Prognostic factors for the outcome of chemotherapy in advanced soft tissuesarcoma: An analysis of 2,185 patients treated with anthracycline-containing first-line regimens - A European Organization for Research and Treatmentof Cancer Soft Tissue and Bone Sarcoma Group Study

Purpose: A total of 2,185 patients with advanced soft tissue sarcomas who h ad been treated in seven clinical trials investigating the use of doxorubic in- or epirubicin-containing regimens as first-line chemotherapy were studi ed in this prognostic-factor analysis. Patients and Methods:: Overall survival time (median, 51 weeks) and respons e to chemotherapy (26% complete response or partial response) were the two end paints. The cofactors were sex; age; performance status; prior therapie s; the presence of locoregional or recurrent disease; lung, liver and bone metastases at the rime of entry onto the trial: long time period between th e initial diagnosis of sarcoma and entry onto the study; and histologic typ e and grade. Results: Univariate analyses showed (a) a significant, favorable influence of good performance status, young age, and absence of river metastases on b oth survival time and response rate, (b) a significant, favorable influence of low histopathologic disease grade on survival time, despite a significa ntly lower response rate, (c) increased survival time for patients with a l ong time period between the initial diagnosis of sarcoma and entry onto the study, despite equivalent response rates, and (d) increased survival time with liposarcoma or synovial sarcoma, a decreased survival time with malign ant fibrous histiocytoma, a lower response rare with leiomyosarcoma, and a higher response rate with liposarcoma (P < .05 for all log-rank and chi(2) tests). The Cox model selected good performance status (P < .0001), absence of liver metastases (P = .0001), low histopathologic grade (P = .0002), lo ng time lapse since initial diagnosis (P = .0004), and young age (P = .0045 ) as favorable prognostic factors of survival time. The logistic model sele cted absence of liver metastases (P .0001), young age(P = .0024), high hist opathologic grade (P = .0051), and liposarcoma (P = .0065) as favorable pro gnostic factors of response race. Conclusion: This analysis demonstrates that for advanced soft tissue sarcom a, response to chemotherapy is no, predicted by the same factors as is over all survival time. This needs to be taken into account in the interpretatio n of trials assessing the value of new agents for this disease on the basis of response to treatment. J Clin Oncol 17:150-157. (C) 1999 by American Society of Clinical Oncology.