Pathological and MRI-Based Infiltrative Markers Show Distinct Associations with Oncologic Outcomes in Undifferentiated Pleomorphic Sarcoma and Myxofibrosarcoma.
- 1Department of Orthopaedic Surgery, Institute of Science Tokyo, Tokyo 113-8510, Japan.
- 2Department of Orthopaedic Surgery, Cancer Institute Hospital of JFCR, Tokyo 135-8550, Japan.
- 3Department of Pathology, Cancer Institute Hospital of JFCR, Tokyo 135-8550, Japan.
Abstract
Undifferentiated pleomorphic sarcoma (UPS) and myxofibrosarcoma (MFS) frequently exhibit infiltrative growth, but whether pathological and magnetic resonance imaging (MRI)-based findings represent the same tumor characteristics remain unclear. We examined the relationships among report-documented pathological infiltration (PI), MRI-defined diffuse infiltration (DI), and radiological infiltration (RI) based on the tail sign, and explored their associations with oncologic outcomes. This single-center retrospective cohort study included 68 treatment-naïve patients with primary UPS or MFS without distant or lymph-node metastasis at presentation who underwent curative-intent resection. The primary outcome was progression-free survival (PFS), with overall survival (OS), distant metastasis-free survival (DMFS), and local recurrence-free survival (LRFS) evaluated as secondary outcomes. Time-to-event associations were evaluated using Firth's penalized Cox regression with parsimonious covariate adjustment and sensitivity analyses restricted to patients with R0 resection. DI, RI, and PI were observed in 75.0%, 76.5%, and 60.3% of patients, respectively. RI positivity was more frequent among patients with PI, whereas DI showed no clear relationship with PI or RI. In an exploratory multivariable model, DI (hazard ratio [HR], 3.30; 95% confidence interval [CI], 1.05-16.51; p = 0.040) and RI (HR, 4.26; 95% CI, 1.31-22.29; p = 0.013) were associated with worse PFS. Local recurrences occurred only in patients with PI, although adjusted estimates were imprecise. These findings suggest that pathological and MRI-based infiltrative markers may capture different and potentially complementary aspects of tumor behavior. External validation using standardized imaging and pathological review is required.
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BibTeX
@article{ariga2026pathological,
title = {{Pathological and MRI-Based Infiltrative Markers Show Distinct Associations with Oncologic Outcomes in Undifferentiated Pleomorphic Sarcoma and Myxofibrosarcoma.}},
author = {Akane Ariga and Yuki Funauchi and Kyoko Yamashita and Masanori Saito and Keiko Hayakawa and Taisuke Tanizawa and Norio Kurosawa and Toshitaka Yoshii and Keisuke Ae},
journal = {Current oncology (Toronto, Ont.)},
year = {2026},
month = sep,
doi = {10.3390/curroncol33100572},
url = {https://europepmc.org/article/MED/42930139},
note = {CC BY},
}
RIS
TY - JOUR
TI - Pathological and MRI-Based Infiltrative Markers Show Distinct Associations with Oncologic Outcomes in Undifferentiated Pleomorphic Sarcoma and Myxofibrosarcoma.
AU - Akane Ariga
AU - Yuki Funauchi
AU - Kyoko Yamashita
AU - Masanori Saito
AU - Keiko Hayakawa
AU - Taisuke Tanizawa
AU - Norio Kurosawa
AU - Toshitaka Yoshii
AU - Keisuke Ae
PY - 2026
DA - 2026/09/22
JO - Current oncology (Toronto, Ont.)
DO - 10.3390/curroncol33100572
UR - https://europepmc.org/article/MED/42930139
AB - Undifferentiated pleomorphic sarcoma (UPS) and myxofibrosarcoma (MFS) frequently exhibit infiltrative growth, but whether pathological and magnetic resonance imaging (MRI)-based findings represent the same tumor characteristics remain unclear. We examined the relationships among report-documented pathological infiltration (PI), MRI-defined diffuse infiltration (DI), and radiological infiltration (RI) based on the tail sign, and explored their associations with oncologic outcomes. This single-center retrospective cohort study included 68 treatment-naïve patients with primary UPS or MFS without distant or lymph-node metastasis at presentation who underwent curative-intent resection. The primary outcome was progression-free survival (PFS), with overall survival (OS), distant metastasis-free survival (DMFS), and local recurrence-free survival (LRFS) evaluated as secondary outcomes. Time-to-event associations were evaluated using Firth's penalized Cox regression with parsimonious covariate adjustment and sensitivity analyses restricted to patients with R0 resection. DI, RI, and PI were observed in 75.0%, 76.5%, and 60.3% of patients, respectively. RI positivity was more frequent among patients with PI, whereas DI showed no clear relationship with PI or RI. In an exploratory multivariable model, DI (hazard ratio [HR], 3.30; 95% confidence interval [CI], 1.05-16.51; p = 0.040) and RI (HR, 4.26; 95% CI, 1.31-22.29; p = 0.013) were associated with worse PFS. Local recurrences occurred only in patients with PI, although adjusted estimates were imprecise. These findings suggest that pathological and MRI-based infiltrative markers may capture different and potentially complementary aspects of tumor behavior. External validation using standardized imaging and pathological review is required.
SN - 1198-0052
SN - 1718-7729
ER -