Le Doussal et al identified factors associated with a good prognosis in patients with localized malignant fibrous histiocytoma (MFH). This can help identify patients who may require more aggressive or experimental therapy. The authors are form the French Federation of Cancer Centers (FNCLCC) Sarcoma Group.
Patient selection: non-metastatic MFH (not Stage IVb)
Parameters:
(1) stage (UICC or AJCC)
(2) ability to be grossly free of disease after initial therapy
(3) location
(4) histologic subtype
(5) age of the patient
|
Parameter |
Finding |
Points |
|
stage of disease |
I |
1 |
|
|
II |
1 |
|
|
III |
0 |
|
|
IVa |
0 |
|
free of gross disease at the end of the initial therapy |
yes |
1 |
|
|
no |
0 |
|
tumor location |
superficial |
1 |
|
|
deep |
0 |
|
histologic subtype |
myxoid |
1 |
|
|
pleomorphic |
0 |
|
|
storiform |
0 |
|
|
inflammatory |
0 |
|
|
giant cells |
0 |
|
age of the patient in years |
<= 50 years of age |
1 |
|
|
> 50 years of age |
0 |
where:
• A superficial location was confined to the subcutaneous tissue. A deep location included those infiltrating skeletal muscle, involving the retroperitoneum or involving the superficial fascia.
|
Unfavorable Finding |
Relative Risk |
p value |
|
stage III or IVa |
3.25 |
< 0.00001 |
|
gross disease present after initial therapy |
3.99 |
0.00024 |
|
tumor deep |
3.37 |
0.0045 |
|
nonmyxoid histologic type |
9.28 |
0.0056 |
|
age > 50 years of age |
2.19 |
0.037 |
from Table 2, page 1827
number of favorable findings =
= SUM(points for the 5 parameters)
Interpretation:
• minimum number of favorable findings: 0
• maximum number of favorable findings: 5
• The more favorable findings, the better the prognosis is for the patient.
Specialty: Hematology Oncology, Surgery, general, Surgery, orthopedic
ICD-10: ,
