MRI features outperform histologic grade for outcome prediction in translocation-driven enriched soft-tissue sarcoma.

IF 4.8 2区医学 Q2 ONCOLOGY

Cancer Imaging Pub Date : 2026-06-22 DOI:10.1186/s40644-026-01080-2

Han-Ying Lin, Ching-Lan Wu, Chih-Hsueh Chen, Chueh-Chuan Yen, Chao-Ming Chen, Chien-An Liu, Po-Kuei Wu, Hung-Ta Wu, Chung-Jung Lin

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引用次数: 0

Abstract

Background: Most MR-based prognostic series in soft-tissue sarcoma (STS) were derived in cohorts dominated by complex-karyotype histologies; whether conventional MR descriptors retain prognostic value in translocation-driven enriched populations is unclear. The purpose of our study is to identify preoperative MR features independently associated with overall survival (OS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS) in a translocation-driven enriched soft-tissue sarcoma cohort.

Methods: In this retrospective single-center study, consecutive adults with histologically confirmed STS who underwent contrast-enhanced MRI before treatment between January 2008 and December 2024 were evaluated. Two radiologists blinded to outcome independently scored 13 prespecified MR features. Cox regression adjusted for age, sex, maximum tumor diameter, and Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade was used to estimate hazard ratios (HRs); a sensitivity analysis added translocation-driven histology.

Results: A total of 158 patients (mean age, 48 years ± 19 [SD]; 84 men) were evaluated; 61 of 152 classifiable patients (40%) had translocation-driven tumors. After adjustment for age, sex, and maximum tumor diameter, heterogeneous gadolinium enhancement was independently associated with shorter OS (HR, 3.9 [95% CI: 1.4, 10.7]; P = .008). Peritumoral edema was independently associated with shorter OS (HR, 2.0 [95% CI: 1.0, 3.7]; P = .04) and was the single independent MR predictor of LRFS (HR, 2.3 [95% CI: 1.2, 4.5]; P = .01). Both associations persisted after adjustment for translocation-driven histology. A 13-feature MR panel did not discriminate FNCLCC grade 3 (area under the curve [AUC], 0.59).

Conclusion: Peritumoral edema and heterogeneous gadolinium enhancement were independent, complementary MR predictors of outcome in translocation-driven enriched soft-tissue sarcoma, outperforming FNCLCC grade and molecular histologic class. These findings require prospective multicenter validation before clinical application.

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MRI特征优于组织学分级预测易位驱动的富集型软组织肉瘤的预后。

背景：大多数基于mri的软组织肉瘤（STS）预后系列来源于以复杂核型组织学为主的队列；传统的MR描述符是否在易位驱动的富集人群中保留预后价值尚不清楚。本研究的目的是在易位驱动的富集型软组织肉瘤队列中确定与总生存期（OS）、局部无复发生存期（LRFS）和无转移生存期（MFS）独立相关的术前MR特征。方法：在这项回顾性单中心研究中，对2008年1月至2024年12月治疗前接受对比增强MRI检查的连续组织学证实的STS成人患者进行评估。两名对结果不知情的放射科医生独立对13个预先指定的MR特征进行评分。Cox回归校正了年龄、性别、最大肿瘤直径和FNCLCC分级，用于估计风险比（hr）；敏感性分析增加了易位驱动组织学。结果：共纳入158例患者（平均年龄48岁±19 [SD]，男性84例）；152例可分类患者中有61例（40%）为易位驱动型肿瘤。在调整了年龄、性别和最大肿瘤直径后，异质性钆增强与较短的OS独立相关（HR, 3.9 [95% CI: 1.4, 10.7]; P = 0.008）。肿瘤周围水肿与较短的OS独立相关（HR, 2.0 [95% CI: 1.0, 3.7]; P = .04），并且是LRFS的单一独立MR预测因子（HR, 2.3 [95% CI: 1.2, 4.5]; P = .01）。在对易位驱动的组织学进行调整后，这两种关联仍然存在。13个特征的MR面板不能区分FNCLCC 3级（曲线下面积[AUC]， 0.59）。结论：肿瘤周围水肿和非均质钆增强是易位驱动的富集型软组织肉瘤预后的独立、互补的MR预测指标，优于FNCLCC分级和分子组织学分级。这些发现需要在临床应用前进行前瞻性多中心验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Imaging ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

7.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Cancer Imaging is an open access, peer-reviewed journal publishing original articles, reviews and editorials written by expert international radiologists working in oncology. The journal encompasses CT, MR, PET, ultrasound, radionuclide and multimodal imaging in all kinds of malignant tumours, plus new developments, techniques and innovations. Topics of interest include: Breast Imaging Chest Complications of treatment Ear, Nose & Throat Gastrointestinal Hepatobiliary & Pancreatic Imaging biomarkers Interventional Lymphoma Measurement of tumour response Molecular functional imaging Musculoskeletal Neuro oncology Nuclear Medicine Paediatric.