Analysis of prognostic factors and chemotherapy of malignant fibrous histiocytoma of soft tissue: a preliminary report.

The inter-group study of malignant fibrous histiocytoma of soft tissue (MFH) was performed during the period January, 1988, to August, 1992 (4 yr 7 mo). There were 107 patients evaluated with an age range of 11 to 92 yr and an average age of 62.0 yr. There were 63 males and 44 females. The duration of follow-up was from 7 mo to 4 yr 5 mo with an average of 2 yr 6.2 mo. MFH occurred principally as a mass on an extremity (lower extremity 62%), upper extremity 18%, trunk 25%, head and neck 2%). It typically involved deep fascia or skeletal muscle (68%) or superficial subcutis (35%). There were 77 storiform-pleomorphic, 22 myxoid, three giant cell, two inflammatory and three angiomatoid variants. The absolute three-year survival rate for all 107 patients was 72%. Patients with tumors located on extremities had a better three-year survival rate than patients with tumors located on the trunk or head and neck (81 vs 54%). There was, however, no statistical difference between the two groups. The prognosis for patients with deep muscular lesions, > 10 cm in diameter, was poor. The depth of the tumor significantly affects survival. The group with superficial tumors had a significantly better three-year survival rate than the other group (86 vs 68%). Local recurrences were found in 8% of patients who had had "complete" excisions. Inadequate surgery greatly increases the incidence of local recurrence and compromises longterm survival. Evaluations of tumor responses to preoperative chemotherapy and radiotherapy by histological studies were made. In total, 38 patients were evaluated. Responses to single and combination chemotherapy occurred in 31% of patients, a rate similar to that seen for other sarcomas.