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<p>Abstract</p> <p>Background</p> <p>The human leucine-rich, repeat-containing G protein-coupled receptor (LGR) 5, also called GPR49, is a marker of stem cells in adult intestinal epithelium, stomach and hair follicles. LGR5/GPR49 is overexpressed in tumors of the colon, ovary and liver and in basal cell carcinomas. Moreover, an expression in skeletal muscle tissues was also detected. However, there has been no investigation regarding the expression and function of LGR5/GPR49 in soft-tissue sarcomas (STS) yet.</p> <p>Methods</p> <p>Seventy-seven frozen tumor samples from adult STS patients were studied using quantitative real-time TaqMan™ PCR analysis. The mRNA levels of wild type <it>LGR5/GPR49 </it>and a newly identified splice variant of <it>LGR5/GPR49 </it>lacking exon 5 (that we called <it>GPR49Δ5</it>) were quantified.</p> <p>Results</p> <p>A low mRNA expression level of <it>GPR49Δ5</it>, but not wild type <it>LGR5/GPR49</it>, was significantly correlated with a poor prognosis for the disease-associated survival of STS patients (RR = 2.6; P = 0.026; multivariate Cox's regression hazard analysis). Furthermore, a low mRNA expression level of <it>GPR49Δ5 </it>was associated with a shorter recurrence-free survival (P = 0.043). However, tumor onset in patients with a lower expression level of <it>GPR49Δ5 </it>mRNA occurred 7.5 years later (P = 0.04) than in patients with a higher tumor level of <it>GPR49Δ5 </it>mRNA.</p> <p>Conclusion</p> <p>An attenuated mRNA level of the newly identified transcript variant <it>GPR49Δ5 </it>is a negative prognostic marker for disease-associated and recurrence-free survival in STS patients. Additionally, a lower <it>GPR49Δ5 </it>mRNA level is associated with a later age of tumor onset. A putative role of <it>GPR49Δ5 </it>expression in tumorigenesis and tumor progression of soft tissue sarcomas is suggested.</p>