Early outcomes of soft tissue sarcomas presenting with metastases and treated with chemotherapy

Objectives: The purpose of this study is to describe outcomes for patients with metastatic soft tissue sarcoma treated with chemotherapy. Methods: We retrospectively reviewed the records of 383 soft tissue sarcoma patients treated at our institution from 1997 to 2006. Thirty-five patients met the inclusion criteria-metastatic disease on presentation; primary tumor outside the abdomen; treatment with chemotherapy; and minimum follow-up of 3 months. Treatments were individualized and determined by a multidisciplinary oncology team. Patient survival was calculated from the diagnostic biopsy to the date of death or last follow-up using the Kaplan-Meier method. Results: Mean age was 47 years (range 17-74 years). Most common tumors involved were MFH and leiomyosarcoma. Sixteen of 35 (46%) patients had died at last follow-up. Mean patient survival was 24 months (range 4-102). The 2-year and 5-year survival rates were 64% and 24%, respectively. Twenty-nine patients (83%) presented with pulmonary metastasis, 6 with bone metastases (17%), 4 with regional node metastases (11%), and 4 with soft tissue metastases (11%). Survival was the same for those with pulmonary and only extrapulmonary metastases. The 10 patients with complete resection or complete chemotherapy response of all detectable lesions had longer mean survival (34 months) than the 25 patients who had partial/no resection or response (20 months) (P = 0.02). Conclusions: Soft tissue sarcoma patients presenting with metastatic disease have a low survival rate, but complete eradication of tumor correlated with longer survival. Longer-term studies especially those tracking the outcome of complete responders and those completely resected will help determine the efficacy of chemotherapy.