Over the last 20 to 30 years, a recognition and general acceptance of the entity of malignant fibrous histiocytoma and monophasic synovial sarcoma has occurred. The introduction of these diagnostic categories among the generic group of spindle cell sarcomas now requires a reevaluation of the more traditional and historic entity of fibrosarcoma and the clinical ramification of this diagnosis. A review of 132 cases of fibrosarcoma using current diagnostic criteria was undertaken to clarify the behavior of fibrosarcoma as diagnosed in current patients. Special attempts were made to correlate histologic grade and Enneking stage in fibrosarcomas in an effort to correlate their predictive value in metastatic rate and survival.
Cancer 64:925-931. 1989.
ITH THE RECOGNITION of the entities of malignant W fibrous histiocytoma and monophasic synovial sarcoma in recent years, the number of soft tissue tumors diagnosed as fibrosarcoma has decreased dramatically. This shift in pathologic diagnosis requires a reexamination of the entity of fibrosarcoma and the consequences of such a diagnosis based on current criteria. Treatment results of earlier series of fibrosarcomas are variable and possibly reflect the mixed population of tumors previously classified as fibrosarcoma as well as the different treatment approaches used. Five-year survival rates range from 4 1 % to 70%. '-4 This retrospective review identifies soft tissue sarcomas that fit current histologic criteria for fibrosarcoma as well as documents the clinical presentation and outcome. Particular attention was paid to the influence of histologic grade, tumor stage, and surgical treatment.
Materials and Methods
The cases in this study were selected from a previously published series of 199 fibrosarcomas from our institution (Mayo Clinic, Rochester, MN)4 and from review of all other available cases previously diagnosed as fibrosarcoma in our surgical pathology files that had received treatment at the Mayo Clinic up to 1983. All cases were reviewed histologically and were required to meet current diagnostic From the *Department of Orthopedics, the tDivision of Pathology, and the