Soft‐tissue sarcoma: Initial characteristics and prognostic factors in patients with and without metastatic disease

Five hundred and sixty‐five patients with soft‐tissue sarcoma were admitted to Memorial Sloan‐Kettering Cancer Center from July 1, 1982 to July 1, 1985. Clinical and pathologic factors were analyzed to identify initial characteristics and to determine factors associated with prognosis and the development of metastasis. In decreasing order of frequency, the most common sites of primary tumor were the extremity (51.1%), retroperito‐neum/viscera (28.8%), trunk (15.9%), head and neck (3.7%) and breast (0.4%). The most common histologie types were liposarcoma (21.4%), malignant fibrous histiocytoma (20.2%), leiomyosarcoma (20.0%), fibrosarcoma (11.0%), and tendosynovial sarcoma (9.6%). One hundred and twenty‐eight patients (22.7%) had metastases in a median follow‐up period of 19 months. Metastasis was more common in patients with retroperito‐neal and visceral sarcomas than in patients with extremity sarcomas. Patients with leiomyosarcomas were more likely to develop metastases than those with other histologie types. Fibrosarcoma and liposarcomas were the least likely to develop metastases in this time frame. Tumors greater than 5 cm in diameter occurred more frequently in patients with metastases. Actuarial survival was related to the site of primary tumor and the histologie type and grade of malignancy. Multivariate analysis indicated that patients with low‐grade sarcomas, extremity sarcomas, and fibrosarcomas and patients without metastatic disease demonstrated significantly improved survival. In patients with metastases, disease‐free interval (< 365 or >365 days) was significantly related to overall survival. Thus the development of metastatic disease and prognosis in patients with soft‐tissue sarcoma is significantly associated with specific clinical and pathologic factors, including site of primary tumor, histologie type, histologie grade, and disease‐free interval.