Source: DGNews  |  Posted 6 years ago

PARIS, FRANCE -- January 31, 2006 -- Use of limb-sparing surgery to treat high-grade malignant fibrous histiocyoma (MFH) is associated with a 62% relapse-free survival rate at 10 years and an 80% overall survival rate, Israeli researchers reported here at the 17[^]th[] International Congress on Anti-Cancer Treatment (ICACT).

Ofer Merimsky, MD, Head, Bone and Soft Tissue Unit, Division of Oncology, Tel Aviv- Sourasky Medical Center, Tel Aviv, Israel, and associates presented results of their 8-year experience in 42 adult patients with high-grade limb MFH who underwent limb-sparing surgery followed by radiation therapy and were followed for a median of 45 months.

Overall, there were 16 recurrences, most of which occurred within 2 to 2.5 years after surgery, Dr. Merimsky said during his presentation here on January 31[^]st[].

Average tumor size was 11 cm for the relapsing disease and 8 cm for the disease-free cases (P = NS). Average tumor diameter for upper limb primary MFH cases was 7 cm, while the average tumor diameter was 10 cm the lower limb cases (P = .08).

Results showed that relapse-free survival was affected mainly by location in the lower limb versus the upper limb irrespective of tumor size. That is, 15 of the 16 relapses were observed in patients with lower limb MFH while only one relapse occurred in a patient with upper limb MFH.

Of non-relapsing patients, 10 had an upper limb primary MFH while 16 had a lower limb mass. This difference was significant (P = .0004).

The location of the primary MFH was unrelated to its size.

In 12 of the 16 patients with relapse, the tumor was deep versus 16 of 26 in the non-relapsing group.

Tumor stage was T2b (International Union Against Cancer classification) in 68.8% of relapse cases, while it was T2b in 53.9% of non-relapsing cases (P = NS).

Surgical margins at the first attempt were inadequate in 87.5% of relapse patients, and in 80.8% of non-relapsing patients (P = NS).

Vascular invasion was rarely observed, therefore, the investigators were not able to evaluate this parameter.

Seven of the 16 patients with relapse had a biopsy at the referring center while none of the non-relapsing patients had biopsies elsewhere (P = .002). Five of the nine patients with local recurrence had a diagnostic biopsy in another center.

Neither induction therapy nor degree of necrosis correlated with the rate of relapse.

According to the researchers, the key factors in disease-free survival are "team experience and group cooperation." Other factors are biology-dependent and are thus "beyond our control," they added.

[Presentation title: A Single Team Experience of Limb-Sparing Approach in Adults with High-Grade Malignant Fibrous Histiocytoma.]