European Journal of Cancer: Highlights of Issue 39:11

Linking negative prognostic factors helps predict outcome

Reproducibility of the SIN system in soft tissue sarcomas

In this issue, Gustafson and colleagues used the SIN system to divide patients into two groups with differing outcomes. They tested the reproducibility of use of the system and found it to be high. The SIN system is based upon the assessment of three negative prognostic factors: large tumour size, vascular invasion and microscopic tumour necrosis. They classified patients with none or 1 of these factors as low risk and patients having 2 or 3 of these factors as high risk. The division of these patients resulted in two groups with widely differing outcomes, as measured by cumulative 5- year metastasis- free survival rates. The authors examined reproducibility in three ways; inter-observer variation in the assessment of the variables, use of the system in a patient group from another institution and comparison to the American Joint Committee on Cancer system. The authors concluded that "this system provides two distinct prognostic groups and has a high reproducibility".

Health-related quality of life in metastatic melanoma patients treated with bio-chemotherapy

As no clear survival benefit has been demonstrated for biochemotherapy (bio-CT) and CT in the treatment of metastatic melanoma patients, HRQOL is an important parameter to measure. Using data from a phase III trial, Chiarion-Sileni and colleagues investigated HRQOL- with the Rotterdam Symptom Checklist (RSCL)- in patients randomised to treatment with bio-CT or CT. They found that mean values of all domains of QOL decreased in the bio-CT arm, but only the activity level and physical symptom distress domains showed a decrease in the CT arm. Both of these domains were independent prognostic factors. The authors suggest that "it could be of interest to evaluate whether a planned psychological intervention is able to improve HRQOL and, thereby, modify the prognosis of patients with advanced melanoma".

Results of the AMORE protocol

In this issue, Buwalda and colleagues present a novel local treatment strategy for children with advanced, non-metastatic, head and neck rhabdomyosarcomas (HNRMS). They treated 20 children (15 with parameningeal HNRMS and 5 with non-parameningeal HNRMS) with Ablative surgery, Moulage technique brachytherapy and surgical Reconstruction. Complete remissions were observed in all of the patients and so far, although the follow-up is fairly short, the long-term sequelae are limited. Five patients experienced a local relapse and one patient a distant relapse. The authors concluded that "the AMORE protocol is a feasible strategy with a good local control rate".

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