Dalal et al developed a nomogram for predicting survival in a patient with a primary liposarcoma arising in the retroperitoneum, trunk or extremity. This can help identify patients who may benefit from more aggressive management or a novel therapeutic approach. The authors are from Memorial Sloan-Kettering Cancer Center and the Cleveland Clinic.
Outcome: disease-specific outcome
Parameters:
(1) gender of the patient
(2) age of the patient (from 10 to 100 years)
(3) presentation
(4) tumor depth relative to fascia
(5) location
(6) histology
(7) margin status at resection
(8) tumor burden in cm (presumably the diameter)
points for age =
= (0.602 * (age in years)) - 6.02
|
Parameter |
Finding |
Points |
|---|---|---|
|
gender of the patient |
female |
0 |
|
|
male |
10.7 |
|
presentation status |
no prior surgical therapy |
30.2 |
|
|
prior surgical excision |
0 |
|
|
biopsy |
40.5 |
|
tumor depth |
deep |
0 |
|
|
superficial |
11.6 |
|
location |
lower extremity |
0 |
|
|
upper extremity |
4.6 |
|
|
trunk |
9.8 |
|
|
retroperitoneum without organ resection |
38.2 |
|
|
retroperitoneum with contiguous organ resection |
41.7 |
|
histology |
well-differentiated |
0 |
|
|
myxoid |
39.4 |
|
|
round cell 5 - 25% |
66.5 |
|
|
round cell > 25% |
79.2 |
|
|
dedifferentiated |
60.1 |
|
|
pleomorphic |
100 |
|
margin status |
microscopically positive |
0 |
|
|
negative |
3.6 |
|
|
grossly positive |
44.8 |
|
Tumor Burden in cm |
Points |
|---|---|
|
0 to 30 cm |
(-0.071 * ((cm)^2)) + (4.428 * (cm)) - 0.270 |
|
30 to 140 cm |
(0.1556 * (cm)) +63.86 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 350 or more
• The higher the score the worse the disease-specific survival.
|
Total Score |
12 Year Disease Specific Survival |
|---|---|
|
< 49 |
> 99% |
|
49 - 268 |
X = (-0.000121 * ((score)^2)) + (0.00019 * (score)) + 4.623 probability = 1 / (1 + EXP((-1) *X)) |
|
> 268 |
< 1% |
|
Total Score |
12 Year Disease Specific Survival |
|---|---|
|
< 49 |
> 99% |
|
49 - 106 |
95 - 99% |
|
107 - 200 |
(-0.000049 * ((score)^2)) + (0.01017 * (score)) + 0.4149 |
|
177 - 244 |
(-0.009006 * (score)) + 2.296 |
|
244 - 268 |
(0.000066 * ((score)^2)) - (0.03799 * (score)) + 5.484 |
|
> 268 |
< 1% |
|
Total Score |
5 Year Disease Specific Survival |
|---|---|
|
< 74 |
> 99% |
|
74 - 293 |
Y = (-0.000122 * ((score)^2)) + (0.00634 * (score)) + 4.544; probability = 1 / (1 + EXP((-1) *Y)) |
|
> 293 |
< 1% |
|
Total Score |
5 Year Disease Specific Survival |
|---|---|
|
< 74 |
> 99% |
|
74 - 133 |
95 - 99% |
|
133 - 202 |
(-0.000042 * ((score)^2)) + (0.01066 * (score)) + 0.2826 |
|
186 - 246 |
(-0.000051 * ((score)^2)) + (0.01368 * (score)) + 0.0156 |
|
246 - 293 |
(0.000079 * ((score)^2)) - (0.04849 * (score)) + 7.451 |
|
> 293 |
< 1% |
Purpose: To determine the prognosis for a patient with a primary liposarcoma of the retroperitoneum, trunk or extremity based on the nomogram of Dalal et al.
Specialty: Hematology Oncology, Surgery, general, Surgery, orthopedic
Objective: severity, prognosis, stage
ICD-10: C49.9,
