Surgery for de novo metastatic soft tissue sarcoma improves survival only in patients with low Ki67 or low total lesion glycolysis

In de novo metastatic soft tissue sarcoma, primary tumor surgery only improved overall survival when Ki67 ≤35% (HR 0.24, 95% CI 0.06-0.89) or total lesion glycolysis on PET/CT was low (HR 0.21, 0.04-0.97). No benefit in high Ki67 or high TLG. Retrospective, 40 patients.

• Retrospective analysis of 40 patients with de novo metastatic soft tissue sarcoma undergoing pretreatment 18F-FDG PET/CT.
• Age >50, LDH >200 U/L, and SUVmax >10 were independently associated with worse overall survival.
• Small sample size, single-center, retrospective design; interaction findings require external validation.

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