Staging and prognostic factors in soft tissue sarcoma

https://doi.org/10.1016/S1053-4296(99)80025-3Get rights and content

Significant advances have been made in the understanding of clinicopathologic prognostic factors for soft tissue sarcoma over the past decade. Foremost among these advances is an improved ability to recognize the subset of patients at high risk for recurrent disease based on clinicopathologic data available at the time of initial presentation. Progress has also helped to elucidate specific molecular factors that have independent prognostic significance. This review outlines the updated American Joint Committee on Cancer staging system for soft tissue sarcoma and summarizes the available data on traditional clinicopathologic and molecular prognostic factors.

References (73)

  • TrojaniM et al.

    Soft-tissue sarcomas of adults: Study of pathological prognostic variables and definition of a histopathological grading system

    Int J Cancer

    (1984)
  • RydholmA et al.

    Prognosis for soft-tissue sarcoma in the locomotor system: A retrospective population-based follow-up study of 237 patients

    Acta Pathol Microbiol Immunol Scand [A]

    (1984)
  • HeiseHW et al.

    Recurrence-free survival time for surgically treated soft tissue sarcoma patients: Multivariate analysis of five prognostic factors

    Cancer

    (1986)
  • RooserB et al.

    Survival in soft tissue sarcoma: Prognostic variables identified by multivariate analysis

    Acta Orthop Scand

    (1987)
  • CollinC et al.

    Localized extremity soft tissue sarcoma: An analysis of factors affecting survival

    J Clin Oncol

    (1987)
  • TsujimotoM et al.

    Multivariate analysis for histologic prognostic factors in soft tissue sarcomas

    Cancer

    (1988)
  • UedaT et al.

    Multivariate analysis for clinical prognostic factors in 163 patients

    Cancer

    (1988)
  • RooserB et al.

    Prognostication in soft tissue sarcoma: A model with four risk factors

    Cancer

    (1988)
  • MandardAM et al.

    Prognostic factors in soft tissue sarcomas: A multivariate analysis of 109 cases

    Cancer

    (1989)
  • BellRS et al.

    The surgical margin in soft-tissue sarcoma

    J Bone Joint Surg Am

    (1989)
  • StotterAT et al.

    The influence of local recurrence of extremity soft tissue sarcoma on metastasis and survival

    Cancer

    (1990)
  • AlvegardTA et al.

    Cellular DNA content and prognosis of high-grade soft tissue sarcoma: The Scandinavian, Sarcoma Group experience

    J Clin Oncol

    (1990)
  • PistersPWT et al.

    Analysis of prognostic factors in 1041 patients with localized soft tissue sarcomas of the extremities

    J Clin Oncol

    (1996)
  • CoindreJM et al.

    Prognostic factors in adult patients with locally controlled soft tissue sarcoma. A study of 546 patients from the French Federation of Cancer Centers Sarcoma Group

    J Clin Oncol

    (1996)
  • BevilacquaRG et al.

    Prognostic factors in primary retroperitoneal soft-tissue sarcomas

    Arch Surg

    (1991)
  • HeslinMJ et al.

    Prognostic factors associated with long-term survival for retroperitoneal sarcoma: Implications for management

    J Clin Oncol

    (1997)
  • TranLM et al.

    Sarcomas of the head and neck: Prognostic factors and treatment strategies

    Cancer

    (1992)
  • KowalskiLP et al.

    Prognostic factors in head and neck soft tissue sarcomas: Analysis of 128 cases

    J Surg Oncol

    (1994)
  • KrausDH et al.

    Prognostic factors for recurrence and survival in head and neck soft tissue sarcomas

    Cancer

    (1994)
  • McGrathPC et al.

    Gastrointestinal sarcomas: Analysis of prognostic factors

    Ann Surg

    (1987)
  • NgEH et al.

    Prognostic factors influencing survival in gastrointestinal leiomyosarcomas: Implications for surgical management and staging

    Ann Surg

    (1992)
  • MeijerS et al.

    Primary colorectal sarcoma: A retrospective review and prognostic factor study of 50 consecutive patients

    Arch Surg

    (1990)
  • OlahKS et al.

    Leiomyosarcomas have a poorer prognosis than mixed mesodermal tumours when adjusting for known prognostic factors: The result of a retrospective study of 423 cases of uterine sarcoma

    Br J Obstet Gynaecol

    (1992)
  • RooserB et al.

    Prognostic factors in synovial sarcoma

    Cancer

    (1989)
  • SingerS et al.

    Synovial sarcoma: Prognostic significance of tumor size, margin of resection, and mitotic activity for survival

    J Clin Oncol

    (1996)
  • Le DoussalV et al.

    Prognostic factors for patients with localized primary malignant fibrous histocytoma: A multicenter study of 216 patients with multivariate analysis

    Cancer

    (1996)
  • Cited by (37)

    • Risk factors for survival of head and neck soft tissue sarcomas: A comparison between 7th and 8th edition AJCC staging systems

      2020, Oral Oncology
      Citation Excerpt :

      To the best of our knowledge, this is the first study to evaluate the prognostic factors for HNSTS survival through a comparison between previous and current AJCC staging systems. Patient age, tumour size, histological grade, distant metastasis, positive resection margin were the major determinants for the survival of all HNSTS patients, as previously reported [7–9,16]. Positive resection margin was the sole significant factor for the S group that showed poor discrimination among different T-categories.

    • Extremity Soft Tissue Sarcoma: Tailoring Resection to Histologic Subtype

      2016, Surgical Oncology Clinics of North America
      Citation Excerpt :

      The interplay can get confusing because prognostic factors vary based on endpoint. For example, in extremity STS, the prognostic factors for local recurrence are not necessarily the same as those for metastasis8; however local recurrence can itself be a prognostic factor for metastasis.9 Histologic grade has an integral role in multiple aspects of STS prognosis, ranging from local recurrence to metastasis and disease specific survival as seen in Kaplan-Meier estimates.7,10,11

    • Local Recurrence of Extremity Soft Tissue Sarcoma

      2016, Surgical Clinics of North America
      Citation Excerpt :

      The anatomic location of these tumors is important because it influences treatment and outcome. Several prognostic factors, such as tumor stage, size, grade, and anatomic location, have been demonstrated to have an impact on overall survival in the management of primary extremity STS.4–6 Similarly, margin of resection, low-grade histology, and the use of radiotherapy are important factors in achieving local disease control.7–9

    • Primary Intracranial Sarcoma Presenting as Chronic Subdural Fluid Collections in a Child

      2016, World Neurosurgery
      Citation Excerpt :

      However, despite the long delay between initial presentation and the development of a progressive malignant process, we speculate the subdural fluid to have arisen as a product of tumor secretion. The prognosis of primary intracranial sarcoma is largely determined by tumor grade.9 In a series of 18 patients with primary intracranial sarcoma treated with subtotal resection and radiotherapy with or without chemotherapy, the 5-year survival rate was 28% for patients with high-grade lesions and 83% for those with low-grade lesions.2

    • Tumors of the Foot and Ankle

      2007, Foot and Ankle: Core Knowledge in Orthopaedics
    View all citing articles on Scopus
    View full text