Local Recurrence and Metastasis Define Distinct Recurrence Phenotypes in Soft Tissue Sarcoma.
High tumor grade nearly triples odds of combined local plus metastatic recurrence
Local Recurrence and Metastasis Define Distinct Recurrence Phenotypes in Soft Tissue Sarcoma.
Soft tissue sarcomas (soft tissue sarcomas) are clinically heterogeneous, yet local recurrence (local recurrence) and metastasis are typically analyzed as separate endpoints.
We aimed to determine whether recurrence in soft tissue sarcomas is better understood as distinct phenotypes defined by the interaction between local and metastatic disease.
A total of 668 patients with histologically confirmed soft tissue sarcomas from two tertiary sarcoma centers were analyzed using prospective registry data (2018-2025).
high grade nearly triples the odds of combined recurrence over local recurrence alone
Phenotypes were distributed as follows: no event (52.2%), metastasis only (23.8%), local recurrence only (13.5%), and combined recurrence (10.5%).
High-grade tumors (G3) were more frequent in metastasis-only (73.0%) and combined phenotypes (65.7%) than in local recurrence only (38.9%) and no event (28.9%) ( p < 0.001).
In the combined phenotype, metastasis preceded local recurrence in 40.0%, local recurrence preceded metastasis in 34.3%, and events were synchronous in 25.7%.
Recurrence in soft tissue sarcomas comprises distinct phenotypes defined by the interaction of local and metastatic disease. In particular, the clinical significance of local recurrence depends on its metastatic context.