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Tumor necrosis is an underappreciated histopathologic factor in the grading of chondrosarcoma
BACKGROUND: Cartilaginous neoplasms can be challenging to grade; there is a need to create an evidence-based rubric for grading. The goal of this study was to identify histopathologic features of chondrosarcoma that were associated with 5-year survival and to compare these to traditional patient, tu...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10288799/ https://www.ncbi.nlm.nih.gov/pubmed/37353743 http://dx.doi.org/10.1186/s12885-023-11022-x |
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author | Lazarides, Alexander L. Abar, Bijan Leckey, Bruce Martin, John T. Kliassov, Evelyna G. Brigman, Brian E. Eward, William C. Cardona, Diana M. Visgauss, Julia D. |
author_facet | Lazarides, Alexander L. Abar, Bijan Leckey, Bruce Martin, John T. Kliassov, Evelyna G. Brigman, Brian E. Eward, William C. Cardona, Diana M. Visgauss, Julia D. |
author_sort | Lazarides, Alexander L. |
collection | PubMed |
description | BACKGROUND: Cartilaginous neoplasms can be challenging to grade; there is a need to create an evidence-based rubric for grading. The goal of this study was to identify histopathologic features of chondrosarcoma that were associated with 5-year survival and to compare these to traditional patient, tumor and treatment variables. METHODS: This was a retrospective review of all patients undergoing surgical resection of a primary chondrosarcoma with at least 2 years of follow up. All specimens were independently reviewed by two pathologists and histopathologic features scored. Univariate and multivariate analyses were performed utilizing Kaplan Meier and proportional hazards methods to identify variables associated with 5-year disease specific survival (DSS) and disease free survival (DFS). RESULTS: We identified 51 patients with an average follow up of 49 months eligible for inclusion. 30% of tumors were low grade, 45% were intermediate grade, and 25% were high grade. In a univariate analysis considering histopathologic factors, higher tumor mitotic rate (HR 8.9, p < 0.001), tumor dedifferentiation (HR 7.3, p < 0.001), increased tumor cellularity (HR 5.8, p = 0.001), increased tumor atypia (HR 5.8, p = 0.001), LVI (HR 4.7, p = 0.04) and higher tumor necrosis (HR 3.7, p = 0.02) were all associated with worse 5-year DSS. In a multivariate analysis controlling for potentially confounding variables, higher tumor necrosis was significantly associated with disease specific survival survival (HR 3.58, p = 0.035); none of the factors were associated with DFS. CONCLUSIONS: This study provides an evidence-based means for considering histopathologic markers and their association with prognosis in chondrosarcoma. Our findings suggest that necrosis and LVI warrant further study. |
format | Online Article Text |
id | pubmed-10288799 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102887992023-06-24 Tumor necrosis is an underappreciated histopathologic factor in the grading of chondrosarcoma Lazarides, Alexander L. Abar, Bijan Leckey, Bruce Martin, John T. Kliassov, Evelyna G. Brigman, Brian E. Eward, William C. Cardona, Diana M. Visgauss, Julia D. BMC Cancer Research BACKGROUND: Cartilaginous neoplasms can be challenging to grade; there is a need to create an evidence-based rubric for grading. The goal of this study was to identify histopathologic features of chondrosarcoma that were associated with 5-year survival and to compare these to traditional patient, tumor and treatment variables. METHODS: This was a retrospective review of all patients undergoing surgical resection of a primary chondrosarcoma with at least 2 years of follow up. All specimens were independently reviewed by two pathologists and histopathologic features scored. Univariate and multivariate analyses were performed utilizing Kaplan Meier and proportional hazards methods to identify variables associated with 5-year disease specific survival (DSS) and disease free survival (DFS). RESULTS: We identified 51 patients with an average follow up of 49 months eligible for inclusion. 30% of tumors were low grade, 45% were intermediate grade, and 25% were high grade. In a univariate analysis considering histopathologic factors, higher tumor mitotic rate (HR 8.9, p < 0.001), tumor dedifferentiation (HR 7.3, p < 0.001), increased tumor cellularity (HR 5.8, p = 0.001), increased tumor atypia (HR 5.8, p = 0.001), LVI (HR 4.7, p = 0.04) and higher tumor necrosis (HR 3.7, p = 0.02) were all associated with worse 5-year DSS. In a multivariate analysis controlling for potentially confounding variables, higher tumor necrosis was significantly associated with disease specific survival survival (HR 3.58, p = 0.035); none of the factors were associated with DFS. CONCLUSIONS: This study provides an evidence-based means for considering histopathologic markers and their association with prognosis in chondrosarcoma. Our findings suggest that necrosis and LVI warrant further study. BioMed Central 2023-06-23 /pmc/articles/PMC10288799/ /pubmed/37353743 http://dx.doi.org/10.1186/s12885-023-11022-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Lazarides, Alexander L. Abar, Bijan Leckey, Bruce Martin, John T. Kliassov, Evelyna G. Brigman, Brian E. Eward, William C. Cardona, Diana M. Visgauss, Julia D. Tumor necrosis is an underappreciated histopathologic factor in the grading of chondrosarcoma |
title | Tumor necrosis is an underappreciated histopathologic factor in the grading of chondrosarcoma |
title_full | Tumor necrosis is an underappreciated histopathologic factor in the grading of chondrosarcoma |
title_fullStr | Tumor necrosis is an underappreciated histopathologic factor in the grading of chondrosarcoma |
title_full_unstemmed | Tumor necrosis is an underappreciated histopathologic factor in the grading of chondrosarcoma |
title_short | Tumor necrosis is an underappreciated histopathologic factor in the grading of chondrosarcoma |
title_sort | tumor necrosis is an underappreciated histopathologic factor in the grading of chondrosarcoma |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10288799/ https://www.ncbi.nlm.nih.gov/pubmed/37353743 http://dx.doi.org/10.1186/s12885-023-11022-x |
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