Prognostic factors in patients with malignant fibrous histiocytoma of the extremities

Objectives: We evaluated prognostic factors in patients with malignant fibrous histiocytoma of the extremity. Methods: The study included 26 patients (22 males, 4 fe¬males; 15 patients < age 60) with a diagnosis of malignant fibrous histiocytoma of the extremity. Clinical and patho¬logical data were analyzed including age, gender, affected extremity, presentation status (primary or recurrent), local¬ization (proximal or distal), size, depth, and grade of the tumor, resection quality, adjuvant therapy, and the pres¬ence of distant metastasis at the time of diagnosis. Results: The mean follow-up of 16 patients who were alive was 44.8 months (range 24 to 120 months). The mean symp¬tom duration before diagnosis was seven months (range 1 to 26 months). All the patients underwent surgical resection. A margin-negative R0 resection was obtained in 17 patients. Amputation was performed in seven patients. Adjuvant che¬motherapy and radiotherapy were administered to 17 patients and 10 patients, respectively. Local recurrence was detected in eight patients. Two patients had distant metastasis at the time of diagnosis while eight patients developed distant me¬tastasis within a mean of 13 months (range 7 to 20 months) postoperatively. Kaplan-Meier analysis showed an overall five-year survival rate of 61.5%, being 100% in low-grade tumors, and 28.2% in high-grade tumors. Tumor grade was the only significant parameter affecting survival in both uni¬variate (p=0.004) and multivariate (p=0.023) analyses. Conclusion: Patients with high-grade malignant fibrous histiocytoma have a poorer prognosis.