Clinicopathological prognostic factors in soft tissue leiomyosarcoma: A multivariate analysis

Aims: Prognostic factors affecting survival in cases of leiomyosarcoma of soft parts were investigated in this study. Methods and results: A retrospective study of 267 patients was carried out. This group comprised 142 females (53%) and 125 males (47%), whose ages ranged from 7 to 95 years (median 58 years). One hundred and five cases were superficially situated (arising from the skin or subcutis), while the remaining 162 cases were deeply situated (subfacial). Nineteen were cases of pleomorphic leiomyosarcoma where the diagnosis had been amended from malignant fibrous histiocytoma to leiomyosarcoma whilst under review. Of the 167 patients with follow-up data, 83 died of leiomyosarcoma. In univariate analysis, depth, tumour size (≥50 mm), mitotic rate of > 20 per 10 high-power fields (HPF), tumour necrosis of > 50% and a high stage according to the most recent American Joint Committee on Cancer (AJCC) staging for soft tissue sarcoma were found to lessen significantly the rate of survival (log rank test; P < 0.05). However, in multivariate analysis (Cox's proportional hazards model), tumour size and high AJCC stage were the only factors that were correlated independently with decreased survival. Conclusions: This study indicates that the most reliable prognostic parameters are tumour size and AJCC stage in leiomyosarcoma.