Control of disease is a more accurate prognostic indicator than tumor response, and a 10% increase of tumor size is associated with worse overall survival, according to a study published in the European Journal of Cancer.1

Researchers in Germany analyzed data from 389 patients with advanced intermediate or high-grade STS through the European Organization for Research and Treatment of Cancer 62012 trial. Patients received at least one cycle of chemotherapy and one assessment of tumor response.

They computed Kaplan-Meier estimates of overall survival by tumor response using a landmark approach after 2, 4 and 6 cycles of chemotherapy, with the prognostic role of the kinetics of tumor response analyzed through Cox proportional hazards.

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Patients with progressive disease after 2, 4 and 6 cycles of chemotherapy had worse overall survival compared to those who were stable or responding.  It was also found that patients with stable or responding disease had similar overall survival outcomes.

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An increase in tumor size by 10% or more was linked with a worse overall survival in Cox proportional hazard analysis.

“Disease control rather than tumor response is a valuable endpoint in advanced or metastatic STS receiving palliative anthracycline-based chemotherapy, supporting the use of time-to-event endpoints in future STS trials,” the authors concluded.


  1. Grünwald V, Litière S, Young R, Lia M, Wardelmann E, van der Graaf W, et al. Absence of progression, not extent of tumour shrinkage, defines prognosis in soft-tissue sarcoma – An analysis of the EORTC 62012 study of the EORTC STBSG [published online ahead of print June 17, 2016.] Eur J Cancer. doi: 10.1016/j.ejca.2016.05.023.