title: Prognostic relevance of the mitotic count and the amount of viable tumour after neoadjuvant chemotherapy for primary, localised, high-grade soft tissue sarcoma.
abstract: BACKGROUND
  We sought to examine whether mitotic count (MC) and the amount of viable tumour (VT) following neoadjuvant systemic chemotherapy (SC) for primary, localised, high-grade soft tissue sarcoma (STS) correlate with prognosis.
  
  
  METHODS
  Retrospective analysis of 57 patients who underwent SC involving a combination of an anthracycline and an alkylating agent, followed by surgical resection between 2001 and 2011.
  
  
  RESULTS
  The amount of VT after chemotherapy was significantly associated with disease-specific survival (DSS) and event-free survival (EFS). Patients with <10% VT had a DSS of 94% at 5 years, compared with 61% for patients with ⩾10% VT (P=0.033); EFS was 75%, compared with 48% (P=0.030). Patients with an MC of ⩾20/10 high power fields (HPF) after chemotherapy had a significantly lower DSS (33% vs 84% at 5 years, P<0.001) and EFS (40% vs 63% at 5 years, P=0.019) than patients with an MC of <20/10 HPF.
  
  
  CONCLUSIONS
  The MC and the amount of VT after neoadjuvant therapy for primary, localised, high-grade STS appear to correlate with prognosis. If these results are validated prospectively, then they could provide a rational for the design of neoadjuvant treatment modification/escalation studies, analogue to the EURAMOS-1 trial for bone sarcomas.
authors.affiliation: 1] Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149 Münster, Germany [2] Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Andreou
authors.affiliation: Department of Pathology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Emil von Behring, Walterhöferstraße 11, 14165 Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Werner
authors.affiliation: Department of Hematology, Oncology and Palliative Care, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Bad Saarow, Pieskower Straße 33, 15526 Bad Saarow, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Pink
authors.affiliation: Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Traub
authors.affiliation: Department of Internal Medicine I, University Hospital Carl Gustav Carus Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schuler
authors.affiliation: Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149 Münster, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Gosheger
authors.affiliation: Department of Radiology, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Jobke
authors.affiliation: Department of Interdisciplinary Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Reichardt
authors.affiliation: Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany.
authors.forename: P U
authors.initials: PU
authors.lastname: Tunn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D002470:Cell Survival / Q000187:drug effects; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D018365:Neoplasm, Residual; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating