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. 2015 Feb 3;112(3):455-60.
doi: 10.1038/bjc.2014.635. Epub 2014 Dec 23.

Prognostic relevance of the mitotic count and the amount of viable tumour after neoadjuvant chemotherapy for primary, localised, high-grade soft tissue sarcoma

D Andreou  1 , M Werner  2 , D Pink  3 , F Traub  4 , M Schuler  5 , G Gosheger  6 , B Jobke  7 , P Reichardt  8 , P U Tunn  4
Affiliations

Prognostic relevance of the mitotic count and the amount of viable tumour after neoadjuvant chemotherapy for primary, localised, high-grade soft tissue sarcoma

D Andreou et al. Br J Cancer. .

Abstract

Background: We sought to examine whether mitotic count (MC) and the amount of viable tumour (VT) following neoadjuvant systemic chemotherapy (SC) for primary, localised, high-grade soft tissue sarcoma (STS) correlate with prognosis.

Methods: Retrospective analysis of 57 patients who underwent SC involving a combination of an anthracycline and an alkylating agent, followed by surgical resection between 2001 and 2011.

Results: The amount of VT after chemotherapy was significantly associated with disease-specific survival (DSS) and event-free survival (EFS). Patients with <10% VT had a DSS of 94% at 5 years, compared with 61% for patients with ⩾10% VT (P=0.033); EFS was 75%, compared with 48% (P=0.030). Patients with an MC of ⩾20/10 high power fields (HPF) after chemotherapy had a significantly lower DSS (33% vs 84% at 5 years, P<0.001) and EFS (40% vs 63% at 5 years, P=0.019) than patients with an MC of <20/10 HPF.

Conclusions: The MC and the amount of VT after neoadjuvant therapy for primary, localised, high-grade STS appear to correlate with prognosis. If these results are validated prospectively, then they could provide a rational for the design of neoadjuvant treatment modification/escalation studies, analogue to the EURAMOS-1 trial for bone sarcomas.

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Figures

Figure 1
Figure 1
Disease-specific (A) and event-free survival (B) probability according to the amount of VT after treatment.
Figure 2
Figure 2
Disease-specific (A) and event-free survival (B) probability according to the MC after treatment.
Figure 3
Figure 3
Disease-specific (A) and event-free survival (B) probability according to the MC and the amount of VT.
Figure 4
Figure 4
Post-relapse survival probability according to the MC after chemotherapy.
See this image and copyright information in PMC

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