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Time dependence of prognostic factors for patients with soft tissue sarcoma : a Scandinavian Sarcoma Group Study of 338 malignant fibrous histiocytomas

Engellau, Jacob LU ; Anderson, Harald LU ; Rydholm, Anders LU ; Bauer, Henrik C F ; Hall, Kirsten Sundby ; Gustafson, Pelle LU ; Åkerman, Måns LU ; Meis-Kindblom, Jeanne ; Alvegård, Thor LU and Nilbert, Mef LU (2004) In Cancer 100(10). p.2233-2239
Abstract

BACKGROUND: Prognostic factors for metastasis in soft tissue sarcoma govern decisions regarding adjuvant treatment. However, the significance of initial tumor-related prognostic factors over time is largely unknown.

METHODS: The current study included 338 patients with malignant fibrous histiocytoma (MFH) of the extremities or the trunk wall whose tumors were reviewed by the Scandinavian Sarcoma Pathology Review Group. Of these 338 patients, 329 (97%) had high-grade tumors. The median follow-up period was 7 years. Metastases occurred in 110 of 338 of patients after a median follow-up period of 14 months, with roughly one-third (32 of 110) occurring after 2 years. The authors investigated the prognostic significance of tumor size,... (More)

BACKGROUND: Prognostic factors for metastasis in soft tissue sarcoma govern decisions regarding adjuvant treatment. However, the significance of initial tumor-related prognostic factors over time is largely unknown.

METHODS: The current study included 338 patients with malignant fibrous histiocytoma (MFH) of the extremities or the trunk wall whose tumors were reviewed by the Scandinavian Sarcoma Pathology Review Group. Of these 338 patients, 329 (97%) had high-grade tumors. The median follow-up period was 7 years. Metastases occurred in 110 of 338 of patients after a median follow-up period of 14 months, with roughly one-third (32 of 110) occurring after 2 years. The authors investigated the prognostic significance of tumor size, tumor depth, histologic grade, microscopic tumor necrosis, vascular invasion, mitotic rate, and local tumor recurrence at various time intervals using metastases as an endpoint.

RESULTS: On univariate analysis, all investigated factors were found to be correlated with metastases for the entire follow-up period and also for the first 2 years of follow-up; beyond this time point, only size, tumor depth, and local recurrence were significant. On multivariate analysis, necrosis and local tumor recurrence were significant for the entire follow-up duration and also for the first 2 years of follow-up, whereas only tumor depth and local recurrence were significant beyond 2 years of follow-up. For all initial factors, the annual metastasis risks in the high-risk and low-risk groups converged to < 0.1 after 2 years and to near 0 after 5 years.

CONCLUSIONS: Prognostic factors for metastasis in MFH were time dependent. The predictive value of the initial prognostic factors was limited to the first 2 years of follow-up. The lack of observed prognostic value beyond 2 years of follow-up probably was attributable to heterogeneity within risk categories as a result of measurement errors and unknown biologic variations.

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type
Contribution to journal
publication status
published
subject
keywords
Adult, Aged, Aged, 80 and over, Extremities, Female, Histiocytoma, Benign Fibrous/pathology, Humans, Incidence, Male, Middle Aged, Mitotic Index, Neoplasm Invasiveness/pathology, Neoplasm Recurrence, Local/pathology, Prognosis, Risk Factors, Sarcoma/pathology, Survival Rate, Time Factors
in
Cancer
volume
100
issue
10
pages
7 pages
publisher
John Wiley and Sons
external identifiers
  • wos:000221157000025
  • pmid:15139069
  • scopus:2342622640
  • pmid:15139069
ISSN
1097-0142
DOI
10.1002/cncr.20254
language
English
LU publication?
yes
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3be28adf-8c07-44bc-90f5-bf9da40af9f4 (old id 123476)
date added to LUP
2016-04-01 12:19:51
date last changed
2021-01-06 02:43:40
@article{3be28adf-8c07-44bc-90f5-bf9da40af9f4,
  abstract     = {<p>BACKGROUND: Prognostic factors for metastasis in soft tissue sarcoma govern decisions regarding adjuvant treatment. However, the significance of initial tumor-related prognostic factors over time is largely unknown.</p><p>METHODS: The current study included 338 patients with malignant fibrous histiocytoma (MFH) of the extremities or the trunk wall whose tumors were reviewed by the Scandinavian Sarcoma Pathology Review Group. Of these 338 patients, 329 (97%) had high-grade tumors. The median follow-up period was 7 years. Metastases occurred in 110 of 338 of patients after a median follow-up period of 14 months, with roughly one-third (32 of 110) occurring after 2 years. The authors investigated the prognostic significance of tumor size, tumor depth, histologic grade, microscopic tumor necrosis, vascular invasion, mitotic rate, and local tumor recurrence at various time intervals using metastases as an endpoint.</p><p>RESULTS: On univariate analysis, all investigated factors were found to be correlated with metastases for the entire follow-up period and also for the first 2 years of follow-up; beyond this time point, only size, tumor depth, and local recurrence were significant. On multivariate analysis, necrosis and local tumor recurrence were significant for the entire follow-up duration and also for the first 2 years of follow-up, whereas only tumor depth and local recurrence were significant beyond 2 years of follow-up. For all initial factors, the annual metastasis risks in the high-risk and low-risk groups converged to &lt; 0.1 after 2 years and to near 0 after 5 years.</p><p>CONCLUSIONS: Prognostic factors for metastasis in MFH were time dependent. The predictive value of the initial prognostic factors was limited to the first 2 years of follow-up. The lack of observed prognostic value beyond 2 years of follow-up probably was attributable to heterogeneity within risk categories as a result of measurement errors and unknown biologic variations.</p>},
  author       = {Engellau, Jacob and Anderson, Harald and Rydholm, Anders and Bauer, Henrik C F and Hall, Kirsten Sundby and Gustafson, Pelle and Åkerman, Måns and Meis-Kindblom, Jeanne and Alvegård, Thor and Nilbert, Mef},
  issn         = {1097-0142},
  language     = {eng},
  number       = {10},
  pages        = {2233--2239},
  publisher    = {John Wiley and Sons},
  series       = {Cancer},
  title        = {Time dependence of prognostic factors for patients with soft tissue sarcoma : a Scandinavian Sarcoma Group Study of 338 malignant fibrous histiocytomas},
  url          = {http://dx.doi.org/10.1002/cncr.20254},
  doi          = {10.1002/cncr.20254},
  volume       = {100},
  year         = {2004},
}