Surgical treatment and prognosis in patients with high-grade soft tissue malignant fibrous histiocytoma of the extremities.

Published

Journal Article

BACKGROUND: Malignant fibrous histiocytoma (MFH) of soft tissue is one of the most common sarcoma in adulthood. However, only a few series have separately studied the clinical behavior and prognosis of this malignancy. METHODS: We retrospectively reviewed 61 patients treated for extremity soft tissue high-grade MFH. Four patients had a history of another malignancy and were excluded from analysis. In 12 referred patients with incomplete excision, re-excision of the tumor bed was offered. Clinical and treatment variables were analyzed for their impact on treatment complications, local recurrence (LR), metastatic disease (MD) and overall survival (OS). RESULTS: Four patients underwent primary amputation. Twenty-three patients necessitated a primary reconstructive procedure for wound closure. Wound healing complication (WHC) developed in 28.3 % of the limb sparing group of patients. LR developed in 11 patients (19.3 %), while 6 of them had second LR. Eighteen patients (31.5 %) developed MD, involving lung at least. Patients who developed MD <12  vs >12 months, died within 19.3 vs 8 months mean time (p < 0.05). Overall survivorship was 66.7 % at 5 years. No statistically significant variables were identified for LR, while multivariate analysis for MD revealed tumor size >5 cm as the only statistically significant variable. For OS, development of MD and age >70 years emerged as independent prognostic factors. CONCLUSIONS: The overall prognosis is poor. LR, although can be managed with tumor re-excision, has high second recurrence rate. Increased tumor size is associated with shorter metastasis-free interval which significantly decreases survival.

Full Text

Duke Authors

Cited Authors

  • Vasileios, KA; Eward, WC; Brigman, BE

Published Date

  • July 2012

Published In

Volume / Issue

  • 132 / 7

Start / End Page

  • 955 - 961

PubMed ID

  • 22487849

Pubmed Central ID

  • 22487849

Electronic International Standard Serial Number (EISSN)

  • 1434-3916

Digital Object Identifier (DOI)

  • 10.1007/s00402-012-1510-y

Language

  • eng

Conference Location

  • Germany