Comparison between a 2- and 3-grade system in predicting metastatic-free survival in extremity soft-tissue sarcoma

• Published in: Journal of surgical oncology 1999-10, Vol.72 (2), p.77-82
• Main Authors: Kandel, Rita A., Bell, Robert S., Wunder, Jay S., O'Sullivan, Brian, Catton, Charles N., White, Lawrence M., Davis, Aileen M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Data Interpretation, Statistical; Disease-Free Survival; Extremities; Female; histologic grading; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Miscellaneous. Technology; Neoplasm Staging - methods; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Recurrence; Risk; sarcoma; Sarcoma - pathology; Soft Tissue Neoplasms - pathology; soft-tissue neoplasms; Survival Analysis
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/(SICI)1096-9098(199910)72:2<77::AID-JSO7>3.0.CO;2-4

Background and Objectives The purpose of this study was to determine whether a histologic grading system consisting of 2 or 3 categories had better discrimination for predicting metastasis‐free survival in extremity soft‐tissue sarcoma. Methods One hundred thirty patients with nonmetastatic soft‐tissue sarcoma were identified and the histologic grade (3‐grade system) for each tumor was determined. For the 2‐grade system, grade was determined by collapsing 3 grades into 2. The Kaplan‐Meier method was used to estimate disease free survival. Results By use of a 3‐grade system, grade 2 tumors showed a 5.2‐fold and grade 3 tumors a 9‐fold increased risk of systemic relapse when compared with grade 1 tumors. When grade 2 and 3 tumors were combined, they had a 2.6‐fold increased risk of systemic relapse compared with grade 1 tumors. When grade 1 and 2 tumors were combined, grade 3 tumors had an 8.4‐fold risk of relapse. After data were controlled for size and depth of tumor, each increase in grade in the 3‐grade system showed a successive 2.3‐fold increase in risk of systemic relapse. Conclusions A 3‐grade system may be more appropriate for predicting systemic relapse than 2 grades. A prospective study is required to confirm this. J. Surg. Oncol. 1999;72:77–82. © 1999 Wiley‐Liss, Inc.