title: An analysis of factors related to recurrence of myxofibrosarcoma.
abstract: OBJECTIVE
  Myxofibrosarcoma is clinically characterized by a high frequency of local recurrence after surgery. To improve the clinical outcome of patients with myxofibrosarcoma, it is imperative to control any postsurgical local recurrence.
  
  
  METHODS
  In this study, we performed a retrospective clinicopathologic analysis of 100 consecutive patients with myxofibrosarcoma to identify factors related to poor prognosis. All of the patients had been diagnosed, and had undergone surgery at the National Cancer Center Hospital between 1999 and 2008.
  
  
  RESULTS
  At the initial visit to our hospital, 64 patients had primary myxofibrosarcoma, whereas 36 had undergone primary unplanned resection at other facilities. Of the 36 patients, 11 consulted our hospital before recurrence and 25 did so after recurrence. A histologically positive margin after surgery was evident in 28% of the cases overall. The estimated 5-year recurrence-free survival rate was 74.8%. Univariate analysis showed that primary unplanned resection at another facility (P = 0.0001) and a histologically positive margin (P = 0.0224) were significant predictors of local recurrence. When these two factors were subjected to multivariate analysis, only primary unplanned resection at another facility was significantly correlated with the estimated recurrence-free survival rate (P = 0.0011). Primary unplanned resection was also significantly related to the 5-year disease-free survival rate (P = 0.0401).
  
  
  CONCLUSIONS
  Our findings indicate that primary unplanned resection at a non-referral hospital is the most important risk factor related to poor prognosis of myxofibrosarcoma. Accurate diagnosis and adequate initial surgery are most important factors for improving the clinical outcomes of myxofibrosarcoma.
authors: *Division of Orthopedic Surgery, Tachikawa Hospital, 4-2-22 Nishikimachi, Tachikawa, Tokyo 190-8531, Japan. k.kikuta@tachikawa-hosp.gr.jp.
authors: Kazutaka
authors: K
authors: Kikuta
authors: Daisuke
authors: D
authors: Kubota
authors: Akihiko
authors: A
authors: Yoshida
authors: Yoshihisa
authors: Y
authors: Suzuki
authors: Hideo
authors: H
authors: Morioka
authors: Yoshiaki
authors: Y
authors: Toyama
authors: Eisuke
authors: E
authors: Kobayashi
authors: Fumihiko
authors: F
authors: Nakatani
authors: Hirokazu
authors: H
authors: Chuuman
authors: Akira
authors: A
authors: Kawai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D018572:Disease-Free Survival; D005163:Factor Analysis, Statistical; D005260:Female; D005350:Fibroma / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery*; D005354:Fibrosarcoma / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D013514:Surgical Procedures, Operative / Q000379:methods / Q000592:standards
keywords: myxofibrosarcoma; recurrence; surgery