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J Am Coll Surg. 2010 Feb;210(2):191-198.e2. doi: 10.1016/j.jamcollsurg.2009.10.007. Epub 2009 Dec 4.

Interaction of histologic subtype and histologic grade in predicting survival for soft-tissue sarcomas.

Author information

  • 1Division of Surgical Oncology, University of California Davis Cancer Center, Sacramento, CA, USA. robert.canter@ucdmc.ucdavis.edu

Abstract

BACKGROUND:

Histologic grade is considered the paramount prognostic factor in predicting survival for soft-tissue sarcomas (STS). Increasing data suggest that histologic type substantially impacts STS behavior.

STUDY DESIGN:

The Surveillance, Epidemiology, and End Results program was used to identify 17,364 cases of STS diagnosed between 1988 and 2004. Using death from STS as 1 of the outcomes variables, histologic types were grouped into 3 categories: favorable (survival >or= 20% above the mean), neutral (survival within 20% of the mean), and unfavorable (survival >or= 20% below the mean). The effect of histology on survival was analyzed stratified by tumor grade. Five-year survival was calculated using Kaplan-Meier analysis.

RESULTS:

Among 73 histologic types, malignant fibrous histiocytoma (24.1%); leiomyosarcoma, not otherwise specified (14.8%); sarcoma, not otherwise specified (12.8%); and myxoid liposarcoma (5.9%) were the most prevalent. Grade distribution was as follows: low, 12.6%; intermediate, 14.9%; high, 37.1%; and unknown, 35.4%. Risk of death from STS increased with increasing grade: 8.0% for low, 25.9% for intermediate, and 38.3% for high. Among low-grade tumors, risk of death from STS ranged from 4.3% for favorable types to 15.3% for unfavorable types. Among intermediate-grade tumors, risk of death from STS ranged from 6.0% for favorable types to 45.4% for unfavorable types. Among high-grade tumors, risk of death from STS ranged from 24.3% for favorable types to 58.9% for unfavorable types.

CONCLUSIONS:

Within categories of STS grade, there are substantial differences in survival, depending on histologic type. Histologic type is an important predictor of biologic behavior in STS.

PMID:
20113939
[PubMed - indexed for MEDLINE]
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