Trends in Overall Survival among Patients Treated for Sarcoma at a Large Tertiary Cancer Center between 1986 and 2014

Erik Stricker; Damon R Reed; Matthew B Schabath; Pagna Sok; Michael E Scheurer; Philip J Lupo

doi:10.3390/cancers15020514

Trends in Overall Survival among Patients Treated for Sarcoma at a Large Tertiary Cancer Center between 1986 and 2014

Cancers (Basel). 2023 Jan 14;15(2):514. doi: 10.3390/cancers15020514.

Authors

Erik Stricker¹, Damon R Reed², Matthew B Schabath³, Pagna Sok⁴, Michael E Scheurer⁴, Philip J Lupo⁴

Affiliations

¹ Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA.
² H. Lee Moffitt Cancer Center, Adolescent and Young Adult Program, Tampa, FL 33612, USA.
³ H. Lee Moffitt Cancer Center, Departments of Cancer Epidemiology and Thoracic Oncology, Tampa, FL 33612, USA.
⁴ Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.

Abstract

Sarcomas are relatively rare malignancies accounting for about 1% of all cancer diagnoses. Studies on sarcomas comprising large cohorts covering extended time periods are lacking. Therefore, this study aimed to evaluate the impact of demographic, behavioral, and clinical characteristics on overall survival (OS) among individuals diagnosed with soft tissue sarcoma (STS) or bone sarcoma at the Moffitt Cancer Center between 1986 and 2014. Unadjusted and multivariable Cox proportional hazard regression (CPHR) models were constructed to generate hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate associations between a range of demographic, behavioral, and clinical characteristics, and OS. Additionally, Kaplan-Meier survival curves, associated log-rank statistics, and adjusted CPHR models were generated by time periods based on the year of first contact (1986-1994, 1995-1999, 2000-2005, 2006-2010, 2011-2014) to evaluate for temporal differences in OS. Of the 2570 patients, 2037 were diagnosed with STS, whereas 533 were diagnosed with bone sarcoma. At the time of analysis, 50% of the population were alive. In multivariable analyses, we observed poorer survival for patients ≥ 40 years of age (HR = 1.54, 95% CI = 1.34-1.78), current smokers (HR = 1.18, 95% CI = 1.01-1.37), patients with metastasis (HR = 2.19, 95% CI = 1.95-2.47), and patients not receiving first-line surgery treatment (HR = 2.11, 95% CI = 1.82-2.45). We discovered limited improvements in OS over time among individuals diagnosed with STS or bone sarcomas with the exception of gastrointestinal stromal tumors (GIST), which showed a significant improvement in OS across time periods (p = 0.0034). Overall, we identified well-established characteristics associated with OS (e.g., metastasis) in addition to factors (e.g., smoking status) not previously reported to impact OS. Improvements in survival over time have been relatively modest, suggesting the need for improved therapeutic options, especially for those diagnosed with less frequent sarcomas.

Keywords: bone sarcoma; cancer registry; epidemiology; sarcoma; soft tissue sarcoma; survival.

Grants and funding

This research received no external funding.