5-year survival was 74.4%. Approximate 5-year survival for NCDB analytic stages I-IV was 86.2%, 53.1%, 52.4%, and 17.4%, respectively. The dedifferentiated subtype of CHS had the poorest 5-year survival (25.4%), while juxtacortical had the highest (93.4%). In 355 patients with high grade CHS, perioperative chemotherapy (33.7% 5-year survival) did not provide improved survival compared to surgery alone (51.2% 5-year survival).

Conclusions: To the best of our knowledge, this is the first NCDB study to evaluate survival by treatment type and stage in CHS, as well as to analyze epidemiologic and prognostic characteristics in all CHS subtypes. This study found CHS was most common in white patients, had a median age at diagnosis of 53 years, and was most frequently found in lower limb long bones and associated joints. The 5-year survival was much worse at stage IV compared to stages I, II, and III, as well as in dedifferentiated and mesenchymal tumor subtypes compared to conventional or other types of CHS. In high grade tumors, perioperative chemotherapy did not improve survival compared to surgery alone.

Background: Chondrosarcoma (CHS) is the second most common primary malignant solid bone tumor. Present management of CHS is based largely on case series from individual treatment centers. This study summarizes descriptive epidemiologic and prognostic characteristics associated with CHS patients utilizing the National Cancer Database (NCDB).

Methods: We identified 6,559 patients with CHS of the bone, joints, and/or articular cartilage in the NCDB from 2004-2015. Kaplan-Meier analyses were used to estimate 2- and 5-year survival, and median survival. Survival comparisons were made using log-rank tests.

Results: Median age at diagnosis was 53 years. 53.3% of cases were in males, and 86.4% were in white patients. 28.2% of cases were in lower limb long bones and associated joints. The most common NCDB analytic stage at presentation was stage I (60.5%). 6.4% of patients had known metastases at diagnosis. 86.6%, 7%, and 12.5% of patients received surgery, chemotherapy, and radiation, respectively. Overall probability of 5-year survival was 74.4%. Approximate 5-year survival for NCDB analytic stages I-IV was 86.2%, 53.1%, 52.4%, and 17.4%, respectively. The dedifferentiated subtype of CHS had the poorest 5-year survival (25.4%), while juxtacortical had the highest (93.4%). In 355 patients with high grade CHS, perioperative chemotherapy (33.7% 5-year survival) did not provide improved survival compared to surgery alone (51.2% 5-year survival).

Conclusions: To the best of our knowledge, this is the first NCDB study to evaluate survival by treatment type and stage in CHS, as well as to analyze epidemiologic and prognostic characteristics in all CHS subtypes. This study found CHS was most common in white patients, had a median age at diagnosis of 53 years, and was most frequently found in lower limb long bones and associated joints. The 5-year survival was much worse at stage IV compared to stages I, II, and III, as well as in dedifferentiated and mesenchymal tumor subtypes compared to conventional or other types of CHS. In high grade tumors, perioperative chemotherapy did not improve survival compared to surgery alone.

Background: Chondrosarcoma (CHS) is the second most common primary malignant solid bone tumor. Present management of CHS is based largely on case series from individual treatment centers. This study summarizes descriptive epidemiologic and prognostic characteristics associated with CHS patients utilizing the National Cancer Database (NCDB).

Methods: We identified 6,559 patients with CHS of the bone, joints, and/or articular cartilage in the NCDB from 2004-2015. Kaplan-Meier analyses were used to estimate 2- and 5-year survival, and median survival. Survival comparisons were made using log-rank tests.

Results: Median age at diagnosis was 53 years. 53.3% of cases were in males, and 86.4% were in white patients. 28.2% of cases were in lower limb long bones and associated joints. The most common NCDB analytic stage at presentation was stage I (60.5%). 6.4% of patients had known metastases at diagnosis. 86.6%, 7%, and 12.5% of patients received surgery, chemotherapy, and radiation, respectively. Overall probability of 5-year survival was 74.4%. Approximate 5-year survival for NCDB analytic stages I-IV was 86.2%, 53.1%, 52.4%, and 17.4%, respectively. The dedifferentiated subtype of CHS had the poorest 5-year survival (25.4%), while juxtacortical had the highest (93.4%). In 355 patients with high grade CHS, perioperative chemotherapy (33.7% 5-year survival) did not provide improved survival compared to surgery alone (51.2% 5-year survival).

Conclusions: To the best of our knowledge, this is the first NCDB study to evaluate survival by treatment type and stage in CHS, as well as to analyze epidemiologic and prognostic characteristics in all CHS subtypes. This study found CHS was most common in white patients, had a median age at diagnosis of 53 years, and was most frequently found in lower limb long bones and associated joints. The 5-year survival was much worse at stage IV compared to stages I, II, and III, as well as in dedifferentiated and mesenchymal tumor subtypes compared to conventional or other types of CHS. In high grade tumors, perioperative chemotherapy did not improve survival compared to surgery alone.

Background: Primary cardiac sarcomas are rare and highly lethal tumors. Current understanding of clinicopathologic characteristics associated with primary cardiac sarcoma is limited to case reports and small case series. To the best of our knowledge, this is the largest study to evaluate clinicopathologic characteristics of primary cardiac sarcoma, and survival benefit of treatment modalities.

Methods: The National Cancer Database was utilized to retrospectively identify 404 patients diagnosed with a single primary cardiac sarcoma between 2004 and 2015. Kaplan-Meier methods were used to estimate survival distribution. Log-rank tests compared survival distributions between groups.

Results: Median age at diagnosis was 50 years. Men (50.7%) and women (49.3%) were affected equally. The most common histology types were hemangiosarcoma (40.1%), sarcoma NOS (14.9%), spindle cell sarcoma (6.9%) and leiomyosarcoma (5.9%). The most common stage at presentation was stage IV (38.1%). 37% of patients presented with metastases at the time of diagnosis, and the most common site of distant metastasis was the
lung (12.6%). Median overall survival (OS) for the entire cohort was 12 months. Median OS for stages I-IV was 23.06, 22.34, 12.98 and 8.08 months, respectively. 63% of patients underwent surgical resection. 58.4% received chemotherapy, and 22% received radiotherapy. Patients who underwent surgery had improved OS compared to those not receiving surgery (15.74 vs. 7.62 months, respectively). In patients with metastatic disease, OS was improved when treated with chemotherapy (11.14 months), compared to surgery alone (5.22 months). Combined treatment of surgery with chemotherapy did not improve outcomes compared to chemotherapy alone (P = .091 on log-rank test). In non-metastatic disease,
patients receiving multi-modality treatment (radiotherapy, chemotherapy and surgery) had improved OS (27.73 months) compared to those who underwent surgery alone, chemotherapy alone or chemotherapy with surgery (6.67, 14.88 and 20.99 months, respectively).

Conclusions: The median age of diagnosis was 50 years, and men and women are affected equally. Stage IV is the most common stage at diagnosis, and prognosis of Stages III and IV are worse in comparison to Stages I and II. In metastatic disease, receipt of chemotherapy is associated with improved survivorship. Multimodality treatment regimens may be recommended in non-metastatic cases.

Background: Primary cardiac sarcomas are rare and highly lethal tumors. Current understanding of clinicopathologic characteristics associated with primary cardiac sarcoma is limited to case reports and small case series. To the best of our knowledge, this is the largest study to evaluate clinicopathologic characteristics of primary cardiac sarcoma, and survival benefit of treatment modalities.

Methods: The National Cancer Database was utilized to retrospectively identify 404 patients diagnosed with a single primary cardiac sarcoma between 2004 and 2015. Kaplan-Meier methods were used to estimate survival distribution. Log-rank tests compared survival distributions between groups.

Results: Median age at diagnosis was 50 years. Men (50.7%) and women (49.3%) were affected equally. The most common histology types were hemangiosarcoma (40.1%), sarcoma NOS (14.9%), spindle cell sarcoma (6.9%) and leiomyosarcoma (5.9%). The most common stage at presentation was stage IV (38.1%). 37% of patients presented with metastases at the time of diagnosis, and the most common site of distant metastasis was the
lung (12.6%). Median overall survival (OS) for the entire cohort was 12 months. Median OS for stages I-IV was 23.06, 22.34, 12.98 and 8.08 months, respectively. 63% of patients underwent surgical resection. 58.4% received chemotherapy, and 22% received radiotherapy. Patients who underwent surgery had improved OS compared to those not receiving surgery (15.74 vs. 7.62 months, respectively). In patients with metastatic disease, OS was improved when treated with chemotherapy (11.14 months), compared to surgery alone (5.22 months). Combined treatment of surgery with chemotherapy did not improve outcomes compared to chemotherapy alone (P = .091 on log-rank test). In non-metastatic disease,
patients receiving multi-modality treatment (radiotherapy, chemotherapy and surgery) had improved OS (27.73 months) compared to those who underwent surgery alone, chemotherapy alone or chemotherapy with surgery (6.67, 14.88 and 20.99 months, respectively).

Conclusions: The median age of diagnosis was 50 years, and men and women are affected equally. Stage IV is the most common stage at diagnosis, and prognosis of Stages III and IV are worse in comparison to Stages I and II. In metastatic disease, receipt of chemotherapy is associated with improved survivorship. Multimodality treatment regimens may be recommended in non-metastatic cases.

Background: Primary cardiac sarcomas are rare and highly lethal tumors. Current understanding of clinicopathologic characteristics associated with primary cardiac sarcoma is limited to case reports and small case series. To the best of our knowledge, this is the largest study to evaluate clinicopathologic characteristics of primary cardiac sarcoma, and survival benefit of treatment modalities.

Methods: The National Cancer Database was utilized to retrospectively identify 404 patients diagnosed with a single primary cardiac sarcoma between 2004 and 2015. Kaplan-Meier methods were used to estimate survival distribution. Log-rank tests compared survival distributions between groups.

Results: Median age at diagnosis was 50 years. Men (50.7%) and women (49.3%) were affected equally. The most common histology types were hemangiosarcoma (40.1%), sarcoma NOS (14.9%), spindle cell sarcoma (6.9%) and leiomyosarcoma (5.9%). The most common stage at presentation was stage IV (38.1%). 37% of patients presented with metastases at the time of diagnosis, and the most common site of distant metastasis was the
lung (12.6%). Median overall survival (OS) for the entire cohort was 12 months. Median OS for stages I-IV was 23.06, 22.34, 12.98 and 8.08 months, respectively. 63% of patients underwent surgical resection. 58.4% received chemotherapy, and 22% received radiotherapy. Patients who underwent surgery had improved OS compared to those not receiving surgery (15.74 vs. 7.62 months, respectively). In patients with metastatic disease, OS was improved when treated with chemotherapy (11.14 months), compared to surgery alone (5.22 months). Combined treatment of surgery with chemotherapy did not improve outcomes compared to chemotherapy alone (P = .091 on log-rank test). In non-metastatic disease,
patients receiving multi-modality treatment (radiotherapy, chemotherapy and surgery) had improved OS (27.73 months) compared to those who underwent surgery alone, chemotherapy alone or chemotherapy with surgery (6.67, 14.88 and 20.99 months, respectively).

Conclusions: The median age of diagnosis was 50 years, and men and women are affected equally. Stage IV is the most common stage at diagnosis, and prognosis of Stages III and IV are worse in comparison to Stages I and II. In metastatic disease, receipt of chemotherapy is associated with improved survivorship. Multimodality treatment regimens may be recommended in non-metastatic cases.

Background: Dedifferentiated liposarcoma (DDL) is a high-grade tumor that either forms as a de novo tumor or as a progression from a low-grade, well-differentiated liposarcoma. DDL is a clinically aggressive tumor associated with low survival probabilities. Prognosis variables for DDL have never been reported in a large patient population.

Methods: 3,573 patients with primary DDL were analyzed from the National Cancer Database (NCDB). The 5- and 10-year survival probabilities  were calculated, and the groups were compared using log-rank comparisons. Median survival was also calculated.

Results: Males comprised 65% of the cohort, 65.4% of the patients were between the age of 51-75 years old, and the median age at diagnosis was 64 years of age. Approximately 65% of tumors were > 10 cm, 89% had no metastases and the most common site of metastasis was the lung (2.5%). The most common tumors were found in the retroperitoneum or peritoneum (40.5%). Overall 5- and 10-year survival probabilities were 51.5% and 34.8%, respectively. Head and neck tumors had the best 5-year outcomes (86.4%) followed by extremities (67.1%), pelvis (65.8%), thorax or trunk (58.9%), retroperitoneum or peritoneum (45.3%), and abdomen (36.8%). Best outcomes were noted in the 26-50 year age group (5-year survival, 66.8%; 10-year survival, 52.9%), < 1 0 cm diameter size (5-year survival: 66.1%; 10-year survival, 46%), stage II (5-year survival, 66.7%), and moderately differentiated tumors (5-year survival, 68.3%). Radiation therapy yielded the best 5- and 10-year survival probabilities of 59% and 39.3%, respectively. Out of all the adjuvant therapies, surgery with radiation resulted in the best 5-year survival of 63.4%.

Conclusions: In the largest and most comprehensive study to date on DDL, major findings include that primary anatomical site is a significant prognostic variable and age at presentation, tumor size, stage, grade, and type of adjuvant therapy significantly affect median survival and overall survival probabilities.

Background: Dedifferentiated liposarcoma (DDL) is a high-grade tumor that either forms as a de novo tumor or as a progression from a low-grade, well-differentiated liposarcoma. DDL is a clinically aggressive tumor associated with low survival probabilities. Prognosis variables for DDL have never been reported in a large patient population.

Methods: 3,573 patients with primary DDL were analyzed from the National Cancer Database (NCDB). The 5- and 10-year survival probabilities  were calculated, and the groups were compared using log-rank comparisons. Median survival was also calculated.

Results: Males comprised 65% of the cohort, 65.4% of the patients were between the age of 51-75 years old, and the median age at diagnosis was 64 years of age. Approximately 65% of tumors were > 10 cm, 89% had no metastases and the most common site of metastasis was the lung (2.5%). The most common tumors were found in the retroperitoneum or peritoneum (40.5%). Overall 5- and 10-year survival probabilities were 51.5% and 34.8%, respectively. Head and neck tumors had the best 5-year outcomes (86.4%) followed by extremities (67.1%), pelvis (65.8%), thorax or trunk (58.9%), retroperitoneum or peritoneum (45.3%), and abdomen (36.8%). Best outcomes were noted in the 26-50 year age group (5-year survival, 66.8%; 10-year survival, 52.9%), < 1 0 cm diameter size (5-year survival: 66.1%; 10-year survival, 46%), stage II (5-year survival, 66.7%), and moderately differentiated tumors (5-year survival, 68.3%). Radiation therapy yielded the best 5- and 10-year survival probabilities of 59% and 39.3%, respectively. Out of all the adjuvant therapies, surgery with radiation resulted in the best 5-year survival of 63.4%.

Conclusions: In the largest and most comprehensive study to date on DDL, major findings include that primary anatomical site is a significant prognostic variable and age at presentation, tumor size, stage, grade, and type of adjuvant therapy significantly affect median survival and overall survival probabilities.

Background: Dedifferentiated liposarcoma (DDL) is a high-grade tumor that either forms as a de novo tumor or as a progression from a low-grade, well-differentiated liposarcoma. DDL is a clinically aggressive tumor associated with low survival probabilities. Prognosis variables for DDL have never been reported in a large patient population.

Methods: 3,573 patients with primary DDL were analyzed from the National Cancer Database (NCDB). The 5- and 10-year survival probabilities  were calculated, and the groups were compared using log-rank comparisons. Median survival was also calculated.

Results: Males comprised 65% of the cohort, 65.4% of the patients were between the age of 51-75 years old, and the median age at diagnosis was 64 years of age. Approximately 65% of tumors were > 10 cm, 89% had no metastases and the most common site of metastasis was the lung (2.5%). The most common tumors were found in the retroperitoneum or peritoneum (40.5%). Overall 5- and 10-year survival probabilities were 51.5% and 34.8%, respectively. Head and neck tumors had the best 5-year outcomes (86.4%) followed by extremities (67.1%), pelvis (65.8%), thorax or trunk (58.9%), retroperitoneum or peritoneum (45.3%), and abdomen (36.8%). Best outcomes were noted in the 26-50 year age group (5-year survival, 66.8%; 10-year survival, 52.9%), < 1 0 cm diameter size (5-year survival: 66.1%; 10-year survival, 46%), stage II (5-year survival, 66.7%), and moderately differentiated tumors (5-year survival, 68.3%). Radiation therapy yielded the best 5- and 10-year survival probabilities of 59% and 39.3%, respectively. Out of all the adjuvant therapies, surgery with radiation resulted in the best 5-year survival of 63.4%.

Conclusions: In the largest and most comprehensive study to date on DDL, major findings include that primary anatomical site is a significant prognostic variable and age at presentation, tumor size, stage, grade, and type of adjuvant therapy significantly affect median survival and overall survival probabilities.