The Prognostic Significance of Sarcoma Metastases to Skin
W-L Wang, RA Bones Valentin, DC Lev, VG Prieto, AJ Lazar. The University of Texas M.D. Anderson Cancer Center, Houston, TX
Background: Sarcoma metastases to skin are relatively rare as most metastases involve lung, liver or deeper soft tissues. Here we examine the distribution and clinical significance of cutaneous and superficial subcutaneous sarcoma metastases.
Design: 65 patients with histologically confirmed dermal and superficial subcutaneous sarcoma metastases were identified in pathology files from more than 25,000 sarcoma patients evaluated at M. D. Anderson (1989-2009). Pathology slides, clinical and radiologic information were evaluated.
Results: Cutaneous metastases were histologically documented in less than 0.25% of more than 25,000 sarcoma patients. The mean patient age was 49 years (16-79) with equivalent gender ratio. The most common source was leiomyosarcoma (28/65, 43%; see Table 1). The most common region of first skin metastasis was head and neck (33, 51%) with the scalp predominating (25,38%). Mean time from primary tumor diagnosis to skin metastasis was 48 months (0-166). 53 patients (81%) had multiple metastases (skin & other). In patients with complete clinical information available, 31 (62%) had other metastases prior to skin involvement, 17 (34%) had skin metastases first and 2 (4%) had simultaneous presentation. Clinical outcome was: 29 (45%) dead of disease; 24 (37%) alive with disease; 12 lost to follow up. Mean time to death was: (1) 80 (9-224) months from primary diagnosis; 45 (5-94) from first metastasis to any site; 27 (5-65) months from first skin metastasis.
|Epithelioid Sarcoma||n= 5|
|Undifferentiated Pleomorphic Sarcoma||n= 4|
|Alveolar Soft Part Sarcoma||n= 3|
|Synovial Sarcoma||n= 2|
|Unclassified sarcoma||n= 2|
|Various (10 types, 1 each)||n=10|