Cancers
Beyond Event-Free Survival: A Multi-State Analysis of Local Recurrence, Metastasis, and Death in Soft Tissue Sarcoma
By Markus Schärer, Philip Heesen, Gabriela Studer and 3 others.
Abstract
Background/Objectives: Event-free survival (EFS) is widely used in soft tissue sarcoma (STS) research but combines clinically distinct outcomes such as local recurrence (LR), distant metastasis (DM), and death into a single endpoint. We aimed to decompose conventional EFS and characterize STS progression as a longitudinal process of transitions between clinically distinct disease states.
Methods
Prospectively and retrospectively collected registry data from 662 patients with STS at two tertiary sarcoma centers were retrospectively analyzed. EFS was decomposed by first-event type, and longitudinal disease evolution was assessed using multi-state modeling and time-dependent Cox regression.