Prognostic factors of soft tissue sarcomas

Background The management and outcome of soft tissue sarcomas is strongly influenced by the rarity of these tumors. Different determinations of tumor-, patient and treatment related facts with predominant influence on outcome and prognosis make comparison of results difficult. Methods To select the prognostic variables, a critical review of all points in the management of soft tissue sarcomas is necessary. Results A variety of clinical, pathological, surgical and adjuvant treatment variables results in relative and absolute prognostic value. The duration of symptoms, the physician delay, the kind of diagnosis, staging and multidisciplinary management are important variables. The anatomical site, sex, age and histologic category seems to play a secondary role. The prognostic value of the size of tumors is related to their localization and resectability, time of diagnosis, quality of resection and adjuvant treatment. Tumor localization and tumor size strongly influences resectability. Tumor grade and quality of surgical resection and therefore local tumor control are the most important prognostic variables. The risk of dissemination and metastatic disease is also highly correlated with tumorgrade, surgical treatment and adjuvant therapy. Conclusions The clinical evaluation and treatment of patients with soft tissue sarcomas are challenging problems. Revised definitions and concepts in prospective multicenter treatment modalities are necessary to improve the prognosis and select factors of prognosis.