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Clinical Study

Cumulative incidence and survival outcomes of brain metastases in sarcoma: a large single center retrospective analysis

British Journal of Cancer volume 133, pages 1508–1517 (2025)Cite this article

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A Correction to this article was published on 16 October 2025

This article has been updated

Abstract

Background

The incidence and predictors of brain metastases (BrM) from sarcoma remain poorly characterized. We aimed to determine the cumulative incidence (CuI) and risk factors for BrM.

Methods

We retrospectively analyzed data from all sarcoma patients who presented to our center (2006–2023). CuI was calculated from initial presentation to BrM, stratified by key variables. Univariable (UVA) and multivariable competing risk regression analyses (MVA) were conducted to identify risk factors.

Results

Among 5110 sarcoma patients, 117 developed BrM. CuI rates were 1.8%, 2.4%, and 2.9% at 24, 48, and 72 months, respectively, within a median onset of 17 months. On UVA, intrathoracic primary site, alveolar soft part (ASPS), epithelioid, intimal and Rhabdomyosarcoma histologies, and stage IV at diagnosis were associated with increased CuI, while age ≥59, retroperitoneal origin and liposarcoma were associated with decreased CuI. On MVA the following remained correlated to BrM incidence: intrathoracic primary (HR 5.13), ASPS (HR 4.2), age ≥59 years (HR 0.45) and liposarcoma (HR 0.11); 44.3% presented with solitary BrM. Median survival post-BrM diagnosis was 6 months.

Conclusion

BrM risk in sarcoma varies by age, histology, and tumor location. Solitary metastases were common in our BrM cohort, and OS post-BrM was poor.

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Fig. 1: Cumulative incidence of brain metastases (BrM).
Fig. 2: Cumulative incidence of brain metastases by gender, age at diagnosis and location of the primary sarcoma.
Fig. 3: Cumulative incidence of brain metastases by histologic subtype, primary sarcoma origin and stage at diagnosis.
Fig. 4: Kaplan–Meier curve of overall survival from brain metastases diagnosis.

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Data availability

The data are available from the corresponding author upon reasonable request.

Change history

  • 02 September 2025

    “The original online version of this article was revised: The article “Cumulative incidence and survival outcomes of brain metastases in sarcoma: a large single center retrospective analysis”, written by Ayah Erjan, Kurl Jamora, Enrique Gutierrez et al, was originally published open access under a “Creative Commons Attribution (CC BY) license 4.0”. As a result of the author’s/authors’ subsequent decision not to publish this article under the open access model, the copyright notice of the article was changed on 12 August 202] to © The Author(s), under exclusive licence to Springer Nature Limited, 2025 with all rights reserved.

  • 16 October 2025

    A Correction to this paper has been published: https://doi.org/10.1038/s41416-025-03176-1

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada

    Ayah Erjan, Kurl Jamora, Enrique Gutierrez, Adeodatus Vito Nicanor, Barbara-Ann Millar, Normand Laperriere, Tatiana Conrad, Dana Keilty, Philip Wong, Peter Chung, Charles Catton, David Kirsch & David B. Shultz

  2. Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, On, Canada

    Ayah Erjan, Kurl Jamora, Enrique Gutierrez, Adeodatus Vito Nicanor, Barbara-Ann Millar, Normand Laperriere, Tatiana Conrad, Dana Keilty, Philip Wong, Peter Chung, Charles Catton, David Kirsch & David B. Shultz

  3. Department of Radiation Oncology, King Hussein Cancer Centre, Amman, Jordan

    Ayah Erjan

  4. Department of Biostatistics, University of Toronto, Toronto, On, Canada

    Anna Santiago

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  1. Ayah Erjan
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Contributions

Study design: AE, DBS, Data Collection: AE, KJ, AVN, EG, Data Analysis: AS; Data Interpretation: AE, KJ, EG, AS, AVN, B-AM, NL, TC, DK, PW, PC, CC, DK, DBS; Writing first draft: AE; Reviewing, editing and approving final manuscript: AE, KJ, EG, AS, AVN, B-AM, NL, TC, DK, PW, PC, CC, DK, DBS; Supervision: DBS.

Corresponding author

Correspondence to David B. Shultz.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This retrospective study utilized previously collected data. Ethical approval was obtained from the University Health Network Research Ethics Board (UHN REB number 23-5735). All methods were performed in accordance with relevant guidelines and regulations. All data were anonymized to ensure participant confidentiality. Informed consent was waived as the study used de-identified data.

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“The original online version of this article was revised: The article “Cumulative incidence and survival outcomes of brain metastases in sarcoma: a large single center retrospective analysis”, written by Ayah Erjan, Kurl Jamora, Enrique Gutierrez et al, was originally published open access under a “Creative Commons Attribution (CC BY) license 4.0”. As a result of the author’s/authors’ subsequent decision not to publish this article under the open access model, the copyright notice of the article was changed on 12 August 202] to © The Author(s), under exclusive licence to Springer Nature Limited, 2025 with all rights reserved.

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Erjan, A., Jamora, K., Gutierrez, E. et al. Cumulative incidence and survival outcomes of brain metastases in sarcoma: a large single center retrospective analysis. Br J Cancer 133, 1508–1517 (2025). https://doi.org/10.1038/s41416-025-03111-4

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