BMC Cancer (Feb 2020)

Development of a disease-specific graded prognostic assessment index for the management of sarcoma patients with brain metastases (Sarcoma-GPA)

  • Anna Patrikidou,
  • Loic Chaigneau,
  • Nicolas Isambert,
  • Kyriaki Kitikidou,
  • Ryan Shanley,
  • Isabelle Ray-Coquard,
  • Thibaud Valentin,
  • Bettina Malivoir,
  • Maryline Laigre,
  • Jacques-Olivier Bay,
  • Laurence Moureau-Zabotto,
  • Emmanuelle Bompas,
  • Sophie Piperno-Neumann,
  • Nicolas Penel,
  • Thierry Alcindor,
  • Cécile Guillemet,
  • Florence Duffaud,
  • Anne Hügli,
  • Cécile Le Pechoux,
  • Frédéric Dhermain,
  • Jean-Yves Blay,
  • Paul W. Sperduto,
  • Axel Le Cesne

DOI
https://doi.org/10.1186/s12885-020-6548-6
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 11

Abstract

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Abstract Background Brain metastases from sarcomatous lesions pose a management challenge owing to their rarity and the histopathological heterogeneity. Prognostic indices such as the Graded Prognostic Assessment (GPA) index have been developed for several primary tumour types presenting with brain metastases (e.g. lung, breast, melanoma), tailored to the specifics of different primary histologies and molecular profiles. Thus far, a prognostic index to direct treatment decisions is lacking for adult sarcoma patients with brain metastases. Methods We performed a multicentre analysis of a national group of expert sarcoma tertiary centres (French Sarcoma Group, GSF-GETO) with the participation of one Canadian and one Swiss centre. The study cohort included adult patients with a diagnosis of a bone or soft tissue sarcoma presenting parenchymal or meningeal brain metastases, managed between January 1992 and March 2012. We assessed the validity of the original GPA index in this patient population and developed a disease-specific Sarcoma-GPA index. Results The original GPA index is not prognostic for sarcoma brain metastasis patients. We have developed a dedicated Sarcoma-GPA index that identifies a sub-group of patients with particularly favourable prognosis based on histology, number of brain lesions and performance status. Conclusions The Sarcoma-GPA index provides a novel tool for sarcoma oncologists to guide clinical decision-making and outcomes research.

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