Prognostic significance of telomerase activity in soft tissue sarcomas

Only few reports on the prognostic significance of telomerase activity in h uman cancer exist. To find a new prognostic marker in soft tissue tumors, w e investigated 60 soft tissue sarcomas of different histology and six benig n tumors for telomerase activity. Telomerase activity was measured by using the non-radioactive PCR-based TRAP-assay. PCR products were analyzed on an automated fluorescence sequencer. Tumors of grade-II and grade-III histolo gy showed a significantly poorer prognosis. Both disease-free (p<0.03) and the overall survival (p<0.02) were reduced in the highly malignant sarcoma patients. We found telomerase activity in 38.3% of the cases, there being a correlation with a more aggressive behavior of soft tissue sarcomas. Telom erase activity correlated with the grade of malignancy (p=0.04), but not wi th sex (p=0.64) or age (p=0.48) of the patients. The total survival was sig nificantly reduced in patients with telomerase-positive sarcomas (p=0.04). Both of the patients having grade I tumors with telomerase activity died of disease, whereas 10 of 11 patients with telomerase-negative grade I tumors are still alive. Only one of the benign tumors showed telomerase activity. We suggest that telomerase activity is a potential prognostic factor in ma lignant soft tissue tumors. Despite the histological heterogeneity of soft tissue tumors, single entities should be assessed for telomerase activity.