A multivariate analysis of the prognosis after surgical treatment of malignant soft-tissue tumors

Abstract

Ninety-seven patients who had received their primary and definitive surgical treatment for a soft-tissue sarcoma during the years 1956--1976 were studied with respect to local recurrence, metastasis, and survival. The aim of the treatment was to eradicate the tumor while preserving good function. The influence of host and tumor properties and different diagnostic and surgical procedures on the prognosis was studied by means of nonparametric multivariate analysis. Ninety-four percent of the tumors were located in the extremities. Malignant fibrous histiocytoma was the most common histologic type. A four-grade scale of histologic malignancy was used. Eighty-eight percent of the tumors were Grade III or IV. In 85% of the patients with an extremity lesion, local extirpation was carried out. The overall local recurrence rate was 21.7% and in 76 patients who underwent an adequate surgical procedure it was 6.6%. The overall five-year survival rate was 59%. The survival depended on the local control of the primary tumor, which was related to the adequacy of the surgical procedure and to the histologic grade of malignancy. No patient with a Grade I or II tumor died. The five-year survival rate for patients with Grade III tumors was 68% and for patients with Grade IV tumors 47%.

Sarcomas in north west England: III Survival

“…histological grade, size, depth, degree of necrosis etc. (Trojani et al, 1984;Rooser et al, 1988;Ueda et al, 1988;Mandard et al, 1989) [ion or on various treatment modalities (Markhede et al, 1982;Bramwell et al, 1985;Suit et al, 1985). In addition, most of tl in sarcoma patients is difficult to assess reliably these observations have been made on hospital-based or on of the rarity of such tumours, their differing toposelected sub-sets of population-based series.…”

“…Most published data on survival in sarcomas relates to selected patients referred to specialist treatment centres (Markhede et al, 1982;Bramwell et al, 1985;Collin et al, 1987;Stotter et al, 1990;El-Jabbour et al, 1990). Survival data from other, more broadly-based groups, have not relied upon centrally reviewed histological diagnoses for all the cases included (Tucker & Fraumeni, 1982;Fraumeni & Boice, 1982).…”

Prognostic factors for survival in soft tissue sarcoma

“…Since then other authors (Mandard et al, 1989;Rooser et al, 1988;Trojani et al, 1984) have, like us, shown it to be an independent prognostic factor. Assessment of the extent of necrosis is the most subjective and difficult of the criteria used in grading (Costa et al, 1984;Trojani et al, 1984 (Mandard et al, 1989;Ueda et al, 1988) and site (Collin et al, 1987;Markhede et al, 1982) is well documented in the literature. In this study, size was an independent prognostic factor in the superficial STS but not in either the overall group or the deep STS.…”

Core-needle biopsy performed by the cytopathologist

“…19,20 With regard to bone sarcomas, all osteosarcomas were high-grade malignant. Chondrosarcomas were graded in three grades and dedifferentiated.…”