We devised a nomogram for nonmetastatic osteosarcoma that proposes improved estimates of metastasis over AJCC staging system or tumor necrosis rate. We suggest that this nomogram allows individualized risk assessments and could be used as the basis for risk-adapted therapy.

Between June 1985 and May 1990 we treated 12 patients with malignant fibrous histiocytoma (MFH) of the limbs by a combination of wide excision and adjuvant radiotherapy. The Enneking surgical staging was II in 11 cases and III in 1. There were 6 women and 6 men, with an average age of 54 years. The leg was involved in 8 patients and the arm in 4. Limb salvage was achieved in 10 patients and amputation was performed in 2. All received adjuvant radiotherapy, with an average of 51.5 Gy. In 6patients adjuvant CYVADIC chemotherapy was adm, inistered for an average of 4 cycles. In the other patients this treatment was not tolerated. Local recurrence occurred in 2 patients and metastases to the lung were seen in a fl~rther 2. At an average follow-up of 41.3 months, the Kaplan-Meier estimation of 5 year survival was 87.5%, with a 5 year continuous disease-free survival rate of 66. 7%. R~sum~: De Juin 1985 ~t Mai 1990 nous avons traitd 12 patients atteints d'histiocytofibrome malin des parties molles, au niveau des extr6mitds. Le traitement principal a consistd dans l'association d'une large excision et d'une radioth6rapie adjuvante. Une chimiothdrapie compl~mentaire a dtd administrde aux patients qui pouvaient en toldrer la toxicitd. II y avait 6 hommes et 6 femmes, glgds de 54 a n s e n moyenne. L'atteinte des membres infdrieurs 6tait plus frdquente (8 cas) que celle des membres supdrieurs (4 cas). Les types de chirurgie utilisds ont dtd soit des interventions de conservation des membres, soit des amputations. Tousles malades ont bdndficid de la radiothdrapie adjuvante (51.5 Gy en moyenne). Une chimiothdrapie par CYVADIC (quatre cycles en Reprint requests to: S.-Y. Lee moyenne) a dtd administrde gt 6 malades. II y a eu 2 cas de rdcidive locale ainsi que 2 m6tastases pulmonaires. Avec un recul moyen de 41,5 mois (de 12 & 72), le taux de survie ~t 5 ans de Kaplan-Meier est de 87,5% et le taux de survie ?t 5 ans sans complications est de 66, 7%.