Prognostic analysis of surgically treated clear cell sarcoma: an analysis of a rare tumor from a single center

• DOI: 10.1007/s10147-019-01487-x
• Publication Date: 2019-06-26T18:12:20Z
• Authors: Shiqi Chen; Peng Luo; Lingge Yang; Biqiang Zheng; Zhengwang Sun; Wangjun Yan; Chunmeng Wang
• Keywords: Adult; Blood Platelets; Male; 0301 basic medicine; Adolescent; Neutrophils; Kaplan-Meier Estimate; Middle Aged; Prognosis; Disease-Free Survival; 3. Good health; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Multivariate Analysis; Humans; Original Article; Female; Lymphocytes; Sarcoma, Clear Cell; Biomarkers; Aged; Proportional Hazards Models; Retrospective Studies

The objective of this retrospective study was to evaluate the prognostic value of various factors in clear cell sarcoma patients after radical surgery.Forty-two clear cell sarcoma patients from August 2006 to March 2018 were included in the study. Curves of disease-free survival and overall survival were calculated using the Kaplan-Meier method, and univariate and multivariate analyses of various prognostic factors were performed using a Cox proportional hazard regression model. Laboratory test of peripheral blood was recorded before surgery. The optimal cutoff value of systemic inflammatory markers was defined by receiver-operating curve analysis.The 5-year DFS and 5-year OS rate were 22% and 46%, respectively. The median DFS and OS times were 12 and 41.5 months, respectively. In univariate analysis, there was a significant association between shorter DFS and tumor size larger than 5 cm (p = 0.0043), positive surgical margin (p = 0.0233), and the neutrophil-to-lymphocyte ratio (NLR) higher than 2.73 (p = 0.0009). Furthermore, we observed a significant association between shorter OS and tumor size larger than 5 cm (p = 0.0075), positive surgical margin (p = 0.0101), NLR higher than 2.73 (p = 0.0126), the platelet-to-lymphocyte ratio (PLR) higher than 103.89 (p = 0.0147) and the lymphocyte-to-monocyte ratio (LMR) lower than 4.2 (p = 0.0445). A multivariate analysis demonstrated that the surgical margin (p = 0.013) and NLR (p = 0.001) were significantly associated with DFS. Tumor size (p = 0.010) and NLR (p = 0.013) were independent prognostic factors for OS.This study had the second largest sample around the world and preoperative NLR may be a useful prognostic factor in CCS patients after radical surgery.