Histopathological grading of soft tissue tumours. Prognostic significance in a prospective study of 278 consecutive cases

Abstract

A consecutive 10-year series of 278 soft tissue sarcomas was prospectively graded, using a system based on the number of mitoses and taking into account parameters such as cellularity, anaplasia, necrosis, and histogenetic type and subtype of tumour. Prognostic factors in relation to metastasis-free survival were studied by uni- and multivariate analysis. Fifty-seven (20.5 per cent) were low-grade tumours, 43 (15.5 per cent) were intermediate, and 178 (64 per cent) were high grade. High-grade tumours were divided into two groups; 80 (29 per cent) grade 3A (= 5-20 mitoses per 10 high power fields (HPF)) and 78 grade 3B (28 per cent) (= more than 20 mitoses/10 HPF); 10 HPF corresponds to 2.5 mm2. Twenty (7.2 per cent) high-grade tumours could not be further subdivided. Grading was found to be the prognostic factor associated with the strongest predictive value. Five-year survival in low-grade and intermediate tumours (95 and 86 percent, respectively) differed significantly (P less than 0.0001) from high grade (50 per cent) and (p = 0.0018) between grade 3A (64 per cent) and grade 3B (41 per cent). Other prognostic indicators of importance in high-grade tumours were age, local recurrence at presentation (primary operation outside the Centre), and localization (superficial vs. deep).

Hypoxia in human soft tissue sarcomas: Adverse impact on survival and no association with p53 mutations

“…Histopathological grade is a classical prognostic indicator for survival in STS (Jensen et al, 1991;Vraa et al, 1998). We found that all 6 patients with grade I or II tumours were alive and 5 of those had less hypoxic tumours.…”

“…Based on examinations of biopsy and/or surgical specimens the group pathologist determined the histopathological diagnosis and tumour grade as previously described (Jensen et al, 1991).…”

Malignant fibrous histiocytoma of the lung: Report of four cases and review of the literature

“…Five-year survival is highly dependent on the tumor grade. Results varied from 95% for Grade 1, 86% for Grade 2, and 50% for Grade 3 tumors in a series by Jensen et al 33 The value of systemic chemotherapy in these tumors is not yet definitely known, its role being limited to those patients with a poor prognosis including large tumor size, high grade, or metastatic disease. …”

Tumour Oxygenation Assessed by Polarographic Needle Electrodes and Bioenergetic Status Measured by31P Magnetic Resonance Spectroscopy in Human Soft Tissue Tumours

“…31P-MRS and PO, assessment were done immediately after the routine magnetic resonance imaging (MRI). Between 1 and 7 days later (median 2 days) a biopsy was excised (or the entire tumour surgically removed) and histopathological diagnosis was achieved (17). This revealed that 27 tumours were soft tissue sarcomas, of which 2 were recurrent diseases.…”