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Prognostic Factors and Outcomes of Patients with Myxofibrosarcoma

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Myxofibrosarcomas (MFS) are a historically heterogeneous group of tumors that exhibit a propensity for local recurrence. The objectives of this study were to analyze the prognostic factors and outcomes of patients with MFS treated at a single institution.

Methods

We retrospectively reviewed the records of 69 consecutive patients with pathologically confirmed MFS of the extremities or superficial trunk who underwent surgery from August 1995 to November 2010. Clinicopathologic features, treatments, and patient outcomes were reviewed.

Results

Sixty-nine patients were identified, of whom 38 were men (55 %). The median age was 62 years. Sixty-four patients (93 %) presented with primary tumors, and 5 patients (7 %) presented with locally recurrent tumors. Median tumor size was 6.0 cm, and 44 patients (64 %) had grade 3 tumors (FNCLCC [Fédération Nationale des Centres de Lutte Contre le Cancer] classification). Margins were microscopically positive in 14 patients (20 %) and negative in 55 patients (80 %), including close margins (<1 mm) in 14 patients (20 %). Fifty-three patients (77 %) received radiotherapy. At a median follow-up of 41 months, there were 11 local (16 %) and 11 distant (16 %) recurrences. The local and distant 5-year recurrence-free survival rates were 72 % and 82 %, and the 5-year overall survival was 61 %. Increased age (scaled by 0.1; hazard ratio [HR] 1.80, P = 0.002) and tumor size (HR 1.12, P = 0.004) were negatively correlated with overall survival. Positive/close (<1 mm) margin status (HR 4.34, P = 0.030) predicted worsened local recurrence-free survival.

Conclusions

MFS exhibit a propensity for local recurrence, which is predicted by resection with positive or close margins. Aggressive surgery combined with radiotherapy may contribute to more effective local control.

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Acknowledgment

Supported in part by Biostatistics Core of Dana-Farber/Harvard Cancer Center, supported by NCI Cancer Center Support Grant NIH 5 P30 CA06516.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Nicole J. Look Hong MD, MSc, Sam S. Yoon MD & John T. Mullen MD

  2. Department of Orthopedic Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Francis J. Hornicek MD, PhD & Kevin A. Raskin MD

  3. Department of Biostatistics, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Jackie Szymonifka MS & Beow Yeap ScD

  4. Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Yen-Lin Chen MD & Thomas F. DeLaney MD

  5. Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    G. Petur Nielsen MD

Authors
  1. Nicole J. Look Hong MD, MSc
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  2. Francis J. Hornicek MD, PhD
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  3. Kevin A. Raskin MD
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  4. Sam S. Yoon MD
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  5. Jackie Szymonifka MS
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  6. Beow Yeap ScD
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  7. Yen-Lin Chen MD
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  8. Thomas F. DeLaney MD
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  9. G. Petur Nielsen MD
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  10. John T. Mullen MD
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Corresponding authors

Correspondence to Nicole J. Look Hong MD, MSc or John T. Mullen MD.

Additional information

The last two authors contributed equally to this work, and both should be considered senior author.

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Look Hong, N.J., Hornicek, F.J., Raskin, K.A. et al. Prognostic Factors and Outcomes of Patients with Myxofibrosarcoma. Ann Surg Oncol 20, 80–86 (2013). https://doi.org/10.1245/s10434-012-2572-3

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  • DOI: https://doi.org/10.1245/s10434-012-2572-3

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