Brain, the last fortress of sarcoma: Similar dismal outcome but discrepancy of timing of brain metastasis in bone and soft tissue sarcoma

Yi Sheng Chou, Chun Yu Liu, Wei Ming Chen, Tain Hsiung Chen, Paul Chih Hsueh Chen, Hung Ta Hondar Wu, Cheng Ying Shiau, Yu Chung Wu, Chien Lin Liu, Ta Chung Chao, Cheng Hwai Tzeng, Tai-Tong Wong, Chueh Chuan Yen

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Abstract

Background and Objective Brain metastasis is a rare but dismal event in sarcomas. However, the pattern of occurrence and the prognostic factors associated with post-brain metastasis survival (PBMS) are not yet well-characterized. Methods Sarcoma patients treated at one institute within 10-year period were retrospectively reviewed and those with brain metastasis were identified. The incidence of brain metastasis was demonstrated by case per person-years and cumulative incidence curves. Univariate factors associated with PBMS were analyzed. Results Among 611 sarcoma patients, 20 (3.3%) developed brain metastasis. Alveolar soft part sarcoma (ASPS) and osteosarcoma were the most common subtypes. Overall, the cumulative incidence was 3.9% at 5 years and 8.4% at 10 years. However, the incidence in STS patients continued to rise up to 10 years after primary diagnosis, whereas it reached a plateau in bone sarcoma patients at 3 years. Median PBMS was 1.67 months. Univariate factors associated with better PBMS included ASPS histology, initial surgical treatment, and brain irradiation for non-surgically treated patients. Conclusion Our study revealed a discrepancy in the timing of occurrence of brain metastasis between STS and bone sarcoma. However, patients with brain metastasis had a poor prognosis, implicating the brain as the last fortress of sarcoma. J. Surg. Oncol. 2011; 104:765-770. © 2011 Wiley Periodicals, Inc.

Original languageEnglish
Pages (from-to)765-770
Number of pages6
JournalJournal of Surgical Oncology
Volume104
Issue number7
DOIs
Publication statusPublished - Dec 1 2011
Externally publishedYes

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Keywords

  • alveolar soft part sarcoma
  • brain metastasis
  • osteosarcoma
  • soft tissue sarcoma

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Chou, Y. S., Liu, C. Y., Chen, W. M., Chen, T. H., Chen, P. C. H., Wu, H. T. H., Shiau, C. Y., Wu, Y. C., Liu, C. L., Chao, T. C., Tzeng, C. H., Wong, T-T., & Yen, C. C. (2011). Brain, the last fortress of sarcoma: Similar dismal outcome but discrepancy of timing of brain metastasis in bone and soft tissue sarcoma. Journal of Surgical Oncology, 104(7), 765-770. https://doi.org/10.1002/jso.22011