The relationship between histopathology and tumor behavior was examined in 71 cases of chondrosarcoma. The tumors were grouped into Grades I, 11, and 111 on the basis of mitotic rate, cellularity, and nuclear size. The five-year survival rates of Grades I, 11, and 111 are 90%, 81%, and 43%, respectively, while the corresponding 10-year survival rates are 83%, 64%, and 29%. None of the Grade I chondrosarcomas metastasized, while metastasis was observed with 10% of the Grade I1 tumors and 71% of the Grade 111 tumors. No definite relationship between tumor grade and local recurrence was found. In addition, the significance of the extent of tlie original operative procedure was evaluated for chondrosarcoma, Grades I and 11. Local recurrence which could not be controlled by additional surgery occurred in 46% of the patients treated initially by local excision, but in only 9.5% of those who were treated by amputation or resection of all or part of the involved bone. It is concluded that chondrosarcomas range from locally aggressive non-metastasizing neoplasms to high-grade malignancies with marked metastatic potential, and that these groups may be defined and separated by the use of histopathologic criteria. The rate of local recurrence, however, is primarily dependent on the adequacy of surgical therapy rather than histologic grade.Cancer 40:818-831, 1977.HONDROSARCOMA IS A NEOPLASM WHICH HAS C long been known for the wide variability of its morphology and clinical course. Previous clinicopathologic evaluations of chondrosarcoma have shown that, in general, tumors of higher histologic grade are associated with shorter survival. "," However, the statistical significance of differences in survival rate by histologic grade has not been evaluated in most studies, and consistent correlation between histologic grade and the probability of metastasis has been lacking. This study was undertaken in an effort to

BACKGROUNDPrognostic factors for patients with soft‐tissue sarcoma who are treated with conservative surgery and radiation are documented poorly.METHODSThe clinicopathologic features and disease outcome for 1225 patients with localized sarcoma who were treated with conservative surgery and radiation were reviewed retrospectively. Actuarial univariate and multivariate statistical methods were used to determine significant prognostic factors for local control, metastatic recurrence, and disease specific survival.RESULTSThe median follow‐up of surviving patients was 9.5 years. The respective local control rates at 5 years, 10 years, and 15 years were 83%, 80%, and 79%. Factors predictive of local recurrence were positive or uncertain resection margins; tumors located in the head and neck and the deep trunk; presentation with local recurrence; patient age > 64 years; malignant fibrous histiocytoma, neurogenic sarcoma. or epithelioid sarcoma histopathology; tumor measuring > 10 cm in greatest dimension; and high pathologic grade. Freedom from metastasis at 5 years, 10 years, and 15 years was 71%, 68%, and 66%, respectively. Factors that were predictive of metastatic recurrence were high tumor grade; large tumor size (> 5 cm); and leiomyosarcoma, rhabdomyosarcoma, synovial sarcoma, or epithelioid sarcoma. The respective disease specific survival rates at 5 years, 10 years, and 15 years were 73%, 68%, and 65%. Adverse factors for disease specific survival were high tumor grade; large tumor size (> 5 cm); tumors located in the head and neck and deep trunk; rhabdomyosarcoma, epithelioid sarcoma, or clear cell sarcoma; patient age > 64 years; and positive or uncertain resection margins.CONCLUSIONSSoft‐tissue sarcoma comprises a heterogeneous group of diseases. Prognostic factors for local recurrence, metastatic recurrence, lymph node recurrence, disease free survival, and disease specific survival are different, and optimal treatment strategies need to take this complexity into account. Cancer 2003;10:2530–43. © 2003 American Cancer Society.DOI 10.1002/cncr.11365

Forty-four cases of skin and soft tissue angiosarcoma seen at M. D. Anderson Hospital before 1976 were reviewed. The cases fell into six different clinical groups: scalp-face, 17 cases; postmastectomy, 14 cases; postradiation, 5 cases; leg with vascular stasis, 2 cases; breast, 2 cases; and miscellaneous, 4 cases. In all cases in the first four groups, the tumors involved primarily the dermis and subcutis and showed similar blends of vasoformative and solid histologic patterns. Two tumors in the miscellaneous group closely resembled those in the larger groups, but the other two in that group (both located in deeper soft tissue sites) and the two breast angiosarcomas had a somewhat different microscopic appearance. Survival was generally poor in all groups, owing to frequent local recurrence and early metastasis; median survival for the entire series was 20 months. Findings of significantly favorable prognostic importance were tumor size less than 5 cm (in the scalp-face group) and a moderate or marked lymphoid infiltrate in and around the tumor. Less significant favorable factors were a distal location ( in the postmastectomy group) and a low degree of pleomorphism. Only nine patients had long-term, disease-free survival.