Advanced soft tissue sarcoma: prognostic factors and aspects of trial methodology

Abstract

A general description of soft tissue sarcomas and their treatments is given in Chapter 1. The chapter also provides an introduction to the work on prognostic factors that is described in this thesis.A general description of soft tissue sarcomas and their treatments is given in Chapter 1. The chapter also provides an introduction to the work on prognostic factors that is described in this thesis. In chapter 2, we have identified the characteristics of the patients (and of their disease) influencing the survival expectation and the probability to respond to first line chemotherapy for advanced disease. Not surprisingly, advanced age is an adverse prognostic factor of survival and response to therapy. Poor performance adversely affects survival but not the probability of response to first line therapy. The number and size of the lesions does not affect response and neither survival, at the time of diagnosis of advanced disease. The survival prognosis is more favorable if the sarcoma was diagnosed at least 2 years before chemotherapy was needed. Patients who were initially diagnosed with low grade disease have a longer survival expectation, despite the fact that they respond less frequently to chemotherapy; and they are probably not appropriate candidates to test the activity of new drugs, especially if response is used as principal end-point