Prognostic Factors for Survival in Patients with Epithelioid Sarcoma: 441 Cases from the SEER Database

• Published in: Clinical orthopaedics and related research 2009-11, Vol.467 (11), p.2939-2948
• Main Authors: Jawad, Muhammad Umar, Extein, Jason, Min, Elijah S., Scully, Sean P.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Biological and medical sciences; Bone Neoplasms - mortality; Bone Neoplasms - pathology; Bone Neoplasms - therapy; Chemotherapy, Adjuvant; Child; Child, Preschool; Combined Modality Therapy; Conservative Orthopedics; Databases, Factual; Disease-Free Survival; Diseases of the osteoarticular system; Female; Humans; Kaplan-Meier Estimate; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Neoplasm Invasiveness - pathology; Neoplasm Staging; Original; Original Article; Orthopedic Procedures - methods; Orthopedics; Prognosis; Proportional Hazards Models; Radiotherapy, Adjuvant; Retrospective Studies; Risk Assessment; Sarcoma - mortality; Sarcoma - pathology; Sarcoma - therapy; SEER Program; Sex Factors; Sports Medicine; Surgery; Surgical Orthopedics; Survival Analysis; Treatment Outcome; Young Adult
• ISSN: 0009-921X; 1528-1132
• DOI: 10.1007/s11999-009-0749-2

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. 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. 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.