EPITHELIOID SARCOMA - CLINICAL BEHAVIOR AND PROGNOSTIC FACTORS OF SURVIVAL

Background: Epithelioid sarcoma is a rare histologic subtype of sarcom a. The clinical behavior and prognostic factors influencing survival i n this disease are examined. Methods: A review of clinicopathologic fe atures of patients with epithelioid sarcoma prospectively followed bet ween July 1982 and July 1995 at Memorial Sloan-Kettering Cancer Center was performed. Kaplan-Meier and log-rank analysis were used. Results: Eleven men (69%) and five women (31%) were treated during this period . Mean age at diagnosis was 33 years, and length of symptoms before di agnosis was 18 months. Tumors presented in the trunk in 44% of patient s, the lower extremity in 31%, and the upper extremity in 25%. Median follow-up time was 45 months. At least one local recurrence was experi enced by 69% of patients. Metastases to regional lymph nodes during th e course of the disease developed in 44% of patients and to the lungs in 44%. Median survival was 88.8 months, with a 66% 5-year survival ra te. Pulmonary metastasis was correlated with decreased survival. Concl usions: A delay in diagnosis of epithelioid sarcoma is common. Epithel ioid sarcoma differs from other sarcoma subtypes in propensity for nod al spread and local recurrence. Careful follow-up evaluating local rec urrence, nodal spread, and pulmonary metastases is warranted.