Journal de cytologie et d'histologie

Histological Grading System for Soft Tissue Sarcoma-A Five Year Study

Abstract

Shikha Ghanghoria, Priyanka Kiyawat and Sonal Meshram

Background: Sarcoma (Greek origin meaning “flesh”) is a heterogeneous group of rare tumors of mesenchymal cell origin affecting approximately 1% of all adult malignancies. Tumour grade has been proposed as an essential factor in the staging of patients with soft tissue sarcomas. Histopathologic grading by French Federation of Cancer Centres (FNCLCC) is widely accepted and applicable to all types of soft tissue sarcomas, it includes criteria for grading tumour differentiation, mitotic count and pattern of tumour necrosis. By this grading system advent of metastasis, prognosis and survival rate can be evaluated.

Aims and objectives: To determine median age, gender, site, histological grades of soft tissue sarcoma according to FNCLCC. To know prevalence of various soft tissue sarcoma in MY hospital. To study the reproducibility of FNCLCC grading system, by comparing results of different pathologist .To get reliable prognostic information by this grading system.

Materials and methods: It is a retrospective and prospective study done over a period of 5 years in M.Y. Hospital. Total 112 cases of soft tissue sarcoma were taken. Soft tissue sarcoma was diagnosed on the basis of CT scan, MRI and were confirmed by histopathological examination and grading was done by FNCLCC. Age, Gender distribution, site, histological type and grading were evaluated and correlated. The results of different observers were compared and evaluated.

Result: In this study we found that the most common age group was 41 yrs-50 yrs with males predominance. The most common site was lower limb and most common type was Osteosarcoma followed by fibrosarcoma, rhabdomyosarcoma, PNET, liposarcoma, mesenchymal sarcoma and others type of soft tissue sarcoma. However, agreement was found in the grading of tumour and commonest grade was Grade II.

Conclusion: French Federation of Cancer Centres (FNCLCC) was better system for grading of soft tissues sarcomas as reproducibility of grading soft tissue sarcomas is good. By this grading system we get reliable information about disease diagnosis, prognosis, advent of metastasis, patient survival rate by post chemo and radio therapy monitoring, risk of relapse assessment and treatment pattern.