Prognosis and survival for soft tissue sarcoma
A prognosis is the doctor’s best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors.
Your doctor will look at certain aspects of the cancer as well as certain characteristics (such as your age). These are called prognostic factors. Your doctor will also look at predictive factors that influence how a cancer will respond to a certain treatment and how likely it is that the cancer will come back after treatment.
Prognostic and predictive factors are often discussed together. They both play a part in deciding on a prognosis and a treatment plan just for you. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis and chances of survival.
The following are prognostic and predictive factors for soft tissue sarcoma.
Grade
Low-grade tumours have a better prognosis than high-grade tumours.
Size of the tumour
Tumours that are 5 cm or smaller have a better prognosis than tumours larger than 5 cm.
Location of the tumour
Soft tissue sarcomas of the arms, legs or on the surface of the torso usually have a better prognosis than soft tissue sarcomas that start in other parts of the body.
Soft tissue sarcomas closer to the surface of the body have a better prognosis than soft tissue sarcomas that are deep in the body.
If the cancer can be removed with surgery
If doctors think that they can remove most or all of the cancer with surgery, the cancer is resectable. If the cancer can’t be removed with surgery, the cancer is unresectable. Resectable soft tissue sarcoma has a more favourable prognosis than unresectable soft tissue sarcoma.
Stage
A lower-stage soft tissue sarcoma has a better prognosis than a higher-stage soft tissue sarcoma.
If the cancer has spread into the bone, nerves or blood and lymph vessels, the prognosis is less favourable.
Surgical margins
After surgery, the tissue removed is sent to a lab. A pathologist looks at it under a microscope to see if there are cancer cells in the healthy tissue that was taken out along with the tumour (called the surgical margin). A negative surgical margin means that there are no cancer cells at the edges of the tissue removed during surgery. A positive surgical margin means that cancer cells are found at the edges.
Positive surgical margins have a less favourable prognosis than negative surgical margins. A positive surgical margin increases the risk of the cancer coming back (recurrence). If a positive surgical margin is expected, radiation therapy may be used before surgery to reduce the risk of recurrence.
Type of tumour
Some types of soft tissue sarcoma tend to have a worse prognosis, including malignant peripheral nerve sheath tumours (MPNSTs), leiomyosarcoma, undifferentiated pleomorphic sarcoma, desmoplastic small round cell tumours and epithelioid sarcoma. These tumour types are usually larger, deeper and high grade.
Age
People older than 60 who are diagnosed with soft tissue sarcoma have a poorer prognosis than younger people.
Survival statistics for soft tissue sarcoma
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