The clinical outcomes of undifferentiated pleomorphic sarcoma (UPS): A single-centre experience of two decades with the assessment of PD-L1 expressions. Issue 7 (July 2020)

• Record Type: Journal Article
• Authors: Lee, Kyoungmin; Song, Joon Seon; Kim, Jeong Eun; Kim, Wanlim; Song, Si Yeol; Lee, Min Hee; Chung, Hye Won; Cho, Kyung-Ja; Lee, Jong-Seok; Ahn, Jin-Hee
• Is Part Of: European journal of surgical oncology. Volume 46:Issue 7(2020)
• Page Start: 1287
• Page End: 1293
• Publication Date: 2020-07
• Subjects: Undifferentiated pleomorphic sarcoma -- Prognosis -- Adjuvant treatment -- PD-L1 expression; : UPS undifferentiated pleomorphic sarcoma -- DFS disease-free survival -- STS soft tissue sarcoma -- MFH malignant fibrous histiocytoma -- PD-1 programmed cell death protein 1 -- PD-L1 programmed cell death-ligand 1 -- AMC Asan Medical Center -- OS overall survival -- HR hazard ratio -- CI confidence interval -- IQR interquartile range; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2020.02.029
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Introduction: Little is known about undifferentiated pleomorphic sarcoma (UPS) because of the low incidence and heterogeneous diagnosis of sarcoma. We investigated the oncologic outcomes of patients with UPS in a real-practice setting in association with adjuvant treatments and assessment of PD-L1 expression. Materials and methods: We retrospectively reviewed consecutive patients who were diagnosed with UPS in Asan Medical Center between January 1995 and December 2016. PD-L1 staining was performed using formalin-fixed paraffin-embedded tumour tissue by immunohistochemistry, and positive PD-L1 expression was defined as staining in ≥1% of tumour cells. The PD-L1 H-score, which was calculated for statistical analysis as intensity (0–3) multiplied by proportion (0–100), ranged from 0 to 300. Results: Of 205 patients included in our analysis, 176 underwent a curative-intent operation for localised disease. The five-year disease-free survival (DFS) rate of resected UPS patients was 54.3%. Administration of adjuvant therapy did not overcome the poor prognostic factors such as primary tumour size (>5 cm) and locations, especially the abdomen and pelvis. The PD-L1 analysis was available for 114 patients, and 83 (72.8%) showed immunoreactivity for PD-L1 with weak (44/83), intermediate (29/83), and strong (10/83) staining intensities. The positive PD-L1 expression seemed to be associated with prolonged DFS, though no statistical significance was observed. Conclusion: Complete surgical resection was the most important UPS treatment strategy, and adjuvant radio- or chemotherapy was insufficient to improve survival. Our results raise the possibility that immunotherapy could be a breakthrough in the treatment of UPS patients.