2002 CTOS Annual Meeting Posters — Surgery

MALIGNANT FIBROUS HISTOCYTOMA OF THE EXTREMITIES AND TRUNK - AN INSTITUTIONAL REVIEW
[Abstract ID: 52]

Category: Surgery

Authors: Alexandra Koenig¹, Matthias Peiper¹, Wolfram Trudo Knoefel¹, Jakob R. Izbicki¹

Author Institutions: ¹Department of Surgery University Hospital Hamburg, Germany

Presenter: Alexandra Koenig
alexandra.koenig@gmx.de

Correspondent: Matthias Peiper
peiper@uke.uni-hamburg.de
Hamburg Germany 20246
Ph: xx4940428032450
Fax: xx4040428033458

Objectives: Malignant fibrous histiocytoma is the most common subtype of soft tissue sarcoma. Detailed understanding of this tumour type may lead to improved therapeutical strategies.

Methods: An institutional review was performed about all MFH patients operated on between 1988 and 1998.

Results: Eighty-six- patients with histologically confirmed MFH (G1: n=8, G2: n=23, G3: n=55) were analysed. Local recurrence was 36% after a median of 13 months. Distant metastases occurred in 29% of patients. After a mean follow-up of 5.5 years, 42 patients were alive without evidence of disease, median survival time was 68 months at a cumulative 5-year survival rate of 65%. Tumour size significantly influenced disease free survival (T2 vs. T1, P < 0.01, risk ratio [RR] 5.5), as did tumour depth (subfascial tumours, P = < 0.01, RR 3.3), and presence of lymph nodes (P = 0.02, RR 6.5). Positive microscopic margins and subfascial tumours were associated with an increased local recurrence rate (RR 5.7, P < 0.0001 and RR 3.5, P = 0.02, respectively). The only multivariate risk factors of distant metastases were tumour depth, in which patients with subfascial tumours fared worse (RR 4.0, P < 0.01) and tumour grade (RR 5.5, P = 0.03).

Conclusions: We conclude that aggressive but limb preserving resection of MFH should be performed at initial operation to minimize risk of local recurrence; a strict follow-up especially of subfascial tumours should be performed.