Staging of soft-tissue sarcomas. Prognostic analysis of clinical and pathological features

Abstract

In a retrospective study of all 137 patients with soft-tissue sarcoma treated by surgery between 1972 and 1984, the clinical course was related to several host and tumour features, including the Surgical Staging System of Enneking, Spanier and Goodman (1980). Only patients free from metastasis with untreated primary lesions on admission were included. According to the Surgical Staging System, nine tumours were IA, 18 IB, 38 IIA and 72 IIB. Only 12 patients underwent amputation; 125 were treated by local surgery. The mean follow-up time was ten years (minimum five). For the whole series the probability of seven-year survival was 0.65; 42 patients (31%) died from tumour disease. All these had metastases and 24 also had local recurrence. The local recurrence rate was 36%. Multivariate analysis identified large tumour size and high histological grade as significant risk factors for metastatic disease and tumour-related death. Sex, age, tumour site, surgical margin and local recurrence showed no correlation with survival. The prognostic contribution of compartmentality was virtually nil. Histological grade combined with tumour size was found to give better prognostic information than that obtained by the Surgical Staging System.

Prognostic factors in superficial adult soft tissue sarcomas: Analysis of a series of 105 patients

“…Moreover, this difference appeared despite a reinforcement of local treatment, as radiotherapy was done in most of the patients with larger tumors. As regards to local prognosis of soft-tissue sarcomas, quality of initial resection has been found to be an important prognostic factor for local control [5,6,9,[15][16][17][18][19][20][21]. This was not significantly evidenced in the present series.…”

Local recurrence of soft tissue sarcoma a risk factor for late metastases: 379 patients followed for 0.5-20 years

“…Host and tumor features often claimed to be of prognostic value are tumor depth, size, malignancy grade, necrosis, vascular invasion, and DNA ploidy (Enneking et al 1980, Markhede et al 1982, Rydholm et al 1984, Collin et al 1987, Rooser et al 1987, Collin et al 1988, Rooser et al 1988, Alvegkd et al 1989a, El-Jabbour et al 1990. Bauer et al 1991, Rydholm et al 1991, Saddegh et al 1992, Westbury 1992.…”

Malignant Fibrous Histiocytoma of Bone and Soft Tissue – Two Different Tumor Entities? A Retrospective Study of 45 Cases

“…As a result the established therapy principles for soft-tissue sarcomas are accepted for MFH of soft tissue. Prognostic fac tors correlating to survival rate are histological grading, size of the tumor [22][23][24], surgical resection margins [25,26], and tumor necrosis [27]. Baseline treatment consists of at least wide resection margins [25], as low malignant soft-tissue MFH is rare.…”