According to a study published in the Journal of Clinical Oncology, factors that were linked with an increased risk of distant metastases in adult patients with high-grade, soft-tissue sarcoma were tumor size, tumor grade, and certain chromosomal abnormalities.
Soft tissue sarcoma is a cancer that develops in tissues such as muscle, tendons, fat, joints, and blood or lymph vessels. More than one-third of patients with soft tissue sarcoma will have cancer the spreads to distant sites of the body, most commonly the lung. Currently, the ability to predict which patients will develop distant metastases is limited, and depends largely on factors such as tumor size and grade.
In order to determine whether information about specific chromosomal abnormalities is linked with the likelihood of distant metastases, researchers in Sweden conducted a study among two groups of patients with soft tissue sarcoma of the extremities or trunk wall. The first group consisted of 122 patients, 59 of whom (48%) developed distant metastases. The second group consisted of 156 patients, 65 of whom (42%) developed distant metastases.
Using the first group of patients, the researchers identified 10 chromosomal changes that were more common in patients who developed distant metastases than in patients who did not develop distant metastases. The researchers then tested whether these chromosomal changes also predicted outcomes in the second set of patients.
- Of the 10 chromosomal abnormalities that were linked with an increased risk of distant metastases in the first group of patients, three were also linked with an increased risk of metastases in the second group of patients.
- When both groups of patients were combined, the four factors that were linked with an increased risk of distant metastases were tumor grade 3, tumor size of 5 cm or larger, and abnormalities in chromosome regions 1p1 and 6p1.
- Although each of these four factors was linked with risk of distant metastases, the ability to accurately predict risk remains relatively poor. Though specific chromosomal changes were more common in patients who developed distant metastases than in patients who did not develop distant metastases, many patients with distant metastases did not have evidence of these chromosomal changes.
The researchers conclude that information about specific chromosomal changes provides prognostic information in patients with soft tissue sarcoma. These chromosomal changes have limitations as prognostic markers, however, since they were present in some patients who did not develop distant metastases and absent in some patients who did develop distant metastases.
Reference: Mertens F, Stromberg U, Rydholm A et al. Prognostic Significance of Chromosome Aberrations in High-Grade Soft Tissue Sarcoma. Journal of Clinical Oncolgy. 2006;24:315-320.