TY - JOUR
T1 - Interaction of Histologic Subtype and Histologic Grade in Predicting Survival for Soft-Tissue Sarcomas
AU - Canter, Robert J
AU - Beal, Shannon
AU - Borys, Dariusz
AU - Martinez, Steve R.
AU - Bold, Richard J
AU - Robbins, Anthony S.
PY - 2010/2
Y1 - 2010/2
N2 - Background: Histologic grade is considered the paramount prognostic factor in predicting survival for soft-tissue sarcomas (STS). Increasing data suggest that histologic type substantially impacts STS behavior. Study Design: The Surveillance, Epidemiology, and End Results program was used to identify 17,364 cases of STS diagnosed between 1988 and 2004. Using death from STS as 1 of the outcomes variables, histologic types were grouped into 3 categories: favorable (survival ≥ 20% above the mean), neutral (survival within 20% of the mean), and unfavorable (survival ≥ 20% below the mean). The effect of histology on survival was analyzed stratified by tumor grade. Five-year survival was calculated using Kaplan-Meier analysis. Results: Among 73 histologic types, malignant fibrous histiocytoma (24.1%); leiomyosarcoma, not otherwise specified (14.8%); sarcoma, not otherwise specified (12.8%); and myxoid liposarcoma (5.9%) were the most prevalent. Grade distribution was as follows: low, 12.6%; intermediate, 14.9%; high, 37.1%; and unknown, 35.4%. Risk of death from STS increased with increasing grade: 8.0% for low, 25.9% for intermediate, and 38.3% for high. Among low-grade tumors, risk of death from STS ranged from 4.3% for favorable types to 15.3% for unfavorable types. Among intermediate-grade tumors, risk of death from STS ranged from 6.0% for favorable types to 45.4% for unfavorable types. Among high-grade tumors, risk of death from STS ranged from 24.3% for favorable types to 58.9% for unfavorable types. Conclusions: Within categories of STS grade, there are substantial differences in survival, depending on histologic type. Histologic type is an important predictor of biologic behavior in STS.
AB - Background: Histologic grade is considered the paramount prognostic factor in predicting survival for soft-tissue sarcomas (STS). Increasing data suggest that histologic type substantially impacts STS behavior. Study Design: The Surveillance, Epidemiology, and End Results program was used to identify 17,364 cases of STS diagnosed between 1988 and 2004. Using death from STS as 1 of the outcomes variables, histologic types were grouped into 3 categories: favorable (survival ≥ 20% above the mean), neutral (survival within 20% of the mean), and unfavorable (survival ≥ 20% below the mean). The effect of histology on survival was analyzed stratified by tumor grade. Five-year survival was calculated using Kaplan-Meier analysis. Results: Among 73 histologic types, malignant fibrous histiocytoma (24.1%); leiomyosarcoma, not otherwise specified (14.8%); sarcoma, not otherwise specified (12.8%); and myxoid liposarcoma (5.9%) were the most prevalent. Grade distribution was as follows: low, 12.6%; intermediate, 14.9%; high, 37.1%; and unknown, 35.4%. Risk of death from STS increased with increasing grade: 8.0% for low, 25.9% for intermediate, and 38.3% for high. Among low-grade tumors, risk of death from STS ranged from 4.3% for favorable types to 15.3% for unfavorable types. Among intermediate-grade tumors, risk of death from STS ranged from 6.0% for favorable types to 45.4% for unfavorable types. Among high-grade tumors, risk of death from STS ranged from 24.3% for favorable types to 58.9% for unfavorable types. Conclusions: Within categories of STS grade, there are substantial differences in survival, depending on histologic type. Histologic type is an important predictor of biologic behavior in STS.
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U2 - 10.1016/j.jamcollsurg.2009.10.007
DO - 10.1016/j.jamcollsurg.2009.10.007
M3 - Article
C2 - 20113939
AN - SCOPUS:74749095862
VL - 210
JO - Surgery Gynecology and Obstetrics
JF - Surgery Gynecology and Obstetrics
SN - 1072-7515
IS - 2
ER -