MFH revisited: Outcome after surgical treatment of undifferentiated pleomorphic or not otherwise specified (NOS) sarcomas of the extremities: An analysis of 140 patients

Background

Undifferentiated pleomorphic sarcoma/NOS (not otherwise specified; former pleomorphic and storiform MFH) of the extremities is a common malignant soft tissue tumor in adults. The objective of this study is to determine prognostic factors for the outcome after surgical treatment with respect to the recent developments in classification.

Methods

From 1996 to 2004, 140 undifferentiated pleomorphic sarcomas/NOS were identified out of 1,200 soft tissue sarcomas of the extremities that were treated at our institution and recorded in a prospective database. Overall survival (OS) and isolated local recurrence (ILR) were determined by Kaplan–Meier analysis. All tumors were retrospectively analyzed regarding prognostic factors of the disease, including patient’s background (primary or recurrent), histological grade (G2/G3), adjuvant chemotherapy and radiotherapy, size (T1–2) and depth of the tumor, and surgical margins (R0, R1, R2).

Results

In 123 patients, a wide resection was performed (limb-sparing surgery). In nine patients, an amputation was necessary. The overall 5-year survival rate was 72% (median follow up: 52 months). There was a significant difference between the group presenting with primary tumors (5-year survival: 84%, p < 0.05) and recurrent tumors (5-year survival: 62%, p < 0.05). Isolated local recurrence occurred in 36 patients.

Conclusions

In terms of OS and ILR, primary or recurrence, negative surgical margins, size and grading had a highly significant influence, whereas the site of surgery and adjuvant chemotherapy, adjuvant radiation and tumor depth did not. Prognosis for patients with undifferentiated pleomorphic sarcoma of the extremities depends predominantly on adequate wide resection of the primary tumor.

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Acknowledgement

We thank Renate Klaassen-Mielke, Institute of Biometry and Statistical Analysis, Ruhr University Bochum for his help in statistical analysis.

We thank Amanda Daigeler for her formal English revision of the manuscript.

Author informationAuthors and Affiliations

Department of Plastic Surgery, Burn Center, Handsurgery, Sarcoma Reference Center, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany

Marcus Lehnhardt, Adrien Daigeler, Heinz H. Homann, Vanessa Schwaiberger, Ole Goertz & Hans U. Steinau

Institute of Pathology, Sarcoma Reference Center, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany

Cornelius Kuhnen

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Correspondence to Marcus Lehnhardt.

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Marcus Lehnhardt and Adrien Daigeler contributed equally to the study.

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Lehnhardt, M., Daigeler, A., Homann, H.H. et al. MFH revisited: outcome after surgical treatment of undifferentiated pleomorphic or not otherwise specified (NOS) sarcomas of the extremities—an analysis of 140 patients. Langenbecks Arch Surg 394, 313–320 (2009). https://doi.org/10.1007/s00423-008-0368-5

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Received: 07 February 2008

Accepted: 06 June 2008

Published: 27 June 2008

Issue Date: March 2009

DOI: https://doi.org/10.1007/s00423-008-0368-5