Flow cytometric S-phase fraction in soft-tissue sarcoma: prognostic importance analysed in 160 patients.
We could determine the S-phase fraction (SPF) by flow cytometric DNA analysis of paraffin archival material in 160 of 260 patients with soft-tissue sarcoma of extremity and trunk wall. The prognostic value of SPF was compared with other clinicopathological factors. The median follow-up time was 16 (6-31) years. In a univariate analysis, deep tumour location, increasing tumour size and histological malignancy grade, microscopic tumour necrosis, vascular invasion, DNA non-diploidy and high SPF (>3.0%) were associated with poor metastasis-free survival. In a multivariate analysis, microscopic tumour necrosis and high SPF were independently prognostic for metastasis. Used in combination with tumour size, microscopic tumour necrosis and vascular invasion, SPF could identify a group of patients with a 5-year metastasis-free survival rate of 0.97. This group constituted one-quarter of all patients. Patients with low SPF who did recur had a prolonged clinical course both as regards metastases and local recurrence. We conclude that SPF is a valuable adjunct in prognostication in soft-tissue sarcoma.
Gustafson
P
P
Department of Orthopedics, University Hospital, Lund, Sweden.
Fernö
M
M
Akerman
M
M
Baldetorp
B
B
Willén
H
H
Killander
D
D
Rydholm
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004273:DNA, Neoplasm / Q000737:chemistry*; D018572:Disease-Free Survival; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009336:Necrosis; D009361:Neoplasm Invasiveness; D011379:Prognosis; D016196:S Phase; D012509:Sarcoma / Q000175:diagnosis* / Q000556:secondary; D012983:Soft Tissue Neoplasms / Q000175:diagnosis*
D004273:DNA, Neoplasm