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

Autor: Neel DV; Harvard Medical School, Boston, Massachusetts, USA., Ma C; Centre for Addiction and Mental Health, Toronto, Ontario, Canada.; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada., Collins NB; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA., Hornick JL; Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA., Demetri GD; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute and Ludwig Center at Harvard, Boston, Massachusetts, USA., Shulman DS; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Jan; Vol. 12 (1), pp. 170-178. Date of Electronic Publication: 2022 Jun 07.
DOI: 10.1002/cam4.4909
Abstrakt: 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 <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 <21 years of age OR tumor <7.5 cm and female sex), intermediate-risk (local/regional stage, age ≥ 21 years with either male sex and tumor <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 < 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.
(© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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