Abdominal metastases of primary extremity soft tissue sarcoma: A systematic review

Table 1 Original articles (n = 6) analysing incidence of abdominal/retroperitoneal metastases in patients with extremity soft tissue sarcoma

Ref.	Topic	Patients		(Prevalent) Histological subtype(s)	Chemotherapy/ radiotherapy	Outcome (after diagnosis of metastasis)
		Total number of STS (n), of whom eSTS, n (%)	Of whom eSTS with AM/RM, n (%)
Thompson et al[16], 2015	Diagnostic pathway	140 (100)	7 (5.0) AM	Epithelioid sarcoma, leiomyosarcoma, liposarcoma, synovial sarcoma	N/A	N/A
King et al[9], 2009	Diagnostic pathway, outcome	124 (100)	7 (5.6) AM	MPNST, leiomyosarcoma, myxofibrosarcoma, pleomorphic sarcoma	N/A	21% mortality rate (n = 21/124)
Gorelik et al[6], 2018	Diagnostic pathway	33 (100)	4 (12.1) AM	Myxoid liposarcoma	89% of patients with metastases (including others than AM) received neoadj. RTX 22% received adj. RTX for primary tumour	N/A
Behranwala et al[8], 2004	Therapeutic approach	2127 (100)	19 (0.9) AM	Myxoid liposarcoma, leiomyosarcoma	CTX + RTX in 3 patients, and CTX or RTX in 1 patient each following resection of AM	Median OS: 12 mo
Ogose et al[11], 2000	Therapeutic approach	282 (100)	24 (8.5) AM	Liposarcoma	None of patients with AM received RTX or CTX	Mean OS (liver/GI metastases): 4.6 mo; Mean OS (pancreatic metastasis): 3.3 mo
Sheah et al[7], 2008	Diagnostic pathway	112 (100)	9 (8.0) AM; 2 (1.8) RM	Myxoid liposarcoma	N/A	N/A

AM: Abdominal metastasis; AWD: Alive with disease; DOD: Dead of disease; eSTS: Extremity soft tissue sarcoma; NED: No evidence of disease; OS: Overall survival; PFS: Progression-free survival; STS: Soft tissue sarcoma; CTX: Chemotherapy; RTX: Radiotherapy; N/A: Not applicable.

Table 2 Original articles (n = 3) and case reports (n = 8) exclusively reporting on patients developing abdominal or retroperitoneal metastases

Ref.	Type	Topic	Patients	(Prevalent) Histological subtype(s)	Chemotherapy/ radiotherapy	Outcome (after diagnosis of metastasis)
Grimme et al[15], 2019	Original article	Therapeutic approach, outcome	38 patients with STS developing liver metastases [of whom 5 (13.2%) had been eSTS]	Leiomyosarcoma, liposarcoma	N/A	Median PFS: 16 mo Median OS: 46 mo
Lev-Chelouche et al[14], 2000	Original article	Diagnostic pathway, therapeutic approach	10 eSTS patients with RM	Liposarcoma	Adj. CTX in 4 patients, ± adj. RTX in 7 (details on combination of CTX/RTX not provided)	Mean OS: 13.3 mo
Rehders et al[23], 2009	Original article	Therapeutic approach	5 patients with eSTS (of 45 patients with STS) developing liver metastases	N/A	CTX following hepatic metastasectomy in 5 patients (no information whether eSTS or other STS)	44 mo (including both eSTS and other STS)
Sabel et al[19], 2001	Case report	N/A	58-yr-old male patient with small-bowel metastasis after 15 yr of follow-up	Alveolar soft part sarcoma	Adj. RTX for primary tumour, CTX for metastases (prior to development of AM)	N/A
Lee et al[18], 2010	Case report	N/A	23-yr-old male patient with gastric metastasis at 16 mo of follow-up	Alveolar soft part sarcoma	RTX for cerebral metastases, CTX declined by patient	DOD soon after metastasectomy (not specified by authors)
Koh et al[21], 2007	Case report	N/A	66-yr-old female with pancreatic metastasis soon after primary tumour diagnosis	Malignant mesenchymoma (70% osteosarcoma, 30% leiomyosarcoma)	CTX and RTX declined by patient	AWD at 9 mo
Mizoshiri et al[17], 2018	Case report	N/A	51-yr-old female with liver metastasis from leiomyosarcoma at 11 mo of follow-up	Leiomyosarcoma	Neoadj. + adj. CTX for primary tumour and CTX following hepatic metastasectomy in female patient	NED at 12 mo (male patient)
			60-yr-old male with liver metastasis from leiomyosarcoma at 3 yr of follow-up		Neoadj. + adj. CTX for male patient for primary tumour
Carboni et al[13], 2006	Case report	N/A	66-yr-old male patient with pancreatic metastasis at 6 yr of follow-up	Myxoid liposarcoma	Adjuvant RTX for local recurrence of primary tumour	NED at 6 mo
Watanabe et al[12], 2001	Case report	N/A	20-yr-old female patient with massive AM (37 cm diameter)	Myxoid liposarcoma	N/A	DOD (after several months, not specified by authors)
Lin et al[10], 2015	Case report	N/A	53-yr-old male patient with AM after 35 mo of follow-up	Myxoid liposarcoma	CTX and RTX for metastatic disease (prior to development of AM)	DOD after 3 mo
Willekens et al[20], 2011	Case report	N/A	27-yr-old female patient with duodenal metastasis	Alveolar soft part sarcoma	RTX for primary tumour	NED at 2 mo

AM: Abdominal metastasis; AWD: Alive with disease; DOD: Dead of disease; eSTS: Extremity soft tissue sarcoma; NED: No evidence of disease; OS: Overall survival; PFS: Progression-free survival; STS: Soft tissue sarcoma; CTX: Chemotherapy; RTX: Radiotherapy; N/A: Not applicable.