PEC‐PRO: A new prognostic score from a series of 87 patients with localized perivascular epithelioid cell neoplasms (PEComas) treated with curative intent

Author:

Gantzer Justine1ORCID,Toulmonde Maud2ORCID,Severac François3,Chamseddine Ali N.4,Charon‐Barra Céline5,Vinson Charles5,Hervieu Alice6,Bourgmayer Agathe1,Bertucci François7,Ryckewaert Thomas8,Valentin Thibaud9,Firmin Nelly10,Chaigneau Loïc11,Bompas Emmanuelle12,Follana Philippe13,Rioux‐Leclercq Nathalie14,Soibinet‐Oudot Pauline15,Bozec Laurence16,Le Loarer François17,Weingertner Noëlle18,Chevreau Christine9ORCID,Duffaud Florence19,Blay Jean‐Yves20ORCID,Kurtz Jean‐Emmanuel1,Schöffski Patrick21ORCID,Brahmi Mehdi20ORCID,Malouf Gabriel G.1

Affiliation:

1. Department of Medical Oncology Institut de Cancérologie de Strasbourg‐Europe Strasbourg France

2. Department of Medical Oncology Institut Bergonié Bordeaux France

3. Department of Public Health Hôpitaux Universitaires de Strasbourg Strasbourg France

4. Department of Medical Oncology Institut Gustave Roussy Villejuif France

5. Department of Pathology Centre Georges François Leclerc Dijon France

6. Department of Medical Oncology Centre Georges François Leclerc Dijon France

7. Department of Medical Oncology Institut Paoli‐Calmettes Marseilles France

8. Department of Medical Oncology Centre Oscar Lambret Lille France

9. Department of Medical Oncology Institut Universitaire du Cancer de Toulouse‐Oncopole Toulouse France

10. Department of Medical Oncology Institut du Cancer de Montpellier Montpellier France

11. Department of Medical Oncology Institut Regional du Cancer en Franche‐Comté Besançon France

12. Department of Medical Oncology Institut de Cancérologie de l’Ouest Nantes France

13. Department of Medical Oncology Centre Antoine‐Lacassagne Nice France

14. Department of Pathology Centre Hospitalier Universitaire de Rennes Rennes France

15. Department of Medical Oncology Institut Godinot Reims France

16. Department of Medical Oncology Institut Curie Saint‐Cloud France

17. Department of Pathology Institut Bergonié Bordeaux France

18. Department of Pathology Hôpitaux Universitaires de Strasbourg Strasbourg France

19. Department of Medical Oncology Centre Hospitalier Universitaire de Marseilles Marseilles France

20. Department of Medical Oncology Centre Léon Bérard Lyon France

21. Department of Medical Oncology University Hospitals Leuven Belgium

Abstract

AbstractBackgroundPerivascular epithelioid cell neoplasms (PEComas) encompass a heterogeneous family of mesenchymal tumors. Previously described clinicopathologic features aimed at distinguishing benign from malignant variants but lacked prognostic value.MethodsThis retrospective analysis examined clinicopathologic data from patients who had localized PEComa across French Sarcoma Network centers. The authors analyzed 12 clinicopathologic features in a Cox proportional hazard framework to derive a multivariate prognostic risk model for event‐free survival (EFS). They built the PEComa prognostic score (PEC‐PRO), in which scores ranged from 0 to 5, based on the coefficients of the multivariate model. Three groups were identified: low risk (score = 0), intermediate risk (score = 1), and high risk (score ≥ 2).ResultsAnalyzing 87 patients who had a median 46‐month follow‐up (interquartile range, 20–74 months), the median EFS was 96.5 months (95% confidence interval [CI], 47.1 months to not applicable), with 2‐year and 5‐year EFS rates of 64.7% and 58%, respectively. The median overall survival was unreached, with 2‐year and 5‐year overall survival rates of 82.3% and 69.3%, respectively. The simplified Folpe classification did not correlate with EFS. Multivariate analysis identified three factors affecting EFS: positive surgical margins (hazard ratio [HR], 5.17; 95% CI, 1.65–16.24; p = .008), necrosis (HR, 3.94; 95% CI, 1.16–13.43; p = .030), and male sex (HR, 3.13; 95% CI, 1.19–8.27; p = 0.023). Four variables were retained in the prognostic model. Patients with low‐risk PEC‐PRO scores had a 2‐year EFS rate of 93.7% (95% CI, 83.8%–100.0%), those with intermediate‐risk PEC‐PRO scores had a 2‐year EFS rate of 67.4% (95% CI, 53.9%–80.9%), and those with high‐risk PEC‐PRO scores had a 2‐year EFS rate of 2.3% (95% CI, 0.0%–18.3%).ConclusionsThe PEC‐PRO score reliably predicts the risk of postoperative recurrence in patients with localized PEComa. It has the potential to improve follow‐up strategies but requires validation in a prospective trial.

Publisher

Wiley

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