Soft-tissue sarcomas are a rare and exceedingly diverse category of tumors that account for 1% of all human malignancies. The most prevalent location of distant metastasis is the lungs, followed by the bone, lymph nodes, liver, brain, and subcutaneous tissue. Clinical data reveals that bone metastasis is part of the natural course of these patients, influencing their prognosis and quality of life. 

At the time of diagnosis, around 2.2% of patients had skeletal metastases. However, after a mean interval of 21.3 months, up to 10% will develop bone metastases. Although systemic chemotherapy with conventional chemotherapy remains the predominant treatment option for people with metastatic sarcoma, selected patients who get multimodality therapy, including surgery, have a higher survival rate. 

Patients with isolated bone metastases had a 5-year overall survival rate of 41.2% (26.9% to 54.9%), which dropped to 32.9% (21.% to 45.1%) when mixed bone and lung metastases were present. Furthermore, excision of the initial soft-tissue sarcoma is a predictor of survival, with a 58% reduction in mortality following surgery (hazard ratio, 0.42, P=0.013). Understanding how these metastases affect patient survival might alter imaging, monitoring, and therapy decisions.

Reference:journals.lww.com/jaaos/Abstract/2022/06010/Musculoskeletal_Metastasis_From_Soft_tissue.2.aspx

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