Abstract
We could determine the S-phase fraction (SPF) by flow cytometric DNA analysis of paraffin archival material in 160 of 260 patients with soft-tissue sarcoma of extremity and trunk wall. The prognostic value of SPF was compared with other clinicopathological factors. The median follow-up time was 16 (6-31) years. In a univariate analysis, deep tumour location, increasing tumour size and histological malignancy grade, microscopic tumour necrosis, vascular invasion, DNA non-diploidy and high SPF (>3.0%) were associated with poor metastasis-free survival. In a multivariate analysis, microscopic tumour necrosis and high SPF were independently prognostic for metastasis. Used in combination with tumour size, microscopic tumour necrosis and vascular invasion, SPF could identify a group of patients with a 5-year metastasis-free survival rate of 0.97. This group constituted one-quarter of all patients. Patients with low SPF who did recur had a prolonged clinical course both as regards metastases and local recurrence. We conclude that SPF is a valuable adjunct in prognostication in soft-tissue sarcoma.
Highlights
The database comprises all patients in the Southern Swedish Health Care Region (1.5 million inhabitants), irrespective of whether the patients have been treated at our institution or at local hospitals in the region
We had no reason to assume that a specific S-phase fraction (SPF) value would be optimal for prognostic dichotomization, and analysed different cut-off values
We found the best cut-off at 3.0%, which identified 47 patients with SPF 3.0% (= high SPF)
Summary
The population-based database at the Musculoskeletal Tumor Center in Lund, Sweden, holds records of 508 patients with softtissue sarcoma of extremity and trunk wall diagnosed between 1964 and 1989. The database comprises all patients in the Southern Swedish Health Care Region (1.5 million inhabitants), irrespective of whether the patients have been treated at our institution or at local hospitals in the region. Correspondence to: P Gustafson microscopic tumour necrosis, vascular invasion and malignancy grading, have been described elsewhere (Gustafson 1994a). The 160 patients had a median age of 62 (range 18-87) years, and a median tumour size of 7 (range 1-30) cm. These patients were not analysed separately, since they did not differ from those who did not receive chemotherapy as regards clinicopathological factors or outcome
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