{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:02:33Z","timestamp":1791385353661,"version":"4.3.3"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Klinikum der Universit\u00e4t M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cancer Res Clin Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>High-dose ifosfamide (HD-IFO) remains an effective regimen for advanced bone and soft tissue sarcomas, but predictors of long-term benefit are poorly defined. This study evaluated clinical outcomes and prognostic factors using machine learning-assisted modeling in sarcoma patients treated with HD-IFO at a high-volume academic center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 26 patients with histologically confirmed bone or soft tissue sarcoma who received HD-IFO (\u2265\u200912\u00a0g\/m\n                      <jats:sup>2<\/jats:sup>\n                      per cycle) between 2015 and 2025. Progression-free survival (PFS) and overall survival (OS) were estimated by the Kaplan\u2013Meier method and compared across RECIST response categories using log-rank testing. Prognostic factors were identified using Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression with leave-one-out cross-validation. The top three variables were entered into multivariable logistic regression to estimate odds ratios (ORs) for OS\u2009&gt;\u200924\u00a0months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median PFS and OS from start of HD-IFO was 6.6\u00a0months (95% CI 4.4\u20139.8) and 24.7\u00a0months (95% CI, 14.7\u201334.2), respectively. Patients with progressive disease (PD) had significantly shorter OS than those with partial response (PR;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0047) or stable disease (SD;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0485). LASSO identified intervention prior to progression, prior tumor control\u2009\u2265\u200912\u00a0months, and absence of metastases as the strongest predictors for OS\u2009&gt;\u200924\u00a0months. In multivariable analysis, intervention prior to progression (OR 24.18, 95% CI 1.81\u20131001.27,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037) and prior tumor control\u2009\u2265\u200912\u00a0months (OR 25.39, 95% CI 2.1\u20131008.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030) independently predicted OS\u2009&gt;\u200924\u00a0months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HD-IFO provides durable disease control in selected sarcoma patients, particularly those with sustained prior tumor control and intervention prior to progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00432-025-06410-8","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T13:56:18Z","timestamp":1767880578000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-term benefit from high-dose ifosfamide in sarcoma depends on sustained prior control and timely intervention: a machine learning analysis"],"prefix":"10.1007","volume":"152","author":[{"given":"Michael","family":"Hoberger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romy L.","family":"Zuber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Burkhard-Meier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorit","family":"Di Gioia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vindi","family":"Jurinovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"V\u00f6lkl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan E.","family":"G\u00fcler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Albertsmeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Klein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Roland","family":"D\u00fcrr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina-Sophie","family":"Schmidt-Hegemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kn\u00f6sel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang G.","family":"Kunz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"von Bergwelt-Baildon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars H.","family":"Lindner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc M.","family":"Berclaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"6410_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12113408","author":"TJ Carter","year":"2020","unstructured":"Carter TJ, Milic M, McDerra J et al (2020) Continuous 14 day infusional ifosfamide for management of soft-tissue and bone sarcoma: a single centre retrospective cohort analysis. 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