Clinicopathologic Features And Prognostic Factors Of Stage ? Or ? Undifferentiated Pleomorphic Sarcoma:A Retrospective Study Of 166 Cases

Objective Undifferentiated pleomorphic sarcoma(UPS)is one of the most common pathological types in soft tissue sarcoma.Exploring the clinicopathological features and prognostic factors of this tumor can help standardize the diagnosis and treatment strategy.Methods A retrospective analysis of 166 patients with stage ? and ? UPS who had undergone surgery in our hospital from January 2005 to January 2018 in the trunk and extremities was performed using Kaplan-Meier and Cox regression models.And multi-factor survival analysis,study the relationship between gender,age,tumor characteristics,tumor stage,pathological characteristics,treatment methods and recurrence,metastasis and survival(P<0.05).Results The UPS patients included in the study underwent surgical treatment in our hospital.The overall survival rates at 3 and 5 years were 81.7%and 76.4%,respectively.The 5-year local recurrence rate(LRFS)and no distant metastasis rate(DMFS)were 74.4%and 67.6%,respectively.Univariate analysis showed that the 3-year and 5-year survival rates of UPS patients were significantly correlated with age,tumor recurrence,tumor size,AJCC stage,surgical margin,Ki67,Vimentin(P<0.05).The 3-year and 5-year recurrence rates of UPS patients were significantly associated with gender,tumor recurrence,surgical margin,and Ki67(both P<0.05).The 3-year and 5-year metastasis rates of UPS patients were significantly associated with age,tumor recurrence,tumor location,margin,Vimentin,and adjuvant chemotherapy(both P<0.05).Cox multivariate analysis showed that the tumor site and surgical margin were independent risk factors for the overall survival of UPS patients.Gender and surgical margin are independent risk factors for recurrence of UPS patients.Age,tumor location,surgical margin,and adjuvant chemotherapy are independent risk factors for the distant metastasis rate of UPS patients.Conclusion The prognosis of UPS is poor,easy to recur and metastasis,and the prognostic factors are complex.Patients with tumor in the trunk,positive margin,Ki67>40%,and strong positive Vimentin expression had poor prognosis.Women,positive margins,and patients with Ki67>40%had a high loeal recurrenee rate.Patients with an age>60 years,tumor in the trunk,positive margin,and a strong positive Vimentin expression are prone to distant metastases.A complete wild resection of the first visit to the primary patient helps to significantly reduce local recurrence and significantly improve prognosis.Assisted chemoradiotherapy did not significantly improve overall survival and reduced recurrence and metastasis rates,which may be related to the lack of strict selection criteria for adjuvant therapy.More molecular mechanisms are needed to explore the feasibility of targeting and immunotherapy,standardize diagnosis and treatment,and improve prognosis.