110
· DOS Abstracts
Pre-treatment biomarkers as prognosticators for
mortality in patients with localized soft tissue sar-
coma
Katja Maretty-Nielsen, Ninna Aggerholm-Pedersen, Johnny Keller, Alma
Pedersen, Steen Baerentzen, Akmal Safwat
Department of Experimental Clinical Oncology, Aarhus University Hospital;
Department of Orthopaedic Surgery, Aarhus University Hospital; Department
of Clinical Epidemiology, Aarhus University Hospital; Department of Pathology,
Aarhus University Hospital; Department of Oncology, Aarhus University
Hospital
Background:
The existing literature on biomarkers and mortality in soft tissue
sarcoma (STS) is limited in both number and size, lacking the data on important
confounders.
Purpose / Aim of Study:
The aim of this study was to determine the prognos-
tic value of pre-treatment biomarkers for mortality in a large population-based
series of adult patients with localized STS.
Materials and Methods:
Pre-treatment levels of albumin, C-reactive protein
(CRP), hemoglobin, neutrophil to lymphocyte ratio (NLR), and sodium were
analysed in 614 consecutive STS patients treated at the Aarhus Sarcoma Centre
between 1994 and 2008. The prognostic value of biomarkers on sarcoma-spe-
cific mortality was estimated as hazard ratios (HR) using Cox proportional haz-
ard models adjusted for important confounders including age and comorbidity.
Findings / Results:
Hypoalbuminemia (HR 1.85 [95% CI 1.14- 2.99]), anemia
(HR 1.66 [95% CI 1.07- 2.56]), and elevated NLR (HR 1.72 [95% CI 1.10-
2.70]) were independently associated with a statistical significant increased
mortality, while there where a clear tendency towards CRP (HR 1.46 [95% CI
0.98-2.19]) being associated as well. Patients with abnormal values in all im-
portant biomarkers had a significant additional risk of dying, compared to pa-
tients with only some abnormal values (HR 3.91 [95% CI 1.68-910]). The me-
dian survival was 95.8 months in patients with normal values compared to 30.7
and 7.2 in patients with only some abnormal values, and patients with abnormal
values in all important biomarkers, respectively.
Conclusions:
Hypoalbuminemia, anemia, and elevated NLR were independent
prognosticators for early death in patients with localized STS. The measurement
of these can be used as an additional diagnostic tool to identify high-risk pa-
tients that could be candidates for possible intensive therapy.
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