title: Primary malignant fibrous histiocytoma of long bones: long-term follow-up.
abstract: OBJECTIVE
  This study aims to evaluate patients diagnosed with malignant fibrous histiocytoma and investigate the possible prognostic factors associated with duration of survival.
  
  
  METHODS
  The study, which was conducted between May 1994 and September 2013, included 14 patients diagnosed as malignant fibrous histiocytoma (12 males, 2 females; median age 48 years; range 17 to 64 years). We evaluated patients' demographic features, location of the pathology, histological findings, surgical margins, and treatment modalities and investigated the effects of these parameters on survival.
  
  
  RESULTS
  Femur was the most frequently involved bone, followed by tibia and humerus. The median follow-up duration of the patients was 129 months. We performed limb salvage surgeries in 13 patients and amputation in one patient. Surgical margins were marginal in three patients and postoperative radiotherapy was performed for local control of the disease. Although there was no local recurrence in these patients, distant metastasis developed in two patients, indicating the importance of surgical margin as a significant factor on survival. Five-year survival rate was 81.9% in patients with wide surgical margins and 33.3% in patients with marginal margins.
  
  
  CONCLUSIONS
  Surgical excision with wide margins and adjuvant chemotherapy provided adequate control of the disease and longer survival. The only prognostic factor statistically significantly associated with duration of survival was surgical margins. Neoadjuvant chemotherapy may be used when there is a suspicion of not obtaining adequately wide surgical margin perioperatively due to close association with neurovascular structures.
authors: Department of Orthopedics and Traumatology, Ankara Numune Training and Research Hospital, 06100 Altındağ, Ankara, Turkey. drbulentozkurt@yahoo.com.
authors: Bülent
authors: B
authors: Özkurt
authors: Kerem
authors: K
authors: Başarır
authors: Yusuf H
authors: YH
authors: Yıldız
authors: Mahmut
authors: M
authors: Kalem
authors: Yener
authors: Y
authors: Sağlık
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D051677:Histiocytoma, Malignant Fibrous / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014421:Turkey; D055815:Young Adult