Abstract
BackgroundThe correct clinical staging of soft tissue sarcomas (STS) is critical for the selection of treatments. The staging system consists of histological grade of the tumors and French Federation of Cancer Center (FNCLCC) system based on mitotic count is widely used for the grading. In this study, we compared the validity and usefulness of Ki-67 grading system with FNCLCC system in JCOG0304 trial which investigated the efficacy and safety of perioperative chemotherapy with doxorubicin and ifosfamide for STS.MethodsAll 70 eligible patients with STS in the extremities treated by perioperative chemotherapy in JCOG0304 were analyzed. Univariate and multivariate Cox regression analyses were conducted to investigate an influence on overall survival.ResultsThe reproducibility of Ki-67 grading system in the histological grading of STS was higher than FNCLCC system (κ = 0.54 [95 % CI 0.39–0.71], and 0.46 [0.32–0.62], respectively). Although FNCLCC grade was not associated with overall survival (OS) in univariate analysis (HR 2.80 [0.74–10.55], p = 0.13), Ki-67 grading system had a tendency to associate with OS in univariate analysis (HR 4.12 [0.89–19.09], p = 0.07) and multivariate analysis with backward elimination (HR 3.51 [0.75–16.36], p = 0.11).ConclusionsThis is the first report demonstrating the efficacy of Ki-67 grading system for the patients with STS in the prospective trial. The results indicate that Ki-67 grading system might be useful for the evaluation of histological grade of STS.
Highlights
The correct clinical staging of soft tissue sarcomas (STS) is critical for the selection of treatments
Using the retrospective data of 95 patients with STS of the extremities, trunk, head, and neck treated in the single institution, we have previously reported the usefulness of a novel histological grading system based on the three parameters: tumor differentiation, degree of necrosis, and Ki-67 (MIB-1) score [7]
Patient characteristics From March 2004 to September 2008, a total of 72 patients were enrolled into the JCOG0304 trial, and 70 eligible patients in the trial were included in the present analysis
Summary
The correct clinical staging of soft tissue sarcomas (STS) is critical for the selection of treatments. Soft tissue sarcomas (STS) in adults are rare malignant tumors, and the incidence of STS is approximately 1 % of all malignant tumors. According to the Soft Tissue Tumor Registry reported by the Musculoskeletal Tumor Committee of the Japanese Orthopaedic Association, only 1540 cases of STS were registered in 2012 in Japan [1]. Surgical resection of the tumor with or without radiotherapy is the standard treatment and highly successful for stage I and II STS, and systemic chemotherapy with doxorubicin (DOX)based regimen is standard for stage IV STS [3]. The standard therapeutic modality for stage III STS is mainly surgical resection; systemic perioperative chemotherapy with DOX plus ifosfamide (IFO) is the promising treatment for high-risk STS [4]. The precise diagnosis and staging is critical for the Tanaka et al World Journal of Surgical Oncology (2016) 14:110 selection of treatments and improvement of outcome of the patients with STS
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