Abstract

Introduction: This study aimed to assess the effects of cancer treatment on sarcoma types and to predict overall survival probabilities using nomograms.

Methods: This study uses the SEER-18 database, version 2020, sponsored by the National Cancer Institute (NCI). The study cohort included participants diagnosed between 2000 and 2018 with soft tissue cancers including heart. A multivariable stratified Cox proportional hazards model was applied to predict mortality rate and nomograms were used to predict overall survival probability.

Results: The median survival time for 24,849 study participants was 48 months (IQR: 19-102) with Spindle cell Sarcoma (ScS) having a shorter median survival time compared with Liposarcoma (LiS). A significant number of Soft Tissue Sarcoma (STS) patients had surgery, where surgery on ScS improved survival by 75% (HR: 0.25, 95% CI: 0.19-0.32, p<0.001) and those who received radiation had a 26% improvement (HR: 0.74, 95% CI: 0.61-0.89, p=0.001). Furthermore, chemotherapy on GcS resulted in a 40% reduction in mortality for patients compared to those who did not receive chemotherapy (HR: 0.60, 95% CI: 0.45-0.80, p<0.001). Based on nomogram, after two, five and ten years, a patient who received surgery on their primary sites would have a survival rate of approximately 90%. In contrast, a patient who did not receive surgery on their primary sites would only live for 20% or less. Patients with MyS have a 90% chance of surviving for 5 and 10 years after surgical intervention, but only 22% and 10% without surgery.

Conclusion: Based on the results of this study, surgical and radiation intervention was associated with improved survival in patients with STS, while chemotherapy and primary systemic therapy had contradictory effects.

Keywords: Soft tissue sarcoma, Cancer stages, Survival, Cancer treatment, Stratified cox model