We analysed 40 patients with soft tissue sarcomas (STS) of the
extremities to investigate the prognostic significance of the growth fraction of the
tumor. The patients consisted of 27 males and 13 females, and the ages ranged
from 18 to 70 years (median 46.9 years). Tumors were located in the thigh (47.
5%), forearm (15%), buttock (10%), shoulder (10%), axilla (5%), arm (5%), lower
leg (5%), and foot (2.5%) in a descending order of frequency. Histologically,
malignant fibrous histiocytoma (25%) and liposarcoma (25%) were the most
common types, followed by synovial sarcoma (17.5%), malignant schwannoma
(10%), and rhabdomyosarcoma (5%). Local recurrence ranging from 1 to 4 times
(average 1.7 times) was noted in 18 cases (45%). Distant metastasis was found in
5 out of 30 patients (16.7%), and the lung, liver, and abdominal wall were the
predilection sites. Cumulative survival rates of all STS studied were 76% and
58% in 2 years and 5 years, respectively. Univariate analysis revealed that
patient's age, surgical stage, histologic grade, differentiation of tumor cells,
mitotic count, and proliferative index were related to survival. Among known
parameters of histologic grading, only mitotic count was correlated with
proliferative index. Multivariate analysis showed that patient's age, surgical stage
and proliferative index were significant prognostic factors. This study indicates
that the proliferative index using the antibody against proliferating cell nuclear
antigen is useful to assess the prognosis of STS
