Derivation and validation of a risk classification tree for patients with synovial sarcoma

Background Synovial sarcoma (SS) accounts for 8%–10% of all soft‐tissue sarcomas. Clinical presentation and outcomes vary, yet discrete risk groups based on validated prognostic indices are not defined for the full spectrum of patients with SS. Methods We performed a retrospective cohort study using...

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Published in:Cancer medicine (Malden, MA) MA), 2023-01, Vol.12 (1), p.170-178
Main Authors: Neel, Dylan V., Ma, Clement, Collins, Natalie B., Hornick, Jason L., Demetri, George D., Shulman, David S.
Format: Article
Language:English
Subjects:
Adult
Age
Cancer therapies
Chemotherapy
Classification
Diagnosis
Epidemiology
Hispanic Americans
Histology
Humans
Medical prognosis
Metastasis
oncology
Patients
Prognosis
prognostic factors
Radiation
Retrospective Studies
Risk Factors
Risk groups
risk‐stratification
Sarcoma
Sarcoma - pathology
Sarcoma, Synovial - diagnosis
Sarcoma, Synovial - therapy
SEER Program
Sex
Survival
Synovial sarcoma
Tumors
Variables
Young Adult
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Shulman, David S.
description Background Synovial sarcoma (SS) accounts for 8%–10% of all soft‐tissue sarcomas. Clinical presentation and outcomes vary, yet discrete risk groups based on validated prognostic indices are not defined for the full spectrum of patients with SS. Methods We performed a retrospective cohort study using data from the SEER (surveillance, epidemiology, and end results program) database of SS patients who were
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Clinical presentation and outcomes vary, yet discrete risk groups based on validated prognostic indices are not defined for the full spectrum of patients with SS. Methods We performed a retrospective cohort study using data from the SEER (surveillance, epidemiology, and end results program) database of SS patients who were &lt;70 years of age at diagnosis. We constructed a recursive partitioning model of overall survival using a training cohort of 1063 patients with variables: Age at diagnosis, sex, race, ethnicity, primary site, tumor size, tumor grade, and stage. Based on this model, we grouped patients into three risk groups and estimated 5‐year overall survival for each group. We then applied these groups to a test cohort (n = 1063). Results Our model identified three prognostic groups with significantly different overall survival: low risk (local/regional stage with either &lt;21 years of age OR tumor &lt;7.5 cm and female sex), intermediate‐risk (local/regional stage, age ≥ 21 years with either male sex and tumor &lt;7.5 cm OR any sex with appendicular anatomic location) and high risk (local/regional stage, age ≥ 21 years, tumor size ≥7.5 cm and non‐appendicular location OR distant stage). Prognostic groups were applied to the test cohort, showing significantly different survival between groups (p &lt; 0.0001). Conclusions Our analysis yields an intuitive risk‐classification tree with discrete groups, which may provide useful information for researchers, patients, and clinicians. Prospective validation of this model may inform efforts at risk‐stratifying treatment. We used a multivariable recursive partitioning model to define prognostic groups for children and adults with synovial sarcoma. These risk groups provide clinicians and researchers with an intuitive framework for estimating individual patient risk.</description><identifier>ISSN: 2045-7634</identifier><identifier>EISSN: 2045-7634</identifier><identifier>DOI: 10.1002/cam4.4909</identifier><identifier>PMID: 35670308</identifier><language>eng</language><publisher>United States: John Wiley &amp; Sons, Inc</publisher><subject>Adult ; Age ; Cancer therapies ; Chemotherapy ; Classification ; Diagnosis ; Epidemiology ; Hispanic Americans ; Histology ; Humans ; Medical prognosis ; Metastasis ; oncology ; Patients ; Prognosis ; prognostic factors ; Radiation ; Retrospective Studies ; Risk Factors ; Risk groups ; risk‐stratification ; Sarcoma ; Sarcoma - pathology ; Sarcoma, Synovial - diagnosis ; Sarcoma, Synovial - therapy ; SEER Program ; Sex ; Survival ; Synovial sarcoma ; Tumors ; Variables ; Young Adult</subject><ispartof>Cancer medicine (Malden, MA), 2023-01, Vol.12 (1), p.170-178</ispartof><rights>2022 The Authors. published by John Wiley &amp; Sons Ltd.</rights><rights>2022 The Authors. Cancer Medicine published by John Wiley &amp; Sons Ltd.</rights><rights>2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5099-90cd7581c060fe46f6db1eb5d75165ea1ee4c8470736de403ccc42206dbba20f3</citedby><cites>FETCH-LOGICAL-c5099-90cd7581c060fe46f6db1eb5d75165ea1ee4c8470736de403ccc42206dbba20f3</cites><orcidid>0000-0001-6964-9842 ; 0000-0002-5994-2604</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2766083819/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2766083819?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11553,25744,27915,27916,37003,37004,44581,46043,46467,53782,53784,74887</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35670308$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Neel, Dylan V.</creatorcontrib><creatorcontrib>Ma, Clement</creatorcontrib><creatorcontrib>Collins, Natalie B.</creatorcontrib><creatorcontrib>Hornick, Jason L.</creatorcontrib><creatorcontrib>Demetri, George D.</creatorcontrib><creatorcontrib>Shulman, David S.</creatorcontrib><title>Derivation and validation of a risk classification tree for patients with synovial sarcoma</title><title>Cancer medicine (Malden, MA)</title><addtitle>Cancer Med</addtitle><description>Background Synovial sarcoma (SS) accounts for 8%–10% of all soft‐tissue sarcomas. Clinical presentation and outcomes vary, yet discrete risk groups based on validated prognostic indices are not defined for the full spectrum of patients with SS. Methods We performed a retrospective cohort study using data from the SEER (surveillance, epidemiology, and end results program) database of SS patients who were &lt;70 years of age at diagnosis. We constructed a recursive partitioning model of overall survival using a training cohort of 1063 patients with variables: Age at diagnosis, sex, race, ethnicity, primary site, tumor size, tumor grade, and stage. Based on this model, we grouped patients into three risk groups and estimated 5‐year overall survival for each group. We then applied these groups to a test cohort (n = 1063). Results Our model identified three prognostic groups with significantly different overall survival: low risk (local/regional stage with either &lt;21 years of age OR tumor &lt;7.5 cm and female sex), intermediate‐risk (local/regional stage, age ≥ 21 years with either male sex and tumor &lt;7.5 cm OR any sex with appendicular anatomic location) and high risk (local/regional stage, age ≥ 21 years, tumor size ≥7.5 cm and non‐appendicular location OR distant stage). Prognostic groups were applied to the test cohort, showing significantly different survival between groups (p &lt; 0.0001). Conclusions Our analysis yields an intuitive risk‐classification tree with discrete groups, which may provide useful information for researchers, patients, and clinicians. Prospective validation of this model may inform efforts at risk‐stratifying treatment. We used a multivariable recursive partitioning model to define prognostic groups for children and adults with synovial sarcoma. 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Medical Complete (Alumni)</collection><collection>Biological Sciences</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Biological Science Database</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Cancer medicine (Malden, MA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Neel, Dylan V.</au><au>Ma, Clement</au><au>Collins, Natalie B.</au><au>Hornick, Jason L.</au><au>Demetri, George D.</au><au>Shulman, David S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Derivation and validation of a risk classification tree for patients with synovial sarcoma</atitle><jtitle>Cancer medicine (Malden, MA)</jtitle><addtitle>Cancer Med</addtitle><date>2023-01</date><risdate>2023</risdate><volume>12</volume><issue>1</issue><spage>170</spage><epage>178</epage><pages>170-178</pages><issn>2045-7634</issn><eissn>2045-7634</eissn><abstract>Background Synovial sarcoma (SS) accounts for 8%–10% of all soft‐tissue sarcomas. Clinical presentation and outcomes vary, yet discrete risk groups based on validated prognostic indices are not defined for the full spectrum of patients with SS. Methods We performed a retrospective cohort study using data from the SEER (surveillance, epidemiology, and end results program) database of SS patients who were &lt;70 years of age at diagnosis. We constructed a recursive partitioning model of overall survival using a training cohort of 1063 patients with variables: Age at diagnosis, sex, race, ethnicity, primary site, tumor size, tumor grade, and stage. Based on this model, we grouped patients into three risk groups and estimated 5‐year overall survival for each group. We then applied these groups to a test cohort (n = 1063). Results Our model identified three prognostic groups with significantly different overall survival: low risk (local/regional stage with either &lt;21 years of age OR tumor &lt;7.5 cm and female sex), intermediate‐risk (local/regional stage, age ≥ 21 years with either male sex and tumor &lt;7.5 cm OR any sex with appendicular anatomic location) and high risk (local/regional stage, age ≥ 21 years, tumor size ≥7.5 cm and non‐appendicular location OR distant stage). Prognostic groups were applied to the test cohort, showing significantly different survival between groups (p &lt; 0.0001). Conclusions Our analysis yields an intuitive risk‐classification tree with discrete groups, which may provide useful information for researchers, patients, and clinicians. Prospective validation of this model may inform efforts at risk‐stratifying treatment. We used a multivariable recursive partitioning model to define prognostic groups for children and adults with synovial sarcoma. These risk groups provide clinicians and researchers with an intuitive framework for estimating individual patient risk.</abstract><cop>United States</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>35670308</pmid><doi>10.1002/cam4.4909</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6964-9842</orcidid><orcidid>https://orcid.org/0000-0002-5994-2604</orcidid><oa>free_for_read</oa></addata></record>
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source Wiley-Blackwell Open Access Collection; Publicly Available Content (ProQuest); PubMed Central
subjects Adult
Age
Cancer therapies
Chemotherapy
Classification
Diagnosis
Epidemiology
Hispanic Americans
Histology
Humans
Medical prognosis
Metastasis
oncology
Patients
Prognosis
prognostic factors
Radiation
Retrospective Studies
Risk Factors
Risk groups
risk‐stratification
Sarcoma
Sarcoma - pathology
Sarcoma, Synovial - diagnosis
Sarcoma, Synovial - therapy
SEER Program
Sex
Survival
Synovial sarcoma
Tumors
Variables
Young Adult
title Derivation and validation of a risk classification tree for patients with synovial sarcoma
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