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Sugiura Y, Machinami R, Matsumoto S, Ae K, Takahashi Y, Hiruta N, Takeuchi K. The association between CD34 expression status and the clinicopathological behavior of dedifferentiated liposarcoma. Pathol Res Pract 2024; 260:155376. [PMID: 38875758 DOI: 10.1016/j.prp.2024.155376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/28/2024] [Indexed: 06/16/2024]
Abstract
Lipogenic and fibrous tumors are thought to originate from CD34-positive stromal fibroblastic/fibrocystic cells. Well-differentiated lipogenic tumors typically express CD34, whereas dedifferentiated liposarcoma (DDLPS) often loses it. We conducted survival analyses involving 59 patients with DDLPS. Males comprised 53% of the cohort, and the median age at the time of wide resection of primary DDLPS was 60 years. Loss of CD34 expression was defined as when ≥50% of the dedifferentiated area was immunohistochemically negative for CD34. As a result, 39 of the 59 patients showed loss of CD34 expression during the initial operation for DDLPS. In the univariate analyses, the tumor site in the retroperitoneum/abdominal cavity and loss of CD34 expression were significantly associated with poor overall survival. In the multivariate analyses, loss of CD34 expression (HR = 2.26; 95% CI = 1.02-5.02; p = 0.04) and the tumor site in the retroperitoneum/abdominal cavity (HR = 3.11; 95% CI = 1.09-8.86; p = 0.03) were retained as independent prognostic factors. Six CD34-positive cases lost CD34 expression when they developed metastasis and/or local recurrence, suggesting that the loss was associated with the later stage of the tumor. Therefore, an association existed between the loss of CD34 expression and clinicopathological behaviors such as poorer prognoses and recurrence.
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Affiliation(s)
- Yoshiya Sugiura
- Department of Pathology, Toho University Medical Center, Sakura Hospital, Sakura, Japan; Department of Surgical Pathology, Toho University Medical Center, Sakura Hospital, Sakura, Japan; Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan.
| | - Rikuo Machinami
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Pathology, Kawakita General Hospital, Tokyo, Japan
| | - Seiichi Matsumoto
- Department of Orthopedic Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Sarcoma Center, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keisuke Ae
- Department of Orthopedic Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Sarcoma Center, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yu Takahashi
- Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Nobuyuki Hiruta
- Department of Pathology, Toho University Medical Center, Sakura Hospital, Sakura, Japan; Department of Surgical Pathology, Toho University Medical Center, Sakura Hospital, Sakura, Japan; Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kengo Takeuchi
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
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Dry SM. Dedifferentiation in bone and soft tissue sarcomas: How do we define it? What is prognostically relevant? Hum Pathol 2024; 147:139-147. [PMID: 38311185 DOI: 10.1016/j.humpath.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/10/2024]
Abstract
Dedifferentiation traditionally is defined by descriptive criteria as a tumor showing an abrupt change in histology from a conventional, classic, low-grade appearing neoplasm to a tumor that is more cellular, pleomorphic and "high grade", with grading typically being performed by subjective criteria. The dedifferentiated areas range from areas with recognizable histologic differentiation which differs from the primary tumor (such as an osteosarcoma arising from a low-grade chondrosarcoma) to areas containing sarcomas without specific histologic differentiation (such as pleomorphic or spindle cell sarcoma). Many, but not all, dedifferentiated tumors are aggressive and associated with significantly shorter survival than their conventional counterparts, even grade 3 conventional tumors. As a result, dedifferentiated tumors are generally considered to be clinically aggressive and as a result, more aggressive surgery or the addition of (neo)adjuvant chemotherapy is often considered. However, long-term (greater than 20 year) survivors are reported in the most common dedifferentiated bone and soft tissue sarcomas. Moreover, use of mitotic criterion for defining dedifferentiation in dedifferentiated liposarcoma as well as grading (by the French system) have been found to be associated with survival. This paper reviews the literature on dedifferentiated chondrosarcoma, dedifferentiated liposarcoma, dedifferentiated chordoma and dedifferentiated parosteal osteosarcoma. As a result of that review, recommendations are advocated to identify evidence-based, objective diagnostic and grading criteria for dedifferentiation that are appropriate for each tumor type. Adding such criteria will improve consistency in diagnosis worldwide, allow easier comparison of clinical research performed on dedifferentiated tumors and help communicate (to patients and clinicians) the tumors with highest risk of clinically aggressive behavior, to allow appropriate and personalized treatment planning.
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Affiliation(s)
- Sarah M Dry
- Department of Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, 13-222 CHS, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.
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3
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Vargas AC, Barton N, Jones V, Joy C, Harraway J, Cheah A, Maclean F. The potential utility of single nucleotide polymorphism microarray (SNP array) in low-grade dedifferentiated liposarcomas. Pathology 2023; 55:879-883. [PMID: 37507332 DOI: 10.1016/j.pathol.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/15/2023] [Accepted: 03/15/2023] [Indexed: 07/30/2023]
Affiliation(s)
- A Cristina Vargas
- Department of Anatomical Pathology, Sonic Healthcare - Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
| | - Narelle Barton
- Department of Cytogenetics, Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | - Victoria Jones
- Department of Cytogenetics, Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | - Christopher Joy
- Department of Cytogenetics, Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | - James Harraway
- Department of Cytogenetics, Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | - Alison Cheah
- Department of Anatomical Pathology, Sonic Healthcare - Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia
| | - Fiona Maclean
- Department of Anatomical Pathology, Sonic Healthcare - Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia; Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
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4
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Morii T, Anazawa U, Sato C, Iwata S, Nakagawa M, Endo M, Nakamura T, Ikuta K, Nishida Y, Nakayama R, Udaka T, Kawamoto T, Kito M, Sato K, Imanishi J, Akiyama T, Kobayashi H, Nagano A, Outani H, Toki S, Nishisho T, Sasa K, Suehara Y, Kawano H, Ueda T, Morioka H. Dedifferentiated liposarcoma in the extremity and trunk wall: A multi-institutional study of 132 cases by the Japanese Musculoskeletal Oncology Group (JMOG). EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:353-361. [PMID: 36088237 DOI: 10.1016/j.ejso.2022.08.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/15/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dedifferentiated liposarcoma occurs predominantly in the retroperitoneum. Given the paucity of cases, information on the clinical characteristics of this entity in the extremities and trunk wall is quite limited. In particular, the significance of preoperative evaluation and principles of intraoperative management of the different components, i.e., well-differentiated and dedifferentiated areas, are still to be defined. METHODS Clinical characteristics, treatment outcomes, and risk factors for poor oncological outcomes in cases of dedifferentiated liposarcoma in the extremity or trunk wall were analyzed by a retrospective, multicentric study. RESULTS A total of 132 patients were included. The mean duration from the initial presentation to dedifferentiation was 101 months in dedifferentiation-type cases. The 5-year local recurrence-free survival, metastasis-free survival, and disease-specific survival rates were 71.6%, 75.7%, and 84.7%, respectively. Among 32 patients with metastasis, 15 presented with extrapulmonary metastasis. A percentage of dedifferentiated area over 87.5%, marginal/intralesional margin, and R1/2 resection in the dedifferentiated area were independent risk factors for local recurrence. Dedifferentiated areas over 36 cm2, French Federation of Cancer Centers Sarcoma Group grade III, and intralesional or marginal resection were independent risk factors for metastasis. A dedifferentiated area over 77 cm2 and lung metastasis were independent risk factors for disease-specific mortality. CONCLUSIONS The typical clinical characteristics of dedifferentiated liposarcoma in the extremity and trunk wall were reconfirmed in the largest cohort ever. The evaluation of the dedifferentiated area in terms of grade, extension, and pathological margin, together with securing adequate surgical margins, was critical in the management of this entity.
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Affiliation(s)
- Takeshi Morii
- Department of Orthopaedic Surgery, Kyorin University Faculty of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Ukei Anazawa
- Department of Orthopaedic Surgery, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba, 272-8513, Japan
| | - Chiaki Sato
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shintaro Iwata
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Makoto Nakagawa
- Department of Orthopaedic Surgery, Kyushu University School of Medicine, 3-1-1 Maidashi, Hagashi-ku, Fukuoka, Fukuoka, 812-8582, Japan
| | - Makoto Endo
- Department of Orthopaedic Surgery, Kyushu University School of Medicine, 3-1-1 Maidashi, Hagashi-ku, Fukuoka, Fukuoka, 812-8582, Japan
| | - Tomoki Nakamura
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Kunihiro Ikuta
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Yoshihiro Nishida
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Robert Nakayama
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Toru Udaka
- Department of Orthopaedic Surgery, Kyorin University Faculty of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan; Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Munehisa Kito
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Kenji Sato
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8606, Japan
| | - Jungo Imanishi
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8606, Japan
| | - Toru Akiyama
- Departments of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan
| | - Hiroshi Kobayashi
- Department of Orthopaedic Surgery, The University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Akihito Nagano
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan
| | - Hidetatsu Outani
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Shunichi Toki
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, Tokushima, 770-8503, Japan
| | - Toshihiko Nishisho
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, Tokushima, 770-8503, Japan
| | - Keita Sasa
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yoshiyuki Suehara
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hirotaka Kawano
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8606, Japan
| | - Takafumi Ueda
- Department of Orthopaedic Surgery, National Hospital Organization Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan
| | - Hideo Morioka
- Department of Orthopaedic Surgery, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
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Gambella A, Bertero L, Rondón-Lagos M, Verdun Di Cantogno L, Rangel N, Pitino C, Ricci AA, Mangherini L, Castellano I, Cassoni P. FISH Diagnostic Assessment of MDM2 Amplification in Liposarcoma: Potential Pitfalls and Troubleshooting Recommendations. Int J Mol Sci 2023; 24:ijms24021342. [PMID: 36674856 PMCID: PMC9863600 DOI: 10.3390/ijms24021342] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023] Open
Abstract
MDM2 amplification represents the leading oncogenic pathway and diagnostic hallmark of liposarcoma, whose assessment is based on Fluorescence In Situ Hybridization (FISH) analysis. Despite its diagnostic relevance, no univocal interpretation criteria regarding FISH assessments of MDM2 amplification have been established so far, leading to several different approaches and potential diagnostic misinterpretations. This study aims to address the most common issues and proposes troubleshooting guidelines for MDM2 amplification assessments by FISH. We retrospectively retrieved 51 liposarcomas, 25 Lipomas, 5 Spindle Cell Lipoma/Pleomorphic Lipomas, and 2 Atypical Spindle Cell Lipomatous Tumors and the corresponding MDM2 FISH analysis. We observed MDM2 amplification in liposarcomas cases only (43 out of 51 cases) and identified three MDM2-amplified patterns (scattered (50% of cases), clustered (14% of cases), and mixed (36% of cases)) and two nonamplified patterns (low number of signals (82% of cases) and polysomic (18% of cases)). Based on these data and published evidence in the literature, we propose a set of criteria to guide MDM2 amplification analysis in liposarcoma. Kindled by the compelling importance of MDM2 assessments to improve diagnostic and therapeutic liposarcoma management, these suggestions could represent the first step to develop a univocal interpretation model and consensus guidelines.
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Affiliation(s)
- Alessandro Gambella
- Division of Liver and Transplant Pathology, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | - Luca Bertero
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | - Milena Rondón-Lagos
- School of Biological Sciences, Universidad Pedagógica y Tecnológica de Colombia, Tunja 150003, Colombia
| | - Ludovica Verdun Di Cantogno
- Department of Laboratory Medicine, Azienda Ospedaliera Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Nelson Rangel
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia
| | - Chiara Pitino
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | | | - Luca Mangherini
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | | | - Paola Cassoni
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Correspondence: ; Tel.: +39-011-633-5588
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6
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Jo VY, Demicco EG. Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Soft Tissue Tumors. Head Neck Pathol 2022; 16:87-100. [PMID: 35312984 PMCID: PMC9018918 DOI: 10.1007/s12105-022-01425-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/03/2022] [Indexed: 01/27/2023]
Abstract
The fifth (5th) edition of the World Health Organization (WHO) Classification of Head and Neck Tumors introduces a new chapter dedicated to soft tissue neoplasms commonly affecting the head and neck. While the diversity, rarity, and wide anatomic range of soft tissue tumors precludes a discussion of all entities that may be found in the head and neck, the addition of this new chapter to the head and neck "blue book" aims to provide a more comprehensive and uniform reference text, including updated diagnostic criteria, of mesenchymal tumor types frequently (or exclusively) arising at head and neck sites. Since publication of the previous edition in 2017, there have been numerous advances in our understanding of the pathogenesis of many soft tissue tumors which have facilitated refinements in tumor classification, identification of novel entities, development of diagnostic markers, and improved prognostication. This review will provide a focused discussion of the soft tissue tumors included in the 5th edition WHO Head and Neck classification, with an emphasis on updates.
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Affiliation(s)
- Vickie Y Jo
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
| | - Elizabeth G Demicco
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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7
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Georgantzoglou N, Green D, Lefferts JA, Giannikaki L, Chliara E, Stavrianaki A, Kerr DA, Linos K. A Rare Case of Low-Grade Dedifferentiated Liposarcoma Presenting as a Pharyngeal Polyp: Avoiding a Pitfall With Significant Repercussions. Int J Surg Pathol 2021; 30:405-412. [PMID: 34894818 DOI: 10.1177/10668969211062859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dedifferentiated liposarcoma is a nonlipogenic sarcoma of variable histological grade that frequently arises in association with a well-differentiated liposarcoma. Dedifferentiation occurs in approximately 10% of well-differentiated liposarcomas and is most commonly encountered in the retroperitoneum. Dedifferentiated liposarcoma of the upper respiratory tract is an extremely rare occurrence. Herein, we report a very rare case of low-grade dedifferentiated liposarcoma of the pharynx that presented as a polyp mimicking a benign process clinically and microscopically. We discuss the relevant molecular findings and review the current literature.
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Affiliation(s)
| | - Donald Green
- 22916Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Joel A Lefferts
- 22916Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.,12285Geisel School of Medicine at Dartmouth, NH, USA
| | | | | | | | - Darcy A Kerr
- 22916Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.,12285Geisel School of Medicine at Dartmouth, NH, USA
| | - Konstantinos Linos
- 22916Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.,12285Geisel School of Medicine at Dartmouth, NH, USA
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Mori T, Yamada Y, Kinoshita I, Kohashi K, Yamamoto H, Ito Y, Susuki Y, Kawaguchi K, Nakashima Y, Oda Y. Clinicopathological and Histopathological Review of Dedifferentiated Liposarcoma: A Comprehensive Study of 123 Primary Tumours. Histopathology 2021; 80:538-557. [PMID: 34699612 DOI: 10.1111/his.14588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/18/2021] [Accepted: 10/24/2021] [Indexed: 11/29/2022]
Abstract
AIMS Dedifferentiated liposarcoma (DDLS) exhibits varying histopathological features, but their significance for the biological behaviour of this disease has not been fully clarified. This study aimed at elucidating the prognostic factors of DDLS by clinicopathologically reviewing a large case series. METHODS AND RESULTS We clinicopathologically reviewed 123 cases of primary de novo DDLS without preoperative treatment, including 81 in the internal trunk (internal DDLS) and 42 in peripheral sites (peripheral DDLS). Univariate and multivariate analyses of their features were also performed for all cases, the internal DDLS group, and the peripheral DDLS group. The results showed that, in all three groups, distant metastasis was significantly associated with shorter overall survival (OS) (univariate analysis, P<0.0001, =0.0011, and 0.0101, respectively), whereas local recurrence showed no significant effect on prognosis. Histopathologically, high mitotic count and the presence of round tumour cells were significantly associated with shorter OS in multivariate analysis of the internal DDLS group (P=0.0022, HR=4.39, 95% CI 1.71-11.28; P=0.0014, HR=7.19, 95% CI 2.14-24.16, respectively). Meanwhile, in the peripheral DDLS group, necrosis and high-grade histological components were significantly associated with shorter OS (univariate analysis, P=0.0068 and 0.0174, respectively). CONCLUSIONS The presence of round tumour cells may be one of the histological factors associated with a worse prognosis in DDLS, as previous studies indicated. This work also suggested that distant metastasis may be predictive of prognosis in both internal and peripheral DDLS, instead of local recurrence.
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Affiliation(s)
- Taro Mori
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuichi Yamada
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Izumi Kinoshita
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Ito
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yosuke Susuki
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kengo Kawaguchi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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9
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Nishio J, Nakayama S, Nabeshima K, Yamamoto T. Biology and Management of Dedifferentiated Liposarcoma: State of the Art and Perspectives. J Clin Med 2021; 10:3230. [PMID: 34362013 PMCID: PMC8348700 DOI: 10.3390/jcm10153230] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 12/12/2022] Open
Abstract
Dedifferentiated liposarcoma (DDL) is defined as the transition from well-differentiated liposarcoma (WDL)/atypical lipomatous tumor (ALT) to non-lipogenic sarcoma, which arises mostly in the retroperitoneum and deep soft tissue of proximal extremities. It is characterized by a supernumerary ring and giant marker chromosomes, both of which contain amplified sequences of 12q13-15 including murinedouble minute 2 (MDM2) and cyclin-dependent kinase 4 (CDK4) cell cycle oncogenes. Detection of MDM2 (and/or CDK4) amplification serves to distinguish DDL from other undifferentiated sarcomas. Recently, CTDSP1/2-DNM3OS fusion genes have been identified in a subset of DDL. However, the genetic events associated with dedifferentiation of WDL/ALT remain to be clarified. The standard treatment for localized DDL is surgery, with or without radiotherapy. In advanced disease, the standard first-line therapy is an anthracycline-based regimen, with either single-agent anthracycline or anthracycline in combination with the alkylating agent ifosfamide. Unfortunately, this regimen has not necessarily led to a satisfactory clinical outcome. Recent advances in the understanding of the pathogenesis of DDL may allow for the development of more-effective innovative therapeutic strategies. This review provides an overview of the current knowledge on the clinical presentation, pathogenesis, histopathology and treatment of DDL.
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Affiliation(s)
- Jun Nishio
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (S.N.); (T.Y.)
| | - Shizuhide Nakayama
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (S.N.); (T.Y.)
| | - Kazuki Nabeshima
- Department of Pathology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan;
| | - Takuaki Yamamoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (S.N.); (T.Y.)
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10
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Kohama I, Asano N, Matsuzaki J, Yamamoto Y, Yamamoto T, Takahashi RU, Kobayashi E, Takizawa S, Sakamoto H, Kato K, Fujimoto H, Chikuda H, Kawai A, Ochiya T. Comprehensive serum and tissue microRNA profiling in dedifferentiated liposarcoma. Oncol Lett 2021; 22:623. [PMID: 34285721 PMCID: PMC8258628 DOI: 10.3892/ol.2021.12884] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 04/30/2021] [Indexed: 12/02/2022] Open
Abstract
Sarcoma is a rare cancer with several subtypes; therefore, our understanding of the pathogenesis of sarcoma is limited, and designing effective treatments is difficult. Circulating microRNAs (miRNAs), including exosomal miRNAs, have attracted attention as biomarkers in cancer. However, the roles of miRNAs and exosomes in sarcoma remain unclear. The present analysis of tissue and serum miRNA expression in osteosarcoma, Ewing's sarcoma and dedifferentiated liposarcoma (DDLPS) identified miR-1246, −4532, −4454, −619-5p and −6126 as biomarkers for DDLPS. These miRNAs were highly expressed in human DDLPS cell lines and exosomes, suggesting that they are secreted from DDLPS tissues. The present results suggested that specific miRNAs may be used as biomarkers for early diagnosis or treatment targets in DDLPS.
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Affiliation(s)
- Isaku Kohama
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Tokyo 104-0045, Japan.,Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Naofumi Asano
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Juntaro Matsuzaki
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Yusuke Yamamoto
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Tomofumi Yamamoto
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Ryou-U Takahashi
- Department of Cellular and Molecular Biology, Division of Integrated Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Eisuke Kobayashi
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Satoko Takizawa
- New Frontiers Research Institute, Toray Industries, Kamakura, Kanagawa 247-8555, Japan
| | - Hiromi Sakamoto
- Department of Clinical Genomics, Fundamental Innovative Oncology Core, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Ken Kato
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Hiroyuki Fujimoto
- Department of Urology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Hirotaka Chikuda
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Takahiro Ochiya
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Tokyo 104-0045, Japan.,Department of Molecular and Cellular Medicine, Institute of Medical Science, Tokyo Medical University, Tokyo 160-0023, Japan
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11
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Lu J, Wood D, Ingley E, Koks S, Wong D. Update on genomic and molecular landscapes of well-differentiated liposarcoma and dedifferentiated liposarcoma. Mol Biol Rep 2021; 48:3637-3647. [PMID: 33893924 DOI: 10.1007/s11033-021-06362-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/16/2021] [Indexed: 01/13/2023]
Abstract
Well-differentiated liposarcoma (WDLPS) is the most frequent subtype of liposarcoma and may transform into dedifferentiated liposarcoma (DDLPS) which is a more aggressive subtype. Retroperitoneal lesions of WDLPS/DDLPS tend to recur repeatedly due to incomplete resections, and adjuvant chemotherapy and radiotherapy have little effect on patient survival. Consequently, identifying therapeutic targets and developing targeted drugs is critical for improving the outcome of WDLPS/DDLPS patients. In this review, we summarised the mutational landscape of WDLPS/DDLPS from recent studies focusing on potential oncogenic drivers and the development of molecular targeted drugs for DDLPS. Due to the limited number of studies on the molecular networks driving WDLPS to DDLPS development, we looked at other dedifferentiation-related tumours to identify potential parallel mechanisms that could be involved in the dedifferentiation process generating DDLPS.
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Affiliation(s)
- Jun Lu
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, 6009, Australia. .,Cell Signalling Group, Harry Perkins Institute of Medical Research and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia.
| | - David Wood
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, 6009, Australia
| | - Evan Ingley
- Cell Signalling Group, Harry Perkins Institute of Medical Research and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia.,Discipline of Medical, Molecular and Forensic Sciences, College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, 6009, Australia
| | - Sulev Koks
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, 6009, Australia
| | - Daniel Wong
- Anatomical Pathology, PathWest, QEII Medical Centre, Perth, WA, 6009, Australia
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12
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Staging and Classification of Primary Musculoskeletal Bone and Soft Tissue Tumors Based on the 2020 WHO Update, From the AJR Special Series on Cancer Staging. AJR Am J Roentgenol 2021; 217:1038-1052. [PMID: 33852362 DOI: 10.2214/ajr.21.25658] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Staging of primary musculoskeletal bone and soft tissue tumors is most commonly performed using the AJCC and the Enneking or Musculoskeletal Tumor Society (MSTS) staging systems. Radiologic imaging is integral in achieving adequate musculoskeletal neoplastic staging by defining lesion extent and identifying regional lymph node involvement and distant metastatic disease. Additional important features in surgical planning, though not distinct components of the staging systems, include cortical involvement, joint invasion, and neurovascular encasement; these features are optimally evaluated by MRI. In 2020, the WHO updated the classification of primary musculoskeletal tumors of soft tissue and bone. The update reflects the continued explosion in identification of novel gene alterations in many bone and soft tissue neoplasms. This has resulted in newly designated lesions, reclassification of lesion categories, and improved specificity of diagnosis. While radiologists do not need to have a comprehensive knowledge of the pathologic details, a broad working understanding of the most recent update is important to aid accurate and timely diagnosis given that histologic grading is a component of all staging systems. By approaching primary musculoskeletal neoplasms through a multidisciplinary approach with colleagues in pathology, orthopedic oncology, radiation oncology, and medical oncology, radiologists may promote improved diagnosis, treatment, and outcomes.
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13
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Abstract
The fifth edition of the World Health Organization Classification of Tumors of Soft Tissue and Bone was published in early 2020. The revisions reflect a consensus among an international expert editorial board composed of soft tissue and bone pathologists, geneticists, a medical oncologist, surgeon, and radiologist. The changes in the soft tissue tumor chapter notably include diverse, recently described tumor types (eg, atypical spindle cell/pleomorphic lipomatous tumor, angiofibroma of soft tissue, and CIC-rearranged sarcoma), new clinically significant prognostic information for a variety of existing entities (eg, dedifferentiated liposarcoma and solitary fibrous tumor), and a plethora of novel genetic alterations, some of practical diagnostic relevance (eg, NAB2-STAT6 in solitary fibrous tumor, FOSB rearrangements in epithelioid hemangioma and pseudomyogenic hemangioendothelioma, and SUZ12 or EED mutations in malignant peripheral nerve sheath tumor, leading to loss of H3K27 trimethylation). In this review, we highlight the major changes to the soft tissue chapter in the 2020 World Health Organization Classification, as well as the new chapter on undifferentiated small round cell sarcomas, with a focus on updates in diagnostic categories, prognostication, and novel markers. Recent discoveries in molecular genetics are also discussed, particularly those of immediate utility in differential diagnosis, including protein correlates detectable using immunohistochemistry.
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14
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Rioja P, Valencia G, Centurión-Rodriguez C, Morante Z, Bravo M, Huanca L, Morante C. Renal liposarcoma: case report and review of systemic treatment. Ecancermedicalscience 2021; 15:1173. [PMID: 33680087 PMCID: PMC7929774 DOI: 10.3332/ecancer.2021.1173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Indexed: 11/06/2022] Open
Abstract
Liposarcomas are malignant mesenchymal tumours usually located in the retroperitoneum, rarely occurring as a single lesion in the kidney. We present a case of a 59-year-old male patient with a left renal mass detected by computed tomography scan. He underwent radical nephrectomy and the histopathological study reported a primary undifferentiated liposarcoma of the kidney without nodal involvement. After 15 months of surgery, he remained asymptomatic and without evidence of disease recurrence. The objective of this report is to present a case and literature review with current evidence of treatment options and prognostic factors for survival.
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Affiliation(s)
- Patricia Rioja
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Guillermo Valencia
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | | | - Zaida Morante
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Mercedes Bravo
- Pathology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Lourdes Huanca
- Pathology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Carlos Morante
- Surgical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
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15
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Yamashita K, Kohashi K, Yamada Y, Akatsuka S, Ikuta K, Nishida Y, Toyokuni S, Oda Y. Prognostic significance of the MDM2/HMGA2 ratio and histological tumor grade in dedifferentiated liposarcoma. Genes Chromosomes Cancer 2020; 60:26-37. [PMID: 33111425 DOI: 10.1002/gcc.22899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 01/13/2023] Open
Abstract
Dedifferentiated liposarcoma (DDLPS) is a relatively common soft tissue sarcoma that results from the progression of well-differentiated liposarcoma (WDLPS). This study aimed to investigate the progression process and to clarify the pathological and genetic factors related to poor prognosis in DDLPS. In 32 DDLPS cases and five WDLPS cases, genetic factors were analyzed by custom comparative genomic hybridization (CGH) array, which was designed to densely cover gene regions known to be frequently amplified in WD/DDLPS. The analyses comparing primary and metastatic lesions and those comparing histologically different areas in the same tumor revealed intra-tumoral genetic heterogeneity and progression. According to a prognostic analysis comparing the good-prognosis and the poor-prognosis groups, we selected MDM2 and HMGA2 as candidate genes associated with poor and good prognosis, respectively. The ratios of the amplification or gain levels of MDM2 and HMGA2 expressed in log ratios (log[MDM2/HMGA2] = log[MDM2]-log[HMGA2]) were significantly associated with prognosis. An amplification or gain level of MDM2 that was more than twice that of HMGA2 (MDM2/HMGA2 > 2, log[MDM2/HMGA2] > 1) was strongly related to poor OS (P < .001) and poor distant metastasis-free survival (DMFS) (P < .001). In the pathological analysis of 44 cases of DDLPS, histological tumor grade, cellular atypia, and MDM2 immunoreactivity were related to overall survival (OS), while HMGA2 immunoreactivity tended to be associated with OS. Cellular atypia was also associated with DMFS. In conclusion, histological grade and MDM2 expression were determined to be prognostically important, and the MDM2/HMGA2 amplification or gain ratio was found to have significant prognostic value by the custom CGH array analysis.
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Affiliation(s)
- Kyoko Yamashita
- Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Pathology and Biological Responses, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuichi Yamada
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinya Akatsuka
- Department of Pathology and Biological Responses, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kunihiro Ikuta
- Department of Orthopedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan.,Medical Genomic Center, Nagoya University Hospital, Nagoya, Japan
| | - Yoshihiro Nishida
- Department of Orthopedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan.,Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Shinya Toyokuni
- Department of Pathology and Biological Responses, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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16
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Seligson ND, Stets CW, Demoret BW, Awasthi A, Grosenbacher N, Shakya R, Hays JL, Chen JL. Inhibition of histone deacetylase 2 reduces MDM2 expression and reduces tumor growth in dedifferentiated liposarcoma. Oncotarget 2019; 10:5671-5679. [PMID: 31620242 PMCID: PMC6779286 DOI: 10.18632/oncotarget.27144] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 07/21/2019] [Indexed: 02/05/2023] Open
Abstract
Dedifferentiated liposarcoma (DDLPS) is a highly morbid mesenchymal tumor characterized and driven by genomic amplification of the MDM2 gene. Direct inhibition of MDM2 has shown promise pre-clinically, but has yet to be validated in clinical trials. Early in vitro studies have demonstrated that pan-histone deacetylase (HDAC) inhibition may have anti-MDM2 effects. Here we present in silico, in vitro, and mouse xenograft studies that suggest that specifically targeting HDAC2 reduces MDM2 expression and has anti-tumor affects in DDLPS. Two independent datasets, The Cancer Genome Atlas (TCGA; n = 58) and the Memorial Sloan-Kettering Cancer Center Dataset (MSKCC; n = 63), were used to identify the co-expression between class I HDACs and MDM2, and their clinical impact. HDAC2 was highly co-expressed with MDM2 (TCGA: Spearman’s coefficient = 0.29, p = 0.03; MSKCC: Spearman’s coefficient = 0.57, p < 0.001). As both a continuous and dichotomous predictor, elevated HDAC2 expression was associated with worsened disease-free survival in the TCGA (Continuous: Hazard-ratio (HR) 1.7; 95% Confidence Interval (95%CI) 0.97–2.9; p = 0.06; Dichotomous: HR 7.1, 95%CI 2.5–19.8, p < 0.001) and distant recurrence-free survival in the MSKCC (Continuous: HR 2.2; 95%CI 1.1–4.8; p = 0.04; Dichotomous: HR 2.8, 95%CI 1.2–6.4, p = 0.02). In vitro, treatment of DDLPS cell lines with the HDAC inhibitors MI-192 (HDAC2/3 inhibitor) or romidepsin (HDAC1/2 inhibitor) reduced MDM2 expression and induced apoptosis. In a murine DDLPS xenograft model, romidepsin reduced tumor growth and lowered tumor MDM2 expression. RNA-sequencing of romidepsin treated mouse tumors demonstrated markers of TP53 reactivation. Taken together, our data supports the hypothesis that targeting HDAC2 may represent a potential strategy to modulate MDM2 expression in DDLPS.
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Affiliation(s)
- Nathan D Seligson
- Department of Pharmacy, The Ohio State University Wexner Medical Center and Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Colin W Stets
- Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Bryce W Demoret
- Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Achal Awasthi
- Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Nicholas Grosenbacher
- Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Reena Shakya
- Target Validation Shared Resource, The Ohio State University Wexner Medical Center and Comprehensive Cancer Center, Columbus, Ohio, USA
| | - John L Hays
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA.,Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA
| | - James L Chen
- Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA.,Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
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17
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Iannessi A, Bertrand AS, Peyrottes I, Thyss A, Machiavello JC, Liberatore M. One-bloc percutaneous large biopsy of soft-tissue tumours: feasibility study and possible indications. Clin Radiol 2019; 74:649.e11-649.e17. [PMID: 31178068 DOI: 10.1016/j.crad.2019.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 05/02/2019] [Indexed: 11/26/2022]
Abstract
AIM To report the early results of the Intact lesion excision system (LES) regarding feasibility, tolerance and efficiency in obtaining soft-tissue tumour samples under ultrasound guidance. MATERIALS AND METHODS The feasibility and tolerance of Intact LES procedures under ultrasound guidance were studied prospectively in 15 patients. The procedure was performed on an outpatient basis under local anaesthesia by a single interventional radiologist with 6 years of experience and lasted around 30 min. RESULTS The feasibility of the Intact LES for soft-tissue masses was good except when lesions were hard and calcified. Tolerance was good, with median pain experienced during the procedure evaluated at 4.5/10 (SD 2.2) and median post-procedural pain at day 1 evaluated at 1.8/10 (SD 2.5). No major complications were observed; however, for vascularised lesions, one case of acute wound bleeding and two post-procedural haematomas led to delayed pain. CONCLUSION Percutaneous biopsy of suspected soft-tissue sarcoma using the LES device under ultrasound guidance is well tolerated and feasible. After a first non-contributing core biopsy, and especially, in the case of lipomatous lesions, it is a valuable option to consider, as is surgical incision biopsy.
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Affiliation(s)
- A Iannessi
- Interventional and Diagnostic Imaging Department, Cancer Center Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France.
| | - A S Bertrand
- Interventional and Diagnostic Imaging Department, Cancer Center Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France
| | - I Peyrottes
- Pathology Department, Cancer Center Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France
| | - A Thyss
- Oncology Department, Cancer Center Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France
| | - J C Machiavello
- Visceral Surgery Department, Cancer Center Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France
| | - M Liberatore
- Diagnostic Imaging Department, Princess Grace Hospital, 1 Avenue Pasteur, 98012 Monaco
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18
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Mantilla JG, Ricciotti RW, Chen EY, Liu YJ, Hoch BL. Amplification of DNA damage-inducible transcript 3 (DDIT3) is associated with myxoid liposarcoma-like morphology and homologous lipoblastic differentiation in dedifferentiated liposarcoma. Mod Pathol 2019; 32:585-592. [PMID: 30420727 DOI: 10.1038/s41379-018-0171-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/04/2018] [Indexed: 12/27/2022]
Abstract
Dedifferentiated liposarcoma is defined as progression of atypical lipomatous tumor/well-differentiated liposarcoma to a higher grade usually non-lipogenic sarcoma, with amplification of 12q13-15. This region contains several genes involved in liposarcoma pathogenesis, including MDM2, CDK4, and DDIT3. While the former two are thought of as the main drivers in dedifferentiated liposarcoma, DDIT3 is typically rearranged in myxoid liposarcoma. Overexpression of DDIT3, along with MDM2 and CDK4, may contribute to the pathogenesis of dedifferentiated liposarcoma by interfering with adipocytic differentiation. Dedifferentiated liposarcoma with DDIT3 amplification has not been well characterized. In this study we evaluate the presence of DDIT3 amplification in 48 cases of dedifferentiated liposarcoma by cytogenomic microarray analysis and its correlation with demographic, clinical, and morphologic characteristics. Data from The Cancer Genome Atlas were also evaluated to determine a relationship between DDIT3 amplification and prognostic outcomes. Of the 48 cases, 16 (33%) had amplification of DDIT3; these patients were on average 11 years younger than patients without DDIT3 amplification (P < 0.05). Myxoid liposarcoma-like morphologic features were identified in 12/16 (75%) cases with DDIT3 amplification and in 7/32 (22%) cases without amplification (P < 0.05). Homologous lipoblastic differentiation was seen in 6/16 (38%) cases with DDIT3 amplification and 2/32 (6%) cases without it (P < 0.05). There was no significant correlation between DDIT3 amplification and tumor location, disease-specific or recurrence-free survival, and distant metastasis. DDIT3 amplification appears to interfere with the adipogenic molecular program and plays a role in inducing or maintaining a lipogenic phenotype in dedifferentiated liposarcoma. From a diagnostic standpoint, it is important to consider DDIT3-amplified dedifferentiated liposarcoma in the differential diagnosis of myxoid liposarcoma, particularly in small biopsies. Further studies evaluating the significance of DDIT3 amplification in the pathogenesis of dedifferentiated liposarcoma, as well as a potential predictor of tumor behavior in well-differentiated liposarcoma, are needed.
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Affiliation(s)
- Jose G Mantilla
- Department of Pathology, University of Washington, Seattle, WA, USA
| | | | - Eleanor Y Chen
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Yajuan J Liu
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Benjamin L Hoch
- Department of Pathology, University of New Mexico, Albuquerque, NM, USA.
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19
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Abstract
Adipocytic neoplasms include a diversity of both benign tumors (lipomas) and malignancies (liposarcomas), and each tumor type is characterized by its own unique molecular alterations driving tumorigenesis. Work over the past 30 years has established the diagnostic utility of several of these characteristic molecular alterations (e.g. MDM2 amplification in well- and dedifferentiated liposarcoma, FUS/EWSR1-DDIT3 gene fusions in myxoid liposarcoma, RB1 loss in spindle cell/pleomorphic lipoma). More recent studies have focused on additional molecular alterations which may have therapeutic or prognostic impact. This review will summarize several of the important molecular findings in adipocytic tumors that have been described over the past 10 years.
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Affiliation(s)
- Elizabeth G Demicco
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
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20
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Mooney KL, Kao CS. A Contemporary Review of Common Adult Non-germ Cell Tumors of the Testis and Paratestis. Surg Pathol Clin 2018; 11:739-758. [PMID: 30447839 DOI: 10.1016/j.path.2018.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article provides a comprehensive review of non-germ cell tumors of the testis and paratestis in adults, incorporating the latest 2016 World Health Organization updates. Clinical features, gross pathologic findings, key morphologic details, immunohistochemical profiles, and differential diagnoses are covered, with an emphasis on how to resolve commonly encountered, and sometimes difficult, differential diagnoses.
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Affiliation(s)
- Kelly L Mooney
- Department of Pathology, Stanford University School of Medicine, 300 Pasteur Drive, L235, Stanford, CA 94305, USA
| | - Chia-Sui Kao
- Department of Pathology, Stanford University School of Medicine, 300 Pasteur Drive, L235, Stanford, CA 94305, USA.
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21
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Vargas AC, Selinger C, Satgunaseelan L, Cooper WA, Gupta R, Stalley P, Brown W, Soper J, Schatz J, Boyle R, Thomas DM, Tattersall MH, Bhadri V, Maclean F, Bonar SF, Scolyer RA, Karim RZ, McCarthy SW, Mahar A, O'Toole SA. FISH analysis of selected soft tissue tumors: Diagnostic experience in a tertiary center. Asia Pac J Clin Oncol 2018; 15:38-47. [DOI: 10.1111/ajco.12980] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 03/29/2018] [Indexed: 12/20/2022]
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22
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Molecular analyses in the diagnosis and prediction of prognosis in non-GIST soft tissue sarcomas: A systematic review and meta-analysis. Cancer Treat Rev 2018; 66:74-81. [DOI: 10.1016/j.ctrv.2018.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/10/2018] [Accepted: 04/20/2018] [Indexed: 12/14/2022]
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23
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Nimura F, Nakasone T, Matsumoto H, Maruyama T, Matayoshi A, Maruyama N, Yoshimi N, Arasaki A, Nishihara K. Dedifferentiated liposarcoma of the oral floor: A case study and literature review of 50 cases of head and neck neoplasm. Oncol Lett 2018; 15:7681-7688. [PMID: 29740489 PMCID: PMC5934721 DOI: 10.3892/ol.2018.8274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/23/2018] [Indexed: 12/23/2022] Open
Abstract
Dedifferentiated liposarcoma (DDLS) has a relatively poor prognosis, however this neoplasm rarely occurs in the head and neck. To date, no definite protocol has been established for the diagnosis and treatment of head and neck DDLS. The present study reports the case of a 69-year-old male patient with DDLS of the oral floor. To the best of our knowledge, this is the first documented case of oral floor DDLS. In addition, this is the first reported case with the development of a second primary malignancy following the treatment of head and neck DDLS. A literature review of 50 cases of head and neck DDLS revealed that preoperative biopsy is not reliable for the diagnosis of these tumors and an accurate pathological diagnosis with total resection is preferred.
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Affiliation(s)
- Fumikazu Nimura
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Toshiyuki Nakasone
- Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Hirofumi Matsumoto
- Department of Pathology, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Tessho Maruyama
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.,Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Akira Matayoshi
- Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Nobuyuki Maruyama
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.,Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Naoki Yoshimi
- Department of Pathology, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.,Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Akira Arasaki
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.,Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Kazuhide Nishihara
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.,Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
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24
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Yamashita K, Kohashi K, Yamada Y, Ishii T, Nishida Y, Urakawa H, Ito I, Takahashi M, Inoue T, Ito M, Ohara Y, Oda Y, Toyokuni S. Osteogenic differentiation in dedifferentiated liposarcoma: a study of 36 cases in comparison to the cases without ossification. Histopathology 2017; 72:729-738. [DOI: 10.1111/his.13421] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/16/2017] [Accepted: 10/24/2017] [Indexed: 02/05/2023]
Affiliation(s)
- Kyoko Yamashita
- Department of Pathology and Biological Responses; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Yuichi Yamada
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Takeaki Ishii
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Yoshihiro Nishida
- Department of Orthopedic Surgery; Nagoya University Graduate School and School of Medicine; Nagoya Japan
| | - Hiroshi Urakawa
- Department of Orthopedic Surgery; Nagoya University Graduate School and School of Medicine; Nagoya Japan
| | - Ichiro Ito
- Department of Pathology; Shizuoka Cancer Center Hospital; Shizuoka Japan
| | - Mitsuru Takahashi
- Division of Orthopaedic Oncology; Shizuoka Cancer Center Hospital; Shizuoka Japan
| | - Takeshi Inoue
- Department of Pathology; Osaka City General Hospital; Osaka Japan
| | - Masafumi Ito
- Department of Pathology; Japanese Red Cross Nagoya First Hospital; Nagoya Japan
| | - Yuuki Ohara
- Department of Pathology and Biological Responses; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Shinya Toyokuni
- Department of Pathology and Biological Responses; Nagoya University Graduate School of Medicine; Nagoya Japan
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Ricciotti RW, Baraff AJ, Jour G, Kyriss M, Wu Y, Liu Y, Li SC, Hoch B, Liu YJ. High amplification levels of MDM2 and CDK4 correlate with poor outcome in patients with dedifferentiated liposarcoma: A cytogenomic microarray analysis of 47 cases. Cancer Genet 2017; 218-219:69-80. [PMID: 29153098 DOI: 10.1016/j.cancergen.2017.09.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 08/18/2017] [Accepted: 09/18/2017] [Indexed: 11/25/2022]
Abstract
Dedifferentiated liposarcoma (DDLS) is characterized at the molecular level by amplification of genes within 12q13-15 including MDM2 and CDK4. However, other than FNCLCC grade, prognostic markers are limited. We aim to identify molecular prognostic markers for DDLS to help risk stratify patients. To this end, we studied 49 cases of DDLS in our institutional archives and performed cytogenomic microarray analysis on 47 cases. Gene copy numbers for 12 loci were evaluated and correlated with outcome data retrieved from our institutional electronic medical records. Using cut point analysis and comparison of Kaplan-Meier survival curves by log rank tests, high amplification levels of MDM2 (>38 copies) and CDK4 (>30 copies) correlated with decreased disease free survival (DFS) (P = .0168 and 0.0169 respectively) and disease specific survival (DSS) (P = .0082 and 0.0140 respectively). Additionally, MDM2 and CDK4 showed evidence of a synergistic effect so that each additional copy of one enhances the effect on prognosis of each additional copy of the other for decreased DFS (P = .0227, 0.1% hazard). High amplification of JUN (>16 copies) also correlated with decreased DFS (P = .0217), but not DSS. The presence of copy number alteration at 3q29 correlated with decreased DSS (P = .0192). The presence of >10 mitoses per 10 high power fields and FNCLCC grade 3 also correlated with decreased DFS (P = .0310 and 0.0254 respectively). MDM2 and CDK4 gene amplification levels, along with JUN amplification and copy alterations at 3q29, can be utilized for predicting outcome in patients with DDLS.
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Affiliation(s)
- Robert W Ricciotti
- Department of Pathology, University of Washington School of Medicine, Seattle, WA
| | - Aaron J Baraff
- Department of BioStatistics, University of Washington School of Medicine, Seattle, WA
| | - George Jour
- Department of Pathology and Laboratory Medicine, MD Anderson Cancer Center at Cooper, Camden, NJ
| | | | - Yu Wu
- Department of Pathology, University of Washington School of Medicine, Seattle, WA
| | - Yuhua Liu
- Department of Pathology, University of Washington School of Medicine, Seattle, WA
| | - Shao-Chun Li
- Department of Pharmacology, School of Medicine, Hebei University, PR China
| | - Benjamin Hoch
- Department of Pathology, University of Washington School of Medicine, Seattle, WA.
| | - Yajuan J Liu
- Department of Pathology, University of Washington School of Medicine, Seattle, WA.
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Dantey K, Schoedel K, Yergiyev O, Bartlett D, Rao UN. Correlation of histological grade of dedifferentiation with clinical outcome in 55 patients with dedifferentiated liposarcomas. Hum Pathol 2017; 66:86-92. [DOI: 10.1016/j.humpath.2017.02.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/23/2017] [Accepted: 02/23/2017] [Indexed: 10/20/2022]
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27
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Oda Y, Yamamoto H, Kohashi K, Yamada Y, Iura K, Ishii T, Maekawa A, Bekki H. Soft tissue sarcomas: From a morphological to a molecular biological approach. Pathol Int 2017; 67:435-446. [DOI: 10.1111/pin.12565] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 07/05/2017] [Indexed: 01/07/2023]
Affiliation(s)
- Yoshinao Oda
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
| | - Yuichi Yamada
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
| | - Kunio Iura
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
- Department of Orthopedic Surgery; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
| | - Takeaki Ishii
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
- Department of Orthopedic Surgery; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
| | - Akira Maekawa
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
- Department of Orthopedic Surgery; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
| | - Hirofumi Bekki
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
- Department of Orthopedic Surgery; Graduate School of Medical Sciences; Kyushu University; 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 Japan
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28
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Primary extraskeletal osteosarcoma: a clinicopathological study of 18 cases focusing on MDM2 amplification status. Hum Pathol 2017; 63:63-69. [DOI: 10.1016/j.humpath.2017.02.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/16/2017] [Accepted: 02/09/2017] [Indexed: 11/17/2022]
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Abstract
INTRODUCTION Liposarcoma (LS) is one of the most common adult soft tissue sarcomas (STS). For metastatic disease, systemic treatment options were historically represented by standard cytotoxic chemotherapy. More recently, innovative therapies have been introduced and they are currently part of the therapeutic armamentarium, positively impacting disease control and patients' quality of life. Moreover, in the last decade, a better understanding of the molecular characteristics of each STS subtype allowed to detect new potential targets and develop novel, biology-driven compounds at different stages of testing. Areas covered: This review is focused on LS, retracing their pharmacological management, starting with a summary of results achieved with standard chemotherapy, then moving to a deeper analysis on data obtained with new, approved therapies and finally reporting an update on ongoing clinical trials, thus providing an overview on the current scenario and outlining how it might evolve in the coming years. Expert commentary: Important strides have been made in the knowledge and treatment of LS. Peculiar molecular features and fundamental signalling pathways represent nowadays druggable targets for novel therapies. However, predictive biomarkers still need to be identified in order to better select the target population, to possibly test combinations of drugs, with the ultimate goal of improving outcomes.
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Affiliation(s)
- Maristella Saponara
- a Department of Specialized, Experimental, and Diagnostic Medicine , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy.,b Department of Cancer Medicine , Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
| | - Silvia Stacchiotti
- b Department of Cancer Medicine , Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
| | - Alessandro Gronchi
- c Department of Surgery , Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
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Li J, Motoi N, Kanda H, Sugiura Y, Nagano H, Yonese J, Okumura S, Matsumoto S, Machinami R, Ishikawa Y. A newly emerged osteosarcomatous dedifferentiation of liposarcoma in lung metastasis - a potential diagnostic pitfall. Pathol Int 2016; 67:50-52. [PMID: 27879024 DOI: 10.1111/pin.12482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 10/24/2016] [Accepted: 10/27/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Jian Li
- Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Pathology, Peking University Shenzhen Hospital, No. 1120, Lianhua North Road, Shenzhen, China
| | - Noriko Motoi
- Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Departments of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tsukiji, Tokyo, Japan
| | - Hiroaki Kanda
- Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Departments of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshiya Sugiura
- Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Departments of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroko Nagano
- Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Departments of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Sakae Okumura
- Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Seiichi Matsumoto
- Orthopedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Rikuo Machinami
- Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Pathology, Kawakita General Hospital, Tokyo, Japan
| | - Yuichi Ishikawa
- Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Departments of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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31
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Federation Nationale des Centers de Lutte Contre le Cancer grading of soft tissue sarcomas on needle core biopsies using surrogate markers. Hum Pathol 2016; 56:147-54. [PMID: 27346575 DOI: 10.1016/j.humpath.2016.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 06/02/2016] [Accepted: 06/11/2016] [Indexed: 11/23/2022]
Abstract
Needle core biopsy (NCB) of soft tissue sarcomas (STSs) presents problems for French Federation Nationale des Centers de Lutte Contre le Cancer (FNCLCC) histological grading because small sample size hinders determination of necrosis and mitotic activity. We graded 53 STSs on NCB using a modified FNCLCC grading system that substitutes Ki-67 immunoexpression for mitotic count and uses a radiological assessment of necrosis, and compared the results with those obtained by conventional FNCLCC grading of the corresponding untreated, surgically resected specimen. Forty-eight of the 53 tumors were classified as malignant on NCB (concordance = 91%). The modified FNCLCC grade correctly separated high-grade (grades II and III) from low-grade sarcomas in 70% of cases and predicted the traditional FNCLCC grade given to the resected specimen in 49% of cases. Ki-67 scores of 2 or 3 were observed in 5 tumors classified as low-grade neoplasms on NCB but upgraded to a high-grade dedifferentiated liposarcoma on resection. Underestimated NCB grades were commonly encountered with lipomatous tumors due to sampling error, whereas Ki-67 or radiologic necrosis scores higher than the corresponding histological scores were responsible for the vast majority of overestimated NCB grades. Our FNCLCC grading scheme replacing conventional mitosis counting and histologic assessment of necrosis with surrogate markers is useful in separating high- and low-grade STSs on NCB for STS treatment planning. High Ki-67 rate should raise suspicion of a higher-grade component, particularly with fatty tumors.
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32
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Ishii T, Kohashi K, Iura K, Maekawa A, Bekki H, Yamada Y, Yamamoto H, Nabeshima K, Kawashima H, Iwamoto Y, Oda Y. Activation of the Akt-mTOR and MAPK pathways in dedifferentiated liposarcomas. Tumour Biol 2015; 37:4767-76. [PMID: 26518767 DOI: 10.1007/s13277-015-4232-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 10/12/2015] [Indexed: 11/27/2022] Open
Abstract
The Akt/mTOR and MAPK pathways play important roles in modulating cellular function in response to extracellular signals, and they are known to be activated in certain kinds of sarcomas. Few investigations have examined these pathways in dedifferentiated liposarcoma (DDLS), in relation to clinicopathological features. Clinicopathological and immunohistochemical analyses were conducted using 99 DDLS specimens. An in vitro study was also conducted to examine the antitumor effects of an mTOR inhibitor and a MEK inhibitor on two DDLS cell lines. The clinicopathological analyses revealed that the AJCC staging was a significant prognostic factor for overall survival and that the tumor size, depth, and location were significant prognostic factors for event-free survival. Phosphorylated Akt (pAkt), pmTOR, pS6RP, p4E-BP1, pMEK, and pERK expressions were positive in 57.4, 52.4, 71.4, 57.1, 84.1, and 50.8 % of the dedifferentiated component of the 63 primary DDLSs. Positive staining for pmTOR was significantly more frequent in the dedifferentiated component than the well-differentiated component. A univariate prognostic analysis revealed that pmTOR expression was associated with poor prognosis in the tumors in the retroperitoneum/ventral body cavity. The mTOR and MEK inhibitors dose-dependently inhibited the cell proliferation of both DDLS cell lines and decreased the expression of downstream pS6RP and pERK, respectively. The combined use of the two inhibitors enhanced antiproliferative activity. In conclusion, the Akt/mTOR and MAPK pathways were activated in DDLS specimens, and the inhibition of these pathways decreased cell proliferation in DDLS cell lines. Our findings suggest that these pathways could be a therapeutic target for patients with DDLS.
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Affiliation(s)
- Takeaki Ishii
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kunio Iura
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Akira Maekawa
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hirofumi Bekki
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yuichi Yamada
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan
| | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yukihide Iwamoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan.
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34
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Zhang H, Yao M, Wu W, Qiu L, Sai W, Yang J, Zheng W, Huang J, Yao D. Up-regulation of annexin A2 expression predicates advanced clinicopathological features and poor prognosis in hepatocellular carcinoma. Tumour Biol 2015; 36:9373-83. [PMID: 26109000 DOI: 10.1007/s13277-015-3678-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 06/15/2015] [Indexed: 12/15/2022] Open
Abstract
Hepatic annexin A2 (ANXA2) orchestrates multiple biologic processes and clinical symptoms and plays a key role in development, metastasis, and drug resistance of lethal hepatocellular carcinoma (HCC). However, the prognostic significance of ANXA2 for HCC has not been elucidated up to now. In this study, ANXA2 was frequently found to be up-regulated in HCC tissues compared with benign liver disease (BLD) tissues, which was consistent with the results in serum samples and tissue specimens of patients with HCC. Furthermore, ANXA2 expression was significantly correlated with differentiated degree, intrahepatic metastasis, portal vein thrombus, and tumor node metastasis (TNM) staging. More importantly, increased ANXA2 level was first confirmed to be closely associated with shortened overall survival of HCC (χ (2) = 12.872, P = 0.005) and identified as an independent prognostic factor (hazard ratio 1.338, 95 % confidence interval (CI) 1.013 ~ 1.766, P = 0.040), suggesting that ANXA2 up-regulation might represent an acquired metastasis phenotype of HCC, help to screen out high-risk population for HCC, or more effectively treat a subset of postsurgical HCC patients positive for ANXA2.
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Affiliation(s)
- Haijian Zhang
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Jiangsu, 226001, China
| | - Min Yao
- Department of Immunology, Medical School of Nantong University, Nantong, China
| | - Wei Wu
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Jiangsu, 226001, China
| | - Liwei Qiu
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Jiangsu, 226001, China
| | - Wenli Sai
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Jiangsu, 226001, China
| | - Junling Yang
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Jiangsu, 226001, China
| | - Wenjie Zheng
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Jiangsu, 226001, China
| | - Jianfei Huang
- Department of Pathology, Affiliated Hospital of Nantong University, Nantong, 226001, China.
| | - Dengfu Yao
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Jiangsu, 226001, China.
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