Prognostic factors for fibromatoses: A correlation of proliferation index, estrogen receptor, p53, retinoblastoma, and src gene products and clinical features with outcome

Background: The aggressiveness of fibromatoses is difficult to predict by morphologic analysis. Additional prognostic markers would be helpful for clinical management. Materials and Methods: Proliferation index (MIB-1), p53, src, retinoblastoma gene protein products, estrogen receptor level, site and depth of lesion were correlated with incidence of recurrence in 52 patients. Superficial (47) and deep (5) fibromatoses were studied. Anatomic sites included the extremities, head, neck, trunk, and pelvis. Results: Twenty (38%) lesions recurred locally. All five deep lesions recurred, but only 32% of superficial tumors recurred. Mean proliferation index for recurrent lesions was 0.82% and 0.73% for nonrecurrent fibromatoses ; no significant differences were observed. Five recurrent lesions (25%) expressed estrogen receptor >5 fmol/mg as did 31% (10 of 32) of the nonrecurrent lesions. None of the tested specimens expressed src gene product. Eight of the lesions which recurred (40%) contained p53, but only five nonrecurring tumors (16%) expressed p53. One of five deep lesions (20%) expressed p53 and 26% (12 of 47) of superficial tumors expressed p53. Forty-six percent (6 of 13) of recurrent lesions tested were retinoblastoma protein product negative, but only 33.3% (7 of 21) of nonrecurring tumors were retinoblastoma protein product negative. Conclusions: Only p53 and depth of lesion were of statistical value for the prediction of recurrence.