We are analyzing https://link.springer.com/article/10.1007/bf02303698.

Title:
Primary gastrointestinal sarcomas: Analysis of prognostic variables | Annals of Surgical Oncology
Description:
Background: Primary gastrointestinal sarcomas are uncommon, and the clinicopathological determinants of survival remain unclear. In order to correlate clinical presentation, pathological assessment, and treatment with outcome, we have analyzed our institution
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         headline:Primary gastrointestinal sarcomas: Analysis of prognostic variables
         description: Background: Primary gastrointestinal sarcomas are uncommon, and the clinicopathological determinants of survival remain unclear. In order to correlate clinical presentation, pathological assessment, and treatment with outcome, we have analyzed our institution's recent experience with these tumors. Methods: Records of adult patients admitted to our institution between July 1982 and December 1991 were reviewed. Results: During this period, 38 adult patients (>16 years of age) were admitted to our institution with a primary gastrointestinal sarcoma. They accounted for 2% of all adult sarcoma admissions during that period. The study population was composed of 26 men and 12 women. Ages ranged from 29 to 82 years (mean 59). Disease was localized to the primary site in 30 patients (81%). The stomach was the most frequent site of disease (20 cases). The small bowel was affected in nine cases (five duodenum, four jejunum) and the large bowel in nine cases (two colon, seven rectum). Ninety-two percent of patients were symptomatic at presentation. A complete resection was performed in 27 cases, incomplete resection in seven cases, and biopsy only in the remaining three patients. Nine patients received doxorubicin-based chemotherapy. Leiomyosarcoma (n=35) was the predominant histological diagnosis. Twenty-six tumors were classified as high grade (68%) and 12 as low grade (32%). Overall actuarial 5-year survival was 28% (median follow-up 26 months). Weight loss (p=0.02) and pain at presentation (p=0.05) were adverse prognostic factors. Histological grade (p=0.0002), completeness/extent of surgical resection (p=0.005), or a small bowel primary site were significant determinants of overall survival. The resection of contiguous organs did not affect survival if the primary tumor was completely excised (p=0.422). Age, race, sex, presentation (prior surgery), tumor size, or adjuvant therapy were not significant prognostic factors. Recurrence was noted in 44% after complete resection, and mean time to recurrence was 9 months (median 7, range <1–37). Hepatic metastases (42%) and local recurrence (42%) were the predominant sites of initial failure. For patients with a complete resection, grade was the major prognostic determinant (5-year survival: high grade/complete resection 18% vs. low grade/complete resection 72%, p=0.002). Conclusion: The prognosis of gastrointestinal sarcomas is poor. Complete surgical excision is the optimal therapy. However, our results suggest that surgery alone is inadequate for high-grade tumors. We believe that these patients should be considered candidates for investigational adjuvant therapies.
         datePublished:
         dateModified:
         pageStart:26
         pageEnd:31
         sameAs:https://doi.org/10.1007/BF02303698
         keywords:
            Sarcoma
            Gastrointestinal tumors
            Surgical Oncology
            Oncology
            Surgery
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               type:ImageObject
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         author:
               name:Kevin C. Conlon
               affiliation:
                     name:Memorial Sloan-Kettering Cancer Center
                     address:
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                        type:PostalAddress
                     type:Organization
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               name:Ephraim S. Casper
               affiliation:
                     name:Memorial Sloan-Kettering Cancer Center
                     address:
                        name:the Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Murray F. Brennan
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                     name:Memorial Sloan-Kettering Cancer Center
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ScholarlyArticle:
      headline:Primary gastrointestinal sarcomas: Analysis of prognostic variables
      description: Background: Primary gastrointestinal sarcomas are uncommon, and the clinicopathological determinants of survival remain unclear. In order to correlate clinical presentation, pathological assessment, and treatment with outcome, we have analyzed our institution's recent experience with these tumors. Methods: Records of adult patients admitted to our institution between July 1982 and December 1991 were reviewed. Results: During this period, 38 adult patients (>16 years of age) were admitted to our institution with a primary gastrointestinal sarcoma. They accounted for 2% of all adult sarcoma admissions during that period. The study population was composed of 26 men and 12 women. Ages ranged from 29 to 82 years (mean 59). Disease was localized to the primary site in 30 patients (81%). The stomach was the most frequent site of disease (20 cases). The small bowel was affected in nine cases (five duodenum, four jejunum) and the large bowel in nine cases (two colon, seven rectum). Ninety-two percent of patients were symptomatic at presentation. A complete resection was performed in 27 cases, incomplete resection in seven cases, and biopsy only in the remaining three patients. Nine patients received doxorubicin-based chemotherapy. Leiomyosarcoma (n=35) was the predominant histological diagnosis. Twenty-six tumors were classified as high grade (68%) and 12 as low grade (32%). Overall actuarial 5-year survival was 28% (median follow-up 26 months). Weight loss (p=0.02) and pain at presentation (p=0.05) were adverse prognostic factors. Histological grade (p=0.0002), completeness/extent of surgical resection (p=0.005), or a small bowel primary site were significant determinants of overall survival. The resection of contiguous organs did not affect survival if the primary tumor was completely excised (p=0.422). Age, race, sex, presentation (prior surgery), tumor size, or adjuvant therapy were not significant prognostic factors. Recurrence was noted in 44% after complete resection, and mean time to recurrence was 9 months (median 7, range <1–37). Hepatic metastases (42%) and local recurrence (42%) were the predominant sites of initial failure. For patients with a complete resection, grade was the major prognostic determinant (5-year survival: high grade/complete resection 18% vs. low grade/complete resection 72%, p=0.002). Conclusion: The prognosis of gastrointestinal sarcomas is poor. Complete surgical excision is the optimal therapy. However, our results suggest that surgery alone is inadequate for high-grade tumors. We believe that these patients should be considered candidates for investigational adjuvant therapies.
      datePublished:
      dateModified:
      pageStart:26
      pageEnd:31
      sameAs:https://doi.org/10.1007/BF02303698
      keywords:
         Sarcoma
         Gastrointestinal tumors
         Surgical Oncology
         Oncology
         Surgery
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            1534-4681
            1068-9265
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         name:Springer-Verlag
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      author:
            name:Kevin C. Conlon
            affiliation:
                  name:Memorial Sloan-Kettering Cancer Center
                  address:
                     name:Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Ephraim S. Casper
            affiliation:
                  name:Memorial Sloan-Kettering Cancer Center
                  address:
                     name:the Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Murray F. Brennan
            affiliation:
                  name:Memorial Sloan-Kettering Cancer Center
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                     name:Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA
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            name:Memorial Sloan-Kettering Cancer Center
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               name:the Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York
               type:PostalAddress
            type:Organization
      name:Murray F. Brennan
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            name:Memorial Sloan-Kettering Cancer Center
            address:
               name:Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA
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