A comparison of the prognoses for deep and subcutaneous sarcomas of the extremities

T. D. Peabody*, D. Monson, A. Montag, M. J. Schell, H. Finn, M. A. Simon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

We evaluated 172 patients who had a soft-tissue sarcoma of the extremity in order to determine whether the prognosis for a subcutaneous sarcoma was better than that for a deep sarcoma. At a median of thirty-six months after the biopsy or definitive operation at our hospital, six of the fifty-two patients who had had a subcutaneous sarcoma had died and one had had a local recurrence; in contrast, forty of the 120 patients who had had a deep sarcoma had died and eight had had a local recurrence. Twenty-five (48 per cent) of the subcutaneous sarcomas were malignant fibrous histiocytomas, and thirty- eight (73 per cent) were small (five centimeters or less in the largest dimension). The three-year estimates of disease-free survival were 85 per cent for the patients who had a subcutaneous sarcoma and 54 per cent for those who had a deep sarcoma (p = 0.002). Although the survival estimates remained significantly different when the groups were matched for histological diagnosis and for intracompartmental location (p = 0.0001 and 0.0006, respectively), they were not significantly different when the groups were matched for the size of the tumor (p = 0.42). A Cox proportional- hazards model confirmed that a tumor size of more than five centimeters and the histological grade are the most significant prognostic factors (p = 0.0007 and p = 0.004, respectively): a tumor size of more than five centimeters was associated with a relative risk of 3.5 (95 per cent confidence interval, 1.7 to 7.3), and a higher histological grade was associated with a relative risk of 4.0 (95 per cent confidence interval, 1.6 to 10.3). Subcutaneous location, when considered separately, was not a significant prognostic factor (p = 0.45). The data indicate that a tumor size of more than five centimeters is a more important prognostic indicator than histological diagnosis, depth, or intracompartmental location.

Original languageEnglish (US)
Pages (from-to)1167-1173
Number of pages7
JournalJournal of Bone and Joint Surgery - Series A
Volume76
Issue number8
DOIs
StatePublished - Jan 1 1994

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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