Predictive value of grade for metastasis development in the main histologic types of adult soft tissue sarcomas - A study of 1240 patients from the French Federation of Cancer Centers Sarcoma Group

BACKGROUND. Histologic grade is said to be the most important prognostic fa ctor in adult soft tissue sarcomas (STS), but most grading systems have bee n tested in the overall sarcoma group and the predictive value of histologi c grade needs to be assessed specifically for each of the histologic catego ries. METHODS. From 1980 to 1994, 1240 nonmetastatic patients were entered in til e French STS database. The following parameters were studied: patient's age and gender, previous history, tumor location, size and depth, neurovascula r or bone involvement (NBI), histologic type and subtype, and grade (the Fr ench Federation of Cancer Centers [FNCLCC] system), Median follow-up for th e survivors was 88 months; only 5% of patients were lost to follow-up. The authors performed univariate and multivariate analyses for metastasis-free survival for the overall sarcoma group and for every main histologic type. RESULTS, In order of importance. parameters were respectively retained as i ndependent predictors of metastasis as follows: grade, tumor size, NBI and tumor depth for the overall group grade and NBI for malignant fibrous histi ocytomas (n = 349), tumor size, histologic subtype and grade for liposarcom as (II = 188), NBI, grade and tumor size for leiomyosarcomas (n = 148), gra de and NBI for synovial sarcomas (n = 125), grade for unclassified sarcomas (n = 140), and sarcomas of other types (n = 158). No parameter was signifi cant for malignant schwannomas (n = 72) or for rhabdomyosarcomas (n = GO). CONCLUSION. In this study histologic grade appeared as an independent predi ctor of metastasis development in the main histologic types of adult STS, w ith die exception of malignant schwannomas and rhabdomyosarcomas. (C) 2001 American Cancer Society.