Malignant peripheral nerve sheath tumours: an outcome analysis of 32 patients in Lerdsin Hospital, Thailand

Background Malignant peripheral nerve sheath tumours (MPNST) are rare soft tissue sarcoma which exhibit a biologically aggressive behaviour with propensity for rapid progression and high mortality rate. Currently, the data for this tumour is lacking especially with regards to the Asian population....

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Main Authors:	Goh, Kian Liang, Kiatisevi, Piya, Sukanthanak, Bhasanan, Piakong, Pongsiri
Format:	Article
Language:	English
Published:	ResearchOne Publishing House 2018
Subjects:	RD701 Orthopedics
Online Access:	http://irep.iium.edu.my/65489/ http://irep.iium.edu.my/65489/ http://irep.iium.edu.my/65489/1/20181009_00001.pdf

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spelling	iium-654892018-12-19T04:15:22Z http://irep.iium.edu.my/65489/ Malignant peripheral nerve sheath tumours: an outcome analysis of 32 patients in Lerdsin Hospital, Thailand Goh, Kian Liang Kiatisevi, Piya Sukanthanak, Bhasanan Piakong, Pongsiri RD701 Orthopedics Background Malignant peripheral nerve sheath tumours (MPNST) are rare soft tissue sarcoma which exhibit a biologically aggressive behaviour with propensity for rapid progression and high mortality rate. Currently, the data for this tumour is lacking especially with regards to the Asian population. Methods A retrospective analysis was performed in 32 patients diagnosed with MPNST from 2009 to 2017 in Lerdsin Hospital. Prognostic factors such as patient demographic factors, tumour and treatment characteristics were evaluated for statistical significance. The mean age of presentation was 51 years old with 66% patients above 44 years old. Of the 32 patients, 14 were males and 18 were females. The most common affected site was lower limb (56%) compared to upper limb (13%) and central location (31%). Thirty-one percent of patients had underlying neurofibromatosis type 1 (NF-1). The largest proportion of patients had high grade tumour (81%) and the mean size of tumour was 12.2 cm (range, 1-25 cm). All except one patient underwent tumour excision whilst 31% had positive margin. Adjuvant treatment was initiated in 50% of the patients which consisted of radiation (61%), chemotherapy (18%) or both (9%). Results The local recurrence rate was 26% with a median survival time after surgery of 56 months (95% CI 31.7-79.5) and 5-year overall survival rate was 39%. High tumour grade and male patients were significantly associated with distant metastasis on univariate analysis but no predictors for local recurrence were identified. Age <45, high tumour grade, triton tumour subtype, diagnosis of NF-1, local recurrence, metastasis and use of adjuvant chemotherapy were all associated with disease specific survival (DSS). Multivariate analysis identified local recurrence (HR=20.035, 95% CI 1.8-222.8) as the single poor prognostic factor for DSS. Other associated factors include presence of NF-1 (HR=7.962, 95% CI 0.9-69.9) and high tumour grade (HR=16.945, 95% CI 0.9-321.8) although not reaching statistical significance. Conclusions High tumour grade, local recurrence and distant metastasis all adversely affects the survival in MPNST. However, adjuvant chemotherapy or radiotherapy did not appear to improve survival. Limitations of this study include retrospective design and small sample size. ResearchOne Publishing House 2018-12 Article PeerReviewed application/pdf en http://irep.iium.edu.my/65489/1/20181009_00001.pdf Goh, Kian Liang and Kiatisevi, Piya and Sukanthanak, Bhasanan and Piakong, Pongsiri (2018) Malignant peripheral nerve sheath tumours: an outcome analysis of 32 patients in Lerdsin Hospital, Thailand. Journal of Bone and Soft Tissue Tumors, 4 (2 (July-Dec)). p. 54. ISSN 2454-5473 http://jbstjournal.com
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RD701 Orthopedics
spellingShingle	RD701 Orthopedics Goh, Kian Liang Kiatisevi, Piya Sukanthanak, Bhasanan Piakong, Pongsiri Malignant peripheral nerve sheath tumours: an outcome analysis of 32 patients in Lerdsin Hospital, Thailand
description	Background Malignant peripheral nerve sheath tumours (MPNST) are rare soft tissue sarcoma which exhibit a biologically aggressive behaviour with propensity for rapid progression and high mortality rate. Currently, the data for this tumour is lacking especially with regards to the Asian population. Methods A retrospective analysis was performed in 32 patients diagnosed with MPNST from 2009 to 2017 in Lerdsin Hospital. Prognostic factors such as patient demographic factors, tumour and treatment characteristics were evaluated for statistical significance. The mean age of presentation was 51 years old with 66% patients above 44 years old. Of the 32 patients, 14 were males and 18 were females. The most common affected site was lower limb (56%) compared to upper limb (13%) and central location (31%). Thirty-one percent of patients had underlying neurofibromatosis type 1 (NF-1). The largest proportion of patients had high grade tumour (81%) and the mean size of tumour was 12.2 cm (range, 1-25 cm). All except one patient underwent tumour excision whilst 31% had positive margin. Adjuvant treatment was initiated in 50% of the patients which consisted of radiation (61%), chemotherapy (18%) or both (9%). Results The local recurrence rate was 26% with a median survival time after surgery of 56 months (95% CI 31.7-79.5) and 5-year overall survival rate was 39%. High tumour grade and male patients were significantly associated with distant metastasis on univariate analysis but no predictors for local recurrence were identified. Age <45, high tumour grade, triton tumour subtype, diagnosis of NF-1, local recurrence, metastasis and use of adjuvant chemotherapy were all associated with disease specific survival (DSS). Multivariate analysis identified local recurrence (HR=20.035, 95% CI 1.8-222.8) as the single poor prognostic factor for DSS. Other associated factors include presence of NF-1 (HR=7.962, 95% CI 0.9-69.9) and high tumour grade (HR=16.945, 95% CI 0.9-321.8) although not reaching statistical significance. Conclusions High tumour grade, local recurrence and distant metastasis all adversely affects the survival in MPNST. However, adjuvant chemotherapy or radiotherapy did not appear to improve survival. Limitations of this study include retrospective design and small sample size.
format	Article
author	Goh, Kian Liang Kiatisevi, Piya Sukanthanak, Bhasanan Piakong, Pongsiri
author_facet	Goh, Kian Liang Kiatisevi, Piya Sukanthanak, Bhasanan Piakong, Pongsiri
author_sort	Goh, Kian Liang
title	Malignant peripheral nerve sheath tumours: an outcome analysis of 32 patients in Lerdsin Hospital, Thailand
title_short	Malignant peripheral nerve sheath tumours: an outcome analysis of 32 patients in Lerdsin Hospital, Thailand
title_full	Malignant peripheral nerve sheath tumours: an outcome analysis of 32 patients in Lerdsin Hospital, Thailand
title_fullStr	Malignant peripheral nerve sheath tumours: an outcome analysis of 32 patients in Lerdsin Hospital, Thailand
title_full_unstemmed	Malignant peripheral nerve sheath tumours: an outcome analysis of 32 patients in Lerdsin Hospital, Thailand
title_sort	malignant peripheral nerve sheath tumours: an outcome analysis of 32 patients in lerdsin hospital, thailand
publisher	ResearchOne Publishing House
publishDate	2018
url	http://irep.iium.edu.my/65489/ http://irep.iium.edu.my/65489/ http://irep.iium.edu.my/65489/1/20181009_00001.pdf
first_indexed	2023-09-18T21:32:55Z
last_indexed	2023-09-18T21:32:55Z
_version_	1777412631049535488

Malignant peripheral nerve sheath tumours: an outcome analysis of 32 patients in Lerdsin Hospital, Thailand

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