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.
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Jonathan B
JB
Koea
Dennis
D
Leung
Jonathan J
JJ
Lewis
Murray F
MF
Brennan
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