Changing odds of survival over time among patients undergoing surgical resection of extremity soft tissue sarcoma

Yongsung Kim, Han Soo Kim, Hwan-Seong Cho, Ilkyu Han

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: While survival after surgical treatment of extremity soft tissue sarcoma (STS) is traditionally reported as actuarial survival, conditional survival (CS) may be more clinically relevant as it accounts for time already survived. We compared actuarial survival and CS of STS patients. Materials and Methods: We analyzed 567 patients who underwent surgery for localized extremity STS. Actuarial survival was estimated using the Kaplan-Meier method. Cox proportional hazards model was used to evaluate factors associated with disease-specific survival. Five-year CS (CS5) estimates at “χ” year(s) after surgery were calculated as CS5 = S(χ + 5)/S(χ). Results: Whereas actuarial survival decreased over time, CS5 increased. The postsurgical 1-, 3-, and 5-year CS5 values were 84.5%, 90.0%, and 93.8%, respectively, whereas the 6-, 8-, and 10-year actuarial survival rates were 82.0%, 79.4%, and 78.5%, respectively. The calculated CS5 exceeded actuarial survival especially in patients with risk factors such as large tumor size and Federation Nationale des Centers de Lutte Contre le Cancer (FNCLCC) grades 2 and 3 tumors. Patients with tumor size ≥5 cm had an actuarial survival of 73.9% at 10 years compared to a CS5 of 95.4% in patients alive at 5 years. Likewise, patients with FNCLCC grade 3 tumors had an actuarial survival of 71.1% at 10 years compared to a CS5 of 96.0% in patients alive at 5 years. Conclusions: Survival estimation by determination of CS can be dynamic and accurate especially in high-risk patients. CS can be useful for survival prediction and clinical decision making in extremity STS patients.

Original languageEnglish
Pages (from-to)193-199
Number of pages7
JournalJournal of Surgical Oncology
Volume120
Issue number2
DOIs
StatePublished - 1 Aug 2019

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Sarcoma
Extremities
Survival
Neoplasms
Proportional Hazards Models
Survival Rate

Keywords

  • actuarial survival
  • conditional survival
  • extremity soft tissue sarcoma

Cite this

@article{42c565d24c164bb186f2a2a0d1965c41,
title = "Changing odds of survival over time among patients undergoing surgical resection of extremity soft tissue sarcoma",
abstract = "Background: While survival after surgical treatment of extremity soft tissue sarcoma (STS) is traditionally reported as actuarial survival, conditional survival (CS) may be more clinically relevant as it accounts for time already survived. We compared actuarial survival and CS of STS patients. Materials and Methods: We analyzed 567 patients who underwent surgery for localized extremity STS. Actuarial survival was estimated using the Kaplan-Meier method. Cox proportional hazards model was used to evaluate factors associated with disease-specific survival. Five-year CS (CS5) estimates at “χ” year(s) after surgery were calculated as CS5 = S(χ + 5)/S(χ). Results: Whereas actuarial survival decreased over time, CS5 increased. The postsurgical 1-, 3-, and 5-year CS5 values were 84.5{\%}, 90.0{\%}, and 93.8{\%}, respectively, whereas the 6-, 8-, and 10-year actuarial survival rates were 82.0{\%}, 79.4{\%}, and 78.5{\%}, respectively. The calculated CS5 exceeded actuarial survival especially in patients with risk factors such as large tumor size and Federation Nationale des Centers de Lutte Contre le Cancer (FNCLCC) grades 2 and 3 tumors. Patients with tumor size ≥5 cm had an actuarial survival of 73.9{\%} at 10 years compared to a CS5 of 95.4{\%} in patients alive at 5 years. Likewise, patients with FNCLCC grade 3 tumors had an actuarial survival of 71.1{\%} at 10 years compared to a CS5 of 96.0{\%} in patients alive at 5 years. Conclusions: Survival estimation by determination of CS can be dynamic and accurate especially in high-risk patients. CS can be useful for survival prediction and clinical decision making in extremity STS patients.",
keywords = "actuarial survival, conditional survival, extremity soft tissue sarcoma",
author = "Yongsung Kim and Kim, {Han Soo} and Hwan-Seong Cho and Ilkyu Han",
year = "2019",
month = "8",
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doi = "10.1002/jso.25487",
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journal = "Journal of Surgical Oncology",
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}

Changing odds of survival over time among patients undergoing surgical resection of extremity soft tissue sarcoma. / Kim, Yongsung; Kim, Han Soo; Cho, Hwan-Seong; Han, Ilkyu.

In: Journal of Surgical Oncology, Vol. 120, No. 2, 01.08.2019, p. 193-199.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Changing odds of survival over time among patients undergoing surgical resection of extremity soft tissue sarcoma

AU - Kim, Yongsung

AU - Kim, Han Soo

AU - Cho, Hwan-Seong

AU - Han, Ilkyu

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Background: While survival after surgical treatment of extremity soft tissue sarcoma (STS) is traditionally reported as actuarial survival, conditional survival (CS) may be more clinically relevant as it accounts for time already survived. We compared actuarial survival and CS of STS patients. Materials and Methods: We analyzed 567 patients who underwent surgery for localized extremity STS. Actuarial survival was estimated using the Kaplan-Meier method. Cox proportional hazards model was used to evaluate factors associated with disease-specific survival. Five-year CS (CS5) estimates at “χ” year(s) after surgery were calculated as CS5 = S(χ + 5)/S(χ). Results: Whereas actuarial survival decreased over time, CS5 increased. The postsurgical 1-, 3-, and 5-year CS5 values were 84.5%, 90.0%, and 93.8%, respectively, whereas the 6-, 8-, and 10-year actuarial survival rates were 82.0%, 79.4%, and 78.5%, respectively. The calculated CS5 exceeded actuarial survival especially in patients with risk factors such as large tumor size and Federation Nationale des Centers de Lutte Contre le Cancer (FNCLCC) grades 2 and 3 tumors. Patients with tumor size ≥5 cm had an actuarial survival of 73.9% at 10 years compared to a CS5 of 95.4% in patients alive at 5 years. Likewise, patients with FNCLCC grade 3 tumors had an actuarial survival of 71.1% at 10 years compared to a CS5 of 96.0% in patients alive at 5 years. Conclusions: Survival estimation by determination of CS can be dynamic and accurate especially in high-risk patients. CS can be useful for survival prediction and clinical decision making in extremity STS patients.

AB - Background: While survival after surgical treatment of extremity soft tissue sarcoma (STS) is traditionally reported as actuarial survival, conditional survival (CS) may be more clinically relevant as it accounts for time already survived. We compared actuarial survival and CS of STS patients. Materials and Methods: We analyzed 567 patients who underwent surgery for localized extremity STS. Actuarial survival was estimated using the Kaplan-Meier method. Cox proportional hazards model was used to evaluate factors associated with disease-specific survival. Five-year CS (CS5) estimates at “χ” year(s) after surgery were calculated as CS5 = S(χ + 5)/S(χ). Results: Whereas actuarial survival decreased over time, CS5 increased. The postsurgical 1-, 3-, and 5-year CS5 values were 84.5%, 90.0%, and 93.8%, respectively, whereas the 6-, 8-, and 10-year actuarial survival rates were 82.0%, 79.4%, and 78.5%, respectively. The calculated CS5 exceeded actuarial survival especially in patients with risk factors such as large tumor size and Federation Nationale des Centers de Lutte Contre le Cancer (FNCLCC) grades 2 and 3 tumors. Patients with tumor size ≥5 cm had an actuarial survival of 73.9% at 10 years compared to a CS5 of 95.4% in patients alive at 5 years. Likewise, patients with FNCLCC grade 3 tumors had an actuarial survival of 71.1% at 10 years compared to a CS5 of 96.0% in patients alive at 5 years. Conclusions: Survival estimation by determination of CS can be dynamic and accurate especially in high-risk patients. CS can be useful for survival prediction and clinical decision making in extremity STS patients.

KW - actuarial survival

KW - conditional survival

KW - extremity soft tissue sarcoma

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U2 - 10.1002/jso.25487

DO - 10.1002/jso.25487

M3 - Article

VL - 120

SP - 193

EP - 199

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

IS - 2

ER -