ANALYSIS OF PROGNOSTIC FACTORS AND CHEMOTHERAPY OF MALIGNANT FIBROUS HISTIOCYTOMA OF SOFT-TISSUE - A PRELIMINARY-REPORT

The inter-group study of malignant fibrous histiocytoma of soft tissue (MFH) was performed during the period january, 1988, to August, 1992 (4 yr 7 mo). There were 107 patients evaluated with an age range of 11 to 92 yr and an average age of 62.0 yr. There were 63 males and 44 fe males. The duration of follow-up was from 7 mo to 4 yr 5 mo with an av erage of 2 yr 6.2 mo. MFH occurred principally as a mass on an extremi ty (lower extremity 62%), upper extremity 18%, trunk 25%, head and nec k 2%). It typically involved deep fascia or skeletal muscle (68%) or s uperficial subcutis (35%). There were 77 storiform-pleomorphic, 22 myx oid, three giant cell, two inflammatory and three angiomatoid variants . The absolute three-year survival rate for all 107 patients was 72%. Patients with tumors located on extremities had a better three-year su rvival rate than patients with tumors located on the trunk or head and neck (81 vs 54%). There was, however, no statistical difference betwe en the two groups. The prognosis for patients with deep muscular lesio ns, > 10 cm in diameter, was poor. The depth of the tumor significantl y affects survival. The group with superficial tumors had a significan tly better three-year survival rate than the other group (86 vs 68%). Local recurrences were found in 8% of patients who had had ''complete' ' excisions. Inadequate surgery greatly increases the incidence of loc al recurrence and compromises longterm survival. Evaluations of tumor responses to preoperative chemotherapy and radiotherapy by histologica l studies were made. In total, 38 patients were evaluated. Responses t o single and combination chemotherapy occurred in 31% of patients, a r ate similar to that seen for other sarcomas.