Multifocality in XXXX : a prognostic factor critical to surgical decision-making.

@entity1 @entity66 @entity242 @entity5 @entity1349
OBJECTIVE: To evaluate the significance of multifocality on @entity1349 ( @entity1349 ) in @entity1 with @entity242 ( @entity242 ) and establish a data-derived, prognostically and therapeutically useful definition of sarcomatosis. SUMMARY BACKGROUND DATA: The incidence, clinical features, and prognostic significance of multifocality in @entity242 is unknown. No current standardized definition for sarcomatosis is available. METHODS: We conducted a retrospective analysis of 393 @entity1 with primary or recurrent nonmetastatic @entity242 treated at a comprehensive @entity5 center between 1996 and 2006. Baseline and treatment variables were compared in @entity1 with @entity66 . A multivariate model was used to evaluate the association of multifocality and @entity1349 and identify additional prognostic factors in @entity1 with @entity66 . RESULTS: The median follow-up time for all @entity1 was 69 months; 79 @entity1 (20%) presented with @entity66 . The 5-year @entity1349 rate was less in the multifocal group compared with the unifocal group (31% vs. 60%, respectively; P < 0.0001). After multivariate analysis, multifocality remained an independent predictor of worse @entity1349 {hazard ratio (HR) 1.7 (95% confidence interval (CI), 1.2-2.5); P = 0.004}. Additionally, @entity1 with more @entity5 had significantly worse prognosis (>7 @entity5 , HR 2.1 (95% CI, 1.1-3.9); P = 0.03), with a 5-year @entity1349 rate of 7%. CONCLUSIONS: Multifocal @entity242 is associated with worse @entity1349 in @entity1 with either primary or recurrent @entity242 ; @entity1 with >7 @entity5 had the worst prognosis. This criterion can be used to define sarcomatosis, thereby identifying @entity1 whose survival will ultimately depend on effective systemic therapy.
