Histopathologic Features of Prognostic Significance in High-Grade Osteosarcoma.
* 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 p...
| Publicado en: | Archives of Pathology & Laboratory Medicine Vol. 140; no. 11; pp. 1231 - 1243 |
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| Autores principales: | , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
College of American Pathologists
Nov2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=119227535&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 119227535 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00039985 1FS jtl: Archives of Pathology & Laboratory Medicine issn: 00039985 maglogo: N pubinfo: dt: Nov2016 vid: 140 iid: 11 pid: 2550 pub: College of American Pathologists place: Northfield, Illinois artinfo: ui: 119227535 119227535 119227535 10.5858/arpa.2015-0389-OA 119227535 ppf: 1231 ppct: 12 formats: fmt: @attributes: type: P tig: atl: Histopathologic Features of Prognostic Significance in High-Grade Osteosarcoma. aug: au: Chui, Michael Herman Kandel, Rita A. Wong, Marcus Griffin, Anthony M. Bell, Robert S. Blackstein, Martin E. Wunder, Jay S. Dickson, Brendan C. affil: Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada sug: subj: Osteosarcoma Pathology Prognosis Biopsy Neoadjuvant Therapy Slides Survival Neoplasm Invasiveness Necrosis Neoplasm Staging Osteosarcoma Classification Fibrosis Retrospective Design Kaplan-Meier Estimator Multivariate Analysis Univariate Statistics Record Review Mann-Whitney U Test Fisher's Exact Test kappa Statistic Log-Rank Test Cox Proportional Hazards Model P-Value Adolescence Adult Middle Age Aged Female Male Human Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Female Male ab: * 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. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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