Analysis of therapeutic strategies and prognostic factors of malignant fibrous histiocytoma of soft tissue / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To assess the therapeutic strategies and risk factors of malignant fibrous histiocytoma of soft tissue.</p><p><b>METHODS</b>The 78 cases with malignant fibrous histiocytoma of soft tissue treated at Muscular Skeletal Tumor Center of People's Hospital, Peking University from December 1999 and October 2010 were retrospected. Univariate and multivariate analyses were performed to determine the probable risk factors including sex, age, tumor location, tumor size and so on.</p><p><b>RESULTS</b>All 60 cases were followed up ranged from 6 to 131 months (medium 35.5 months). The 1-, 3-, 5-year overall survival rate was 84.9%, 72.9% and 56.9% respectively. Local recurrence rate is 33.3% (20 cases) with a median time of 11.5 months (1 to 72 months) and metastatic rate is 15.0% (9 cases) with a median time of 7 months (1 to 26 months). Univariate analysis indicated that condition of presentation (primary case or recurrence case), tumor size and surgical margin were significantly related to survival rate (all P < 0.05, Kaplan-Meier Log-rank test), surgical margin and radiotherapy related to local recurrence rate (P value were 0.000 and 0.039 respectively), and surgical margin related to metastatic rate. Multivariate analysis showed that surgical margin was independent risk factors for survival rate (P = 0.002, OR = 5.753, 95%CI 1.904 - 17.386) and local recurrence rate (P = 0.000, RR = 0.044, 95%CI 0.010 - 0.188).</p><p><b>CONCLUSIONS</b>Surgical margin was independent risk factors for survival rate and local recurrence rate. Comprehensive therapy of surgery followed by radiotherapy can improve survival rate, reduce local recurrence rate.</p>