Histopathologic type: an independent prognostic factor in primary soft tissue sarcoma of the extremity?
BACKGROUND
We attempted to define the effect of tumor histotype on local recurrence, distant metastasis, and disease-specific survival in patients with surgically treated primary extremity sarcoma.


METHODS
A total of 951 patients with primary, localized soft tissue extremity sarcoma were followed up prospectively. Patient- and tumor-related variables, including histopathologic type, were used to identify independent prognostic factors for the study end points of local recurrence, distant recurrence, and disease-specific survival.


RESULTS
There were 137 local recurrences, and significant adverse prognostic factors for local recurrence were patient age >50 years, microscopically positive margins, and malignant peripheral nerve tumor. Adverse prognostic factors for distant recurrence (200 patients) were tumor size >5 cm, tumors beneath the investing fascia, high tumor grade, and leiomyosarcoma. Of the 199 patients who died of disease-related causes, patient age >50 years, tumors beneath the investing fascia, high tumor grade, microscopically positive margin, tumor size >5 cm, leiomyosarcoma, and malignant peripheral nerve tumor were adverse prognostic factors.


CONCLUSIONS
These data suggest that differences in biological behavior may exist between sarcoma histotypes and deserve further study.
Koea
Jonathan B
JB
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Leung
Dennis
D
Lewis
Jonathan J
JJ
Brennan
Murray F
MF
D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D005354:Fibrosarcoma / Q000401:mortality; D006801:Humans; D007890:Leiomyosarcoma / Q000401:mortality / Q000601:surgery; D008080:Liposarcoma / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010524:Peripheral Nervous System Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D012509:Sarcoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery