CLINICAL OUTCOME OF PATIENTS WITH PREVIOUSLY UNTREATED SOFT-TISSUE SARCOMAS IN RELATION TO TUMOR GRADE, DNA-PLOIDY AND KARYOTYPE

The most important prognostic factor in soft tissue sarcomas (STS) is tumor grade. Since most grading methods are subject to the interpretat ion of the individual pathologist, there is a need for objective crite ria such as DNA ploidy and karyotype, which are of prognostic value in several types of malignancy. We have analyzed the relationships among tumor grade, DNA ploidy, cytogenetic abnormalities and the clinical o utcome of 44 previously untreated patients with 12 different histologi cal types of primary STS. The tumors were graded according to the meth od of Coindre, which resulted in 9 grade 1 (20%), 18 grade II (41%) an d 17 grade III (39%) STS. DNA flow cytometry and chromosomal analysis were performed using standard techniques. After a median follow-up tim e of 39 (range, 2-124) months, Kaplan-Meier survival analysis was perf ormed. Significant differences in 5-year overall survival were found b etween patients with grade I or II and grade III STS (p < 0.05), Seven teen STS were aneuploid and 26 were euploid, in 21 of 39 successfully cultured STS an abnormal karyotype was found. There were no significan t differences in survival in relation to DNA ploidy or the presence of chromosomal abnormalities. Our results show that grading had higher p rognostic value than DNA ploidy or the presence of cytogenetic abnorma lities in this heterogeneous group of STS. (C) 1997 Wiley-Liss, Inc.