Real-World Trends and Outcomes for Localized High-Grade Soft Tissue Sarcoma: Insights from a Sarcoma Unit in Australia
- Author(s)
- Shahnam, A; Lewin, J; Hamilton, A; Luen, SJ; Desai, J; Orme, L; Gyorki, D; Snow, H; Di Bella, C; O'Reilly-Harbidge, S; Pang, G; Chu, J; Chander, S; Fong, S; Slavin, J; Mitchell, C; Bae, S;
- Journal Title
- Asia-Pacific Journal of Clinical Oncology
- Publication Type
- Online publication before print
- Abstract
- AIMS: This study aimed to evaluate temporal trends in treatment patterns for localized soft tissue sarcomas (STSs) and identify factors associated with relapse-free survival (RFS) and overall survival (OS). METHODS: A retrospective cohort study was conducted using the Australian Comprehensive Cancer Outcomes and Research Database (ACCORD) and electronic health records from a high-volume sarcoma unit. Patients aged ≥18 years with grade 3, localized STS ≥5 cm diagnosed between 2013 and 2023 were included. The cohort was divided into two periods (2013-2017 and 2018-2023) to assess changes in treatment practices. Kaplan-Meier and Cox proportional hazards models evaluated RFS and OS. RESULTS: Among 202 patients, radiation use decreased in the late period (79% vs. 64%, p = 0.03), with a trend toward increased systemic therapy (8% vs. 16%, p = 0.13). Median RFS was 19 months (95% confidence interval [CI]: 14.9-26.0), with no significant difference between periods (hazard ratio [HR] 1.30, 95% CI: 0.93-1.82, p = 0.13). Median OS was 48 months (95% CI: 38.1-62.9), also showing no difference (HR 1.20, 95% CI: 0.80-1.78, p = 0.38). Radiotherapy improved RFS (HR 0.69, 95% CI: 0.49-0.98, p = 0.04) but not OS. Systemic therapy showed no RFS or OS benefit. Exploratory analyses identified age, tumor size, FDG-PET SUVmax, site, and Sarculator risk as prognostic factors. CONCLUSION: Treatment patterns evolved over time, reflecting emerging evidence, but no significant RFS or OS differences were observed. Further research is needed, including exploring prognostic factors like elevated baseline FDG-PET SUVmax.
- Keywords
- localized; real‐world outcomes; soft tissue sarcoma
- Department(s)
- Medical Oncology; Surgical Oncology; Radiation Oncology; Pathology
- Publisher's Version
- https://doi.org/10.1111/ajco.70043
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2026-01-08 05:22:15
Last Modified: 2026-01-08 05:22:22