Histopathologic Features of Prognostic Significance in High-Grade Osteosarcoma
| Autor: | Anthony M. Griffin, Marcus Wong, Michael Herman Chui, Robert S. Bell, Brendan C. Dickson, Martin E. Blackstein, Jay S. Wunder, Rita A. Kandel |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Oncology Univariate analysis Pathology medicine.medical_specialty Multivariate analysis medicine.diagnostic_test Lymphovascular invasion Proportional hazards model business.industry Univariate Context (language use) General Medicine medicine.disease Pathology and Forensic Medicine 03 medical and health sciences Medical Laboratory Technology 030104 developmental biology 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine Biopsy medicine Osteosarcoma business |
| Zdroj: | Archives of Pathology & Laboratory Medicine. 140:1231-1242 |
| ISSN: | 1543-2165 0003-9985 |
| DOI: | 10.5858/arpa.2015-0389-oa |
| Popis: | Context.— In osteosarcoma treated with neoadjuvant chemotherapy the extent of tumor necrosis on resection is considered an indicator of treatment response, and this has been shown to correlate with survival in most but not all studies. Objective.— To identify additional histologic variables of prognostic significance in high-grade osteosarcoma. Design.— Slides of pretreatment biopsy and primary postneoadjuvant chemotherapy resections from 165 patients with high-grade osteosarcoma were reviewed. Univariate (Kaplan-Meier) and multivariate (Cox regression) analyses were performed to identify clinical and histomorphologic attributes associated with overall survival. Results.— Univariate analyses confirmed the prognostic significance of metastatic status on presentation, primary tumor size, anatomic site, and histologic subtype. Additionally, the identification of lymphovascular invasion, 10% or more residual viable tumor, and 10 or more mitoses per 10 high-powered fields assessed in posttreatment resections were associated with poor survival, retaining significance in multivariate analyses. Based on results from multivariate analysis, we developed a prognostic index incorporating primary tumor size and site, and significant histologic features assessed on resection (ie, lymphovascular invasion status, mitotic rate, and extent of viable tumor). This scoring system segregates patients into 3 risk categories with significant differences in overall survival and retained significance in an independent validation set of 42 cases. Conclusions.— The integration of clinical and microscopic features improves prognostication of patients with osteosarcoma. |
| Databáze: | OpenAIRE |
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