Malignant fibrous histiocytoma of bone: A survival analysis from the National Cancer Database

BACKGROUND AND OBJECTIVES: Malignant fibrous histiocytoma (MFH) of bone, now known as undifferentiated pleomorphic sarcoma of bone, is a rare neoplasm that accounts for less than 2% of all primary malignant bone tumors. The objective of the current study was to evaluate prognosis and survival for MFH of bone. METHODS: The 2004 to 2016 National Cancer Database was queried to identify patients with a primary MFH of bone. Kaplan-Meier survival and Cox regression analyses were used to analyze overall survival and risk factors associated with overall mortality. RESULTS: The overall 5-year and 10-year survival rates were 38.3% and 30.5%, respectively. Increasing stage and metastatic disease at presentation were associated with poor overall survival (P < .001). Patients aged 18 to 50 years (hazard ratio [HR], 0.51), 51 to 75 years (HR, 0.61), and those undergoing surgery (HR, 0.39) had improved survival. Having Medicare insurance (HR, 1.48), residing in a low educated area (HR, 2.56), and positive surgical margins (HR, 1.80) were associated with poor survival. CONCLUSIONS: The overall prognosis of MFH of bone is poor with a reported 5-year survival rate of 38.3%. Undergoing surgery and younger age were associated with a better prognosis. Older age, having Medicare insurance, and positive surgical margins were predictors of mortality.