The objective of this study was to evaluate the efficacy and safety of adjuvant radiotherapy (aRT) in patients with soft-tissue sarcoma (STS) re-excised after unplanned tumor resection (UPR). From 2000 to 2015, we retrospectively evaluated patients with STS of limb or trunk who underwent post-UPR re-excision in our expert center and received or not aRT. Median follow-up was 121 months (IQR 94-165). Among the 145 patients, 37 were not treated with aRT (no-RT) and 108 received aRT with a median radiation dose of 50 Gy (IQR 50-60). At 10 years, patients in the aRT and no-RT groups showed a cumulative incidence of local failure (10y-LF) of 14.7% and 37.7%, and a local recurrence-free survival (10y-LRFS) of 61.3% and 45.8%, respectively. Multivariate analysis identified aRT and age ≥70 years as independent predictors of both LF and LRFS, while grade 3 and deep-seated tumor were independent predictors of LRFS. In overall population, 10-year distant metastasis-free survival (10y-DMFS) and overall survival (10y-OS) were 63.7% and 69.4%. In multivariate analyses, age ≥70 years, grade 3, and deep-seated lesion were associated with shorter DMFS and OS. Acute severe adverse events were not significantly increased in aRT group (14.8% vs. 18.1%, P = .85) but dramatically increased if radiation dose exceeded 50 Gy (risk ratio 2.96 compared to ≤50 Gy, P = .04). In STS patients re-excised after UPR, 50 Gy aRT was safe and associated with reduced LF and longer LRFS. It seems to be beneficial even in absence of residual disease or in absence of initial adverse prognostic factors.

Background: Non-seminomatous germ cell tumors (NSGCTs) represent a rare yet the most prevalent malignancy among young men. Bone metastases (BMs) are exceedingly uncommon in this neoplasm, and available data regarding the initial disease presentation, survival outcomes, and prognostic significance of BMs are limited. Methods: We conducted a retrospective analysis of 40 NSGCT patients with BMs treated between 2001 and 2021 in our tertiary care center. The cohort was stratified into synchronous (n = 29) and metachronous (n = 11) groups based on the presence of BM at diagnosis or only at relapse, respectively. We assessed overall survival (OS), progression-free survival (PFS), disease presentation, and treatments. Results: After a median follow-up of 93 months, the 5-year PFS and OS rates were 37.6% and 53.9% in the synchronous group and 18.2% and 36.4% in the metachronous group, respectively. At the initial diagnosis, most patients were classified into the IGCCCG poor prognostic group (n = 34, 85%). BMs were mostly asymptomatic (n = 23, 57.5%), involved the spine (n = 37, 92.5%), and could become visible only after disease response (n = 4, 10%). A pathological examination of resected bone lesions after first-line treatment revealed necrosis (n = 5, 71.4%), teratoma, or seminoma (both n = 1, 14.3%). At first relapse, eight patients in the synchronous group did not experience bone recurrence, while eight patients experienced recurrence at the initial affected bone site. Conclusions: In NSGCT patients, BMs often present asymptomatically and may initially be unnoticed. However, these patients may have a poorer prognosis compared to those in the IGCCCG poor prognostic group. Further studies including control groups are needed to assess the independent prognostic significance of BMs.

FGFR3 alterations are observed in 10% to 15% of patients with advanced urothelial carcinoma (UC). We aimed to clarify the prognostic and predictive value of FGFR3 alterations in patients receiving first-line platinum-based chemotherapy (PBC) for advanced urothelial carcinoma. We conducted a multicenter retrospective cohort study including patients with histologically confirmed UC treated in first line with PBC, with or without immune-checkpoint inhibitors (ICIs) administered as maintenance or second line. Only patients with known FGFR3 status on baseline tumor tissue, locally assessed were included. Progression-free survival (PFS) was the primary endpoint. Secondary endpoints included overall survival (OS), objective response rates (ORR), and PFS with ICIs, stratified by FGFR3 status. Between 2016 and 2022, 191 pts were included, of whom 58 (30.4%) had FGFR3-altered tumors (FGFR3^alt). Baseline characteristics were well balanced. ICIs were administered to 34% of patients. After a median follow-up of 32 months, median PFS under PBC was 6.6 months in FGFR3^alt and 7.5 in FGFR3 wild type subgroups (HR = 1.27; P = .15) respectively. Median OS was 22.1 versus 20.8 months (HR = 0.91; P = .658), and ORR in 133 pts were similar across subgroups (70.7% vs. 69.2% respectively). In multivariate analysis, FGFR3 status was not associated with survival. FGFR3 status did not significantly impact response to PBC in first-line treatment or ICIs. These findings underscore that the presence of an FGFR3 alteration does not guide the choice of platinum-based treatment, and the need for prospective biomarker-driven trials to identify best treatment sequences in advanced UC.