[Treatment of malignant fibrous histiocytoma of soft tissues]

Thirty-six patients with soft tissue malignant fibrous histiocytoma were followed up. At the time of this study, 14 of the 36 patients were alive and the average follow-up period was 59.3 months. The average age at initial diagnosis was 62.1 years. Of the 36 patients, 13 were initially treated by us. All of the marginal excision cases (17) showed recurrence. Five of 8 additional excision cases had residual tumor and three of these showed recurrence. Those cases given primary wide excision (5) showed no local recurrence. One out of 3 amputation cases showed recurrence five years after the operation. Thus, the total recurrence rate was 64%. The average period of recurrence was 9.3 months (n = 21). Radiotherapy was effective in four patients among 11 irradiated cases. Chemotherapy is difficult to apply, since patients are generally too old to tolerate intensive chemotherapy and also the drug-sensitivity is low. For this reason, we have insufficient clinical experience to make an evaluation. Five-year survival rate was 45% and 10-year survival, 30%. Early detection of the tumor and adequate initial surgery are the best ways of improving the results of treatment for MFH. Chemotherapy and radiotherapy might achieve adjuvant effects and produce better results.