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Chadha M, Iadecola S, Jenks A, Pankova V, Tam YB, Burns J, Arthur A, Wilding CP, Chen L, Chudasama P, Callegaro D, Strauss DC, Thway K, Gronchi A, Jones RL, Miceli R, Pasquali S, Huang PH. Proteomic profiling improves prognostic risk stratification of the Sarculator nomogram in soft tissue sarcomas of the extremities and trunk wall. Cancer Med 2024; 13:e70026. [PMID: 39041188 PMCID: PMC11263812 DOI: 10.1002/cam4.70026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 06/05/2024] [Accepted: 07/07/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND High-risk soft tissue sarcomas of the extremities and trunk wall (eSTS), as defined by the Sarculator nomogram, are more likely to benefit from (neo)adjuvant anthracycline-based therapy compared to low/intermediate-risk patients. The biology underpinning these differential treatment outcomes remain unknown. METHODS We analysed proteomic profiles and clinical outcomes of 123 eSTS patients. A Cox model for overall survival including the Sarculator was fitted to individual data to define four risk groups. A DNA replication protein signature-Sarcoma Proteomic Module 6 (SPM6) was evaluated for association with clinicopathological factors and risk groups. SPM6 was added as a covariate together with Sarculator in a multivariable Cox model to assess improvement in prognostic risk stratification. RESULTS DNA replication and cell cycle proteins were upregulated in high-risk versus very low-risk patients. Evaluation of the functional effects of CRISPR-Cas9 gene knockdown of proteins enriched in high-risk patients using the cancer cell line encyclopaedia database identified candidate drug targets. SPM6 was significantly associated with tumour malignancy grade (p = 1.6e-06), histology (p = 1.4e-05) and risk groups (p = 2.6e-06). Cox model analysis showed that SPM6 substantially contributed to a better calibration of the Sarculator nomogram (Index of Prediction Accuracy = 0.109 for Sarculator alone versus 0.165 for Sarculator + SPM6). CONCLUSIONS Risk stratification of patient with STS is defined by distinct biological pathways across a range of cancer hallmarks. Incorporation of SPM6 protein signature improves prognostic risk stratification of the Sarculator nomogram. This study highlights the utility of integrating protein signatures for the development of next-generation nomograms.
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Affiliation(s)
- Madhumeeta Chadha
- Division of Molecular PathologyThe Institute of Cancer ResearchLondonUK
| | - Sara Iadecola
- Unit of Biostatistics for Clinical ResearchFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Andrew Jenks
- Division of Molecular PathologyThe Institute of Cancer ResearchLondonUK
| | - Valeriya Pankova
- Division of Molecular PathologyThe Institute of Cancer ResearchLondonUK
| | - Yuen Bun Tam
- Division of Molecular PathologyThe Institute of Cancer ResearchLondonUK
| | - Jessica Burns
- Division of Molecular PathologyThe Institute of Cancer ResearchLondonUK
| | - Amani Arthur
- Division of Molecular PathologyThe Institute of Cancer ResearchLondonUK
| | | | - Liang Chen
- Precision Sarcoma Research GroupGerman Cancer Research Center (DKFZ) and National Center for Tumor DiseasesHeidelbergGermany
| | - Priya Chudasama
- Precision Sarcoma Research GroupGerman Cancer Research Center (DKFZ) and National Center for Tumor DiseasesHeidelbergGermany
| | - Dario Callegaro
- Department of SurgeryFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | | | - Khin Thway
- Division of Molecular PathologyThe Institute of Cancer ResearchLondonUK
- The Royal Marsden NHS Foundation TrustLondonUK
| | - Alessandro Gronchi
- Department of SurgeryFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Robin L. Jones
- The Royal Marsden NHS Foundation TrustLondonUK
- Division of Clinical StudiesThe Institute of Cancer ResearchLondonUK
| | - Rosalba Miceli
- Unit of Biostatistics for Clinical ResearchFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Sandro Pasquali
- Department of SurgeryFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
- Molecular Pharmacology, Department of Experimental OncologyFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Paul H. Huang
- Division of Molecular PathologyThe Institute of Cancer ResearchLondonUK
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Sugita S, Tanaka K, Oda Y, Nojima T, Konishi N, Machida R, Kita R, Fukuda H, Ozaki T, Hasegawa T. Prognostic evaluation of the Ki-67 labeling system in histological grading of non-small round cell sarcoma: a supplementary analysis of a randomized controlled trial, JCOG1306. Jpn J Clin Oncol 2024; 54:675-680. [PMID: 38391203 DOI: 10.1093/jjco/hyae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/27/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Soft tissue sarcoma (STS) has various histological types and is rare, making it difficult to evaluate the malignancy of each histological type. Thus, comprehensive histological grading is most important in the pathological examination of STS. The Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grading system is most commonly used in daily pathological analysis of STS. Among the FNCLCC grading system parameters, mitotic count is a key morphological parameter reflecting the proliferative activity of tumor cells, although its reproducibility may be lacking. Here, we compared the prognostic utility of the conventional and modified FNCLCC grading systems in JCOG1306. METHODS We analyzed 140 patients with non-small round cell sarcoma. We performed Ki-67 immunostaining using open biopsy specimens before preoperative chemotherapy in all patients. We assessed histological grade in individual cases by conventional FNCLCC grading (tumor differentiation, mitotic count, and necrosis) and modified FNCLCC grading using the Ki-67 labeling index instead of mitotic count. We conducted univariable and multivariable Cox regression analyses to investigate the influence of grade on overall survival. RESULTS In univariable analysis, prognosis was worse for patients with conventional FNCLCC Grade 3 tumors compared with Grade 1 or 2 tumors (hazard ratio [HR] 4.21, 95% confidence interval [CI] 1.47-12.05, P = 0.008). Moreover, prognosis was worse in patients with modified FNCLCC Grade 3 tumors compared with Grade 1 or 2 tumors (HR 4.90, 95% CI 1.64-14.65, P = 0.004). In multivariable analysis including both conventional and modified FNCLCC grading, the modified grading more strongly affected overall survival (HR 6.70, 95% CI 1.58-28.40, P = 0.010). CONCLUSIONS The modified FNCLCC grading system was superior to the conventional system in predicting the prognosis of patients with non-small round cell sarcoma according to this supplementary analysis of data from the randomized controlled trial JCOG1306.
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Affiliation(s)
- Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine, Chuo-ku, Sapporo
| | - Kazuhiro Tanaka
- Department of Advanced Medical Sciences, Oita University, Yufu, Oita
| | - Yoshinao Oda
- Department of Anatomic Pathology, Kyushu University, Fukuoka
| | - Takayuki Nojima
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Kahoku, Ishikawa
| | - Naomi Konishi
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - Ryunosuke Machida
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - Ryosuke Kita
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - Haruhiko Fukuda
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University, Okayama, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine, Chuo-ku, Sapporo
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Hoshino T, Takada Y, Sugihara A, Kinugasa M, Tsuji Y. Well-Differentiated Liposarcoma That Increased in Size after Menopause: A Case Report and a Review of the Literature. Case Rep Obstet Gynecol 2024; 2024:7599714. [PMID: 38435759 PMCID: PMC10908573 DOI: 10.1155/2024/7599714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/20/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024] Open
Abstract
This study reports a case of uterine liposarcoma together with a literature review. At 52 years old, our patient was diagnosed with lipoleiomyoma by MRI. A mass (39 × 32 × 41 mm3) protruding from the anterior wall of the uterine body was observed. When the patient was 58, her previous doctor found that the tumor had grown, and she was referred to the gynecology department of our hospital. On MRI, the major diameter was 1.23-fold longer and the volume was 1.85-fold higher compared with the prior imaging findings. Diffusion-weighted images revealed no significant anomalous signals. Thus, malignant tumors were included in the differential diagnosis. The patient consented to total abdominal hysterectomy and bilateral salpingo-oophorectomy. The mass on the anterior wall remained completely in the myometrium. No implantation was found in the abdominal cavity, and ascites was not detected. No bleeding or necrosis was observed on the cut surface. Histopathologically, differences in the sizes of adipocytes and stromal cells were identified. There were irregularities in the nuclear findings. The immunohistochemical findings were as follows: CDK4 (+), desmin (+), S100p (-), and Ki - 67 = 1%. Therefore, a diagnosis of well-differentiated liposarcoma was rendered. The lesion was localized in the uterus, and it was completely removed during surgery. Well-differentiated liposarcoma of uterine primary has no possibility of recurrence following complete resection, and thus, the patient underwent follow-up without additional treatment. No metastasis or recurrence has been observed for 10 months after surgery.
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Affiliation(s)
- Tatsuji Hoshino
- Department of Obstetrics and Gynecology, Meiwa General Hospital, Nishinomiya, Japan
| | - Yoshihiro Takada
- Department of Radiology, Meiwa General Hospital, Nishinomiya, Japan
| | - Ayako Sugihara
- Department of Pathology, Meiwa General Hospital, Nishinomiya, Japan
| | - Masato Kinugasa
- Department of Obstetrics and Gynecology, Meiwa General Hospital, Nishinomiya, Japan
| | - Yoshiyuki Tsuji
- Department of Obstetrics and Gynecology, Meiwa General Hospital, Nishinomiya, Japan
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Xiao LX, Liu L, Deng W. Case report: The first account of undifferentiated sarcoma with epithelioid features originating in the pleura. Front Med (Lausanne) 2024; 11:1301941. [PMID: 38362539 PMCID: PMC10867128 DOI: 10.3389/fmed.2024.1301941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
Undifferentiated epithelioid sarcoma (USEF) is a rare subtype of undifferentiated soft tissue sarcoma that presents unique challenges in clinical diagnosis and treatment. Here, we report a case of USEF occurring in the pleura of a 51-year-old man for the first time. Thoracoscopic examination revealed widespread nodular changes, and pathological analysis confirmed the presence of numerous epithelioid atypical cells. Immunohistochemical (IHC) analysis demonstrated an undifferentiated phenotype with distinct characteristics: epithelial membrane antigen (foci +), vimentin (+), Ki-67 (+70% +), TTF-1 (+), P53 (mutant type +90%), INI-1 (+), and CK5/6 (small foci +). Immunohistochemical examination of the tumor showed that the tumor was an undifferentiated epithelioid sarcoma. High-throughput DNA sequencing revealed pivotal mutations, including a nonsense mutation in the NF1 gene (c.641A > G(p.H214R)). and critical TP53 missense mutation (c.641A > G(p.H214R)). This TP53 mutation, with a tumor mutation burden of 16.5 Muts/Mb, signifies a high level of genomic instability, likely contributing to the rapid progression and aggressiveness of the disease. Detection of the TP53 mutation provides essential insights, indicating the disease's rapid progression and highlighting the potential for targeted therapies. Although the patient's disease progressed extremely rapidly and he tragically died within a week, we discussed the results of IHC and DNA sequencing in detail and discussed his possible treatment options. Insights gained from this case will be critical in shaping future diagnostic and therapeutic paradigms for USEF, particularly in the context of TP53 mutations.
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Affiliation(s)
- Ling-Xi Xiao
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Liu
- Department of Pathology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wang Deng
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Miyanishi K, Nururrozi A, Igase M, Tanabe M, Sakurai M, Sakai Y, Shimonohara N, Murakami M, Mizuno T. Activation of the Akt signalling pathway as a prognostic indicator in canine soft tissue sarcoma. J Comp Pathol 2023; 206:44-52. [PMID: 37839309 DOI: 10.1016/j.jcpa.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/18/2023] [Accepted: 08/31/2023] [Indexed: 10/17/2023]
Abstract
Canine soft tissue sarcoma (STS) is relatively common in dogs and is the generic term for tumours that originate from mesenchymal cells. While histopathological grade and immunolabelling with Ki-67 have been used for estimating prognosis, additional indicators are needed for predicting prognosis. Aberrant cell signalling pathways may contribute to disease activity and, therefore, prognostic markers. However, their role in canine STS remains poorly understood. The aim of this study was to investigate expression of phosphorylated Akt (phospho-Akt) and phosphorylated S6 (phospho-S6) as potential prognostic indicators. Immunohistochemical labelling was conducted on clinical samples of canine STS (n = 67). We found that phospho-Akt expression was positively correlated with histopathological grade (P = 0.001) and Ki-67 index (P <0.01). There was no apparent relationship between the type of STS and the expression of phospho-Akt. The number of cases that expressed phospho-S6, which is the downstream molecule of the Akt signalling pathway, was higher in immunopositive phospho-Akt cases than in immunonegative phospho-Akt cases (P <0.0001). Furthermore, phospho-Akt expression was significantly higher in recurrent and metastatic cases. We also confirmed that phosphorylation of Akt occurred in conjunction with S6 phosphorylation in three canine STS cell lines. These results suggest that immunolabelling for phospho-Akt, phospho-S6 and Ki-67 could potentially be used as a prognostic indicator and therapeutic target in canine STS.
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Affiliation(s)
- Kyohei Miyanishi
- Laboratory of Molecular Diagnostics and Therapeutics, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Alfarisa Nururrozi
- Laboratory of Molecular Diagnostics and Therapeutics, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Masaya Igase
- Laboratory of Molecular Diagnostics and Therapeutics, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Mika Tanabe
- Veterinary Pathology Diagnostic Center, Fukuoka, Japan
| | - Masashi Sakurai
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Yusuke Sakai
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | | | - Mami Murakami
- Laboratory of Veterinary Clinical Oncology, Joint Department of Veterinary Medicine, Gifu University, Gifu, Japan
| | - Takuya Mizuno
- Laboratory of Molecular Diagnostics and Therapeutics, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan.
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6
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Zhu YF, Li YS, Zhang Y, Liu YJ, Zhang YN, Tao J, Wang SW. Radiomics model based on intravoxel incoherent motion and diffusion kurtosis imaging for predicting histopathological grade and Ki-67 expression level of soft tissue sarcomas. Acta Radiol 2023; 64:2541-2551. [PMID: 37312501 DOI: 10.1177/02841851231179933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Accurate identification of the histopathological grade and the Ki-67 expression level is important in clinical cases of soft tissue sarcomas (STSs). PURPOSE To explore the feasibility of a radiomics model based on intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) and diffusion kurtosis imaging (DKI) MRI parameter maps in predicting the histopathological grade and Ki-67 expression level of STSs. MATERIAL AND METHODS In total, 42 patients diagnosed with STSs between May 2018 and January 2020 were selected. The MADC software in Functool of GE ADW 4.7 workstation was used to obtain standard apparent diffusion coefficient (ADC), D, D*, f, mean diffusivity, and mean kurtosis (MK). The histopathological grade and Ki-67 expression level of STSs were identified. The radiomics features of IVIM and DKI parameter maps were used as the dataset. The area under the receiver operating characteristic curve (AUC) and F1-score were calculated. RESULTS D-SVM achieved the best diagnostic performance for histopathological grade. The AUC in the validation cohort was 0.88 (sensitivity: 0.75 [low level] and 0.83 [high level]; specificity: 0.83 [low level] and 0.75 [high level]; F1-score: 0.75 [low level] and 0.83 [high level]). MK-SVM achieved the best diagnostic performance for Ki-67 expression level. The AUC in the validation cohort was 0.83 (sensitivity: 0.83 [low level] and 0.50 [high level; specificity: 0.50 [low level] and 0.83 [high level]; F1-score: 0.77 [low level] and 0.57 [high level]). CONCLUSION The proposed radiomics classifier could predict the pathological grade of STSs and the Ki-67 expression level in STSs.
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Affiliation(s)
- Yi-Feng Zhu
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Yu-Shi Li
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Yu Zhang
- Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, PR China
| | - Ya-Jie Liu
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Yi-Ni Zhang
- Department of Pathology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Juan Tao
- Department of Pathology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Shao-Wu Wang
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
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Pavlidis ET, Pavlidis TE. New trends in the surgical management of soft tissue sarcoma: The role of preoperative biopsy. World J Clin Oncol 2023; 14:89-98. [PMID: 36908679 PMCID: PMC9993143 DOI: 10.5306/wjco.v14.i2.89] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/26/2022] [Accepted: 01/10/2023] [Indexed: 02/21/2023] Open
Abstract
Soft tissue sarcoma (STS) accounts for 1% of all malignant neoplasms in adults. Their diagnosis and management constitute a challenging target. They originate from the mesenchyme, and 50 subtypes with various cytogenetic profiles concerning soft tissue and bones have been recognized. These tumors mainly affect middle-aged adults but may be present at any age. Half of the patients have metastatic disease at the time of diagnosis and require systemic therapy. Tumors above 3-5 cm in size must be suspected of potential malignancy. A thorough history, clinical examination and imaging that must precede biopsy are necessary. Modern imaging techniques include ultrasound, computed tomography (CT), new magnetic resonance imaging (MRI), and positron emission tomography/CT. MRI findings may distinguish low-grade from high-grade STS based on a diagnostic score (tumor heterogeneity, intratumoral and peritumoral enhancement). A score ≥ 2 indicates a high-grade lesion, and a score ≤ 1 indicates a low-grade lesion. For disease staging, abdominal imaging is recommended to detect early abdominal or retroperitoneal metastases. Liquid biopsy by detecting genomic material in serum is a novel diagnostic tool. A preoperative biopsy is necessary for diagnosis, prognosis and optimal planning of surgical intervention. Core needle biopsy is the most indicative and effective. Its correct performance influences surgical management. An unsuccessful biopsy means the dissemination of cancer cells into healthy anatomical structures that ultimately affect resectability and survival. Complete therapeutic excision (R0) with an acceptable resection margin of 1 cm is the method of choice. However, near significant structures, i.e., vessels, nerves, an R2 resection (macroscopic margin involvement) preserving functionality but having a risk of local recurrence can be an acceptable choice, after informing the patient, to prevent an unavoidable amputation. For borderline resectability of the tumor, neoadjuvant chemo/radiotherapy has a place. Likewise, after surgical excision, adjuvant therapy is indicated, but chemotherapy in nonmetastatic disease is still debatable. The five-year survival rate reaches up to 55%. Reresection is considered after positive or uncertain resection margins. Current strategies are based on novel chemotherapeutic agents, improved radiotherapy applications to limit local side effects and targeted biological therapy or immunotherapy, including vaccines. Young age is a risk factor for distant metastasis within 6 mo following primary tumor resection. Neoadjuvant radiotherapy lasting 5-6 wk and surgical resection are indicated for high-grade STS (grade 2 or 3). Wide surgical excision alone may be acceptable for patients older than 70 years. However, locally advanced disease requires a multidisciplinary task of decision-making for amputation or limb salvage.
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Affiliation(s)
- Efstathios T Pavlidis
- 2nd Propedeutic Department of Surgery, Hippocration Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
| | - Theodoros E Pavlidis
- 2nd Propedeutic Department of Surgery, Hippocration Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
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8
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Yang Y, Zhang L, Wang T, Jiang Z, Li Q, Wu Y, Cai Z, Chen X. MRI Fat‐Saturated T2‐Weighted
Radiomics Model for Identifying the Ki‐67 Index of Soft Tissue Sarcomas. J Magn Reson Imaging 2022. [DOI: 10.1002/jmri.28518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yang Yang
- Department of Radiology Hospital of Chengdu University of Traditional Chinese Medicine Chengdu People's Republic of China
| | - Liyuan Zhang
- Department of Plastic Surgery Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu People's Republic of China
| | - Ting Wang
- Department of Plastic Surgery The First People's Hospital of Yibin Yibin People's Republic of China
| | - Zhiyuan Jiang
- Department of Plastic Surgery Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu People's Republic of China
| | - Qingqing Li
- Department of Plastic Surgery Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu People's Republic of China
| | - Yinghua Wu
- Department of Radiology Hospital of Chengdu University of Traditional Chinese Medicine Chengdu People's Republic of China
| | - Zhen Cai
- Department of Plastic Surgery Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu People's Republic of China
| | - Xi Chen
- Sichuan College of Traditional Chinese Medicine Mianyang People's Republic of China
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9
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Li X, Tao J, Zhu Y, Yin Z, Zhang Y, Wang S. Soft tissue sarcoma: intravoxel incoherent motion and diffusion kurtosis imaging parameters correlate with the histological grade and Ki-67 expression. Acta Radiol 2022; 64:1546-1555. [PMID: 36259287 DOI: 10.1177/02841851221131931] [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: 11/15/2022]
Abstract
BACKGROUND Accurate prediction of the histological grade and Ki-67 expression of soft tissue sarcoma (STS) before surgery is essential for the subsequent diagnosis, treatment, and prognostic evaluation of patients. PURPOSE To evaluate intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) in predicting the histological grade and Ki-67 expression of STS. MATERIAL AND METHODS A total of 40 patients underwent 3-T MRI, including conventional sequences; IVIM and DKI parameters were obtained. All patients were divided into a low-grade (grade 1 and grade 2) group and a high-grade (grade 3) group through pathological analysis. Ki-67 expression of each lesion was calculated. Chi-square test, independent sample t-test, Mann-Whitney U test, Pearson, Spearman, and receiver operating characteristic curve analysis were performed. RESULTS There were 17 patients in the low-grade group and 23 in the high-grade group. Ki-67 expression was in the range of 10%-80%. D value was inversely correlated with Ki-67 expression. MK value showed a moderate positive correlation with Ki-67 expression. Regarding histological grading, only the peritumoral enhancement was statistically different between low- and high-grade STS on conventional MRI (P=0.024). The high-grade group had significantly higher MK value and lower D and MD value than the low-grade group. MK value showed the best diagnostic performance. The combination of MK and MD yielded the highest specificity (88.24%), and the combination of D, MK, and MD yielded the best area under the curve value (0.841) and sensitivity (95.65%). CONCLUSION IVIM and DKI parameters were correlated with Ki-67 expression and could help differentiate between low- and high-grade STS.
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Affiliation(s)
- Xiangwen Li
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Juan Tao
- Department of Pathology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Yifeng Zhu
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Zhenzhen Yin
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Yu Zhang
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
| | - Shaowu Wang
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, PR China
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10
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Wang P, Xu D, Hu Y, Li H, Li A. Correlation between quantitative parameters of CEUS and Ki-67 labeling index in soft-tissue sarcoma. Acta Radiol 2022:2841851221115081. [PMID: 35903876 DOI: 10.1177/02841851221115081] [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
BACKGROUND Apart from the immunohistochemical Ki-67 labeling index (LI), clinicians need a non-invasive and convenient way to predict the prognosis of patients with soft-tissue sarcoma (STS). PURPOSE To investigate the correlation between quantitative parameters of contrast-enhanced ultrasound (CEUS) and Ki-67 LI in STS. MATERIAL AND METHODS A total of 25 patients diagnosed with STS who underwent CEUS examination using SonoVue®, between January 2019 to November 2020, were included in the study. They were then divided into a high-proliferation group and low-proliferation group according to 30% Ki-67 positive tumor cells. The quantitative parameters in the semi-automatic time intensity curve analysis software, including arrival time, time to peak, peak intensity, rise time (RT), rise slope, 50% wash-out time, and 50% wash-out intensity, were extracted from the time intensity curve of CEUS by two independent observers. Statistical evaluation of the correlation and difference between CEUS quantitative parameters and Ki-67 LI between the two groups was performed. According to the area under the curve (AUC) analysis, optimal cutoff points of parameters with significant difference were determined. RESULTS CEUS RT of the high-proliferation group in STS was significantly higher than that of the low-proliferation group (ρ = 0.509, P = 0.01). The most reasonable cutoff to distinguish between low- and high-proliferation groups was 10.84 s. The sensitivity, specificity, and the AUC were 86.7%, 80%, and 0.80, respectively. CONCLUSION CEUS RT was correlated with Ki-67 LI of STS, which can be used as a minimally invasive auxiliary tool to predict the prognosis of STS in clinical practice.
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Affiliation(s)
- Pingping Wang
- Department of Ultrasound, 162752Affiliated Zhongda Hospital of Southeast University, Nanjing, PR China
| | - Di Xu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yu Hu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hai Li
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Ao Li
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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11
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Hashimoto K, Nishimura S, Ito T, Akagi M. Malignant giant cell tumor of toe: A case report and review of literature. Medicine (Baltimore) 2022; 101:e29471. [PMID: 35665736 PMCID: PMC9276190 DOI: 10.1097/md.0000000000029471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/27/2022] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION A giant cell tumor of soft tissue (GCST) is a benign soft tissue tumor that often occurs subcutaneously in the extremities. Rare cases of malignant GCST have been reported, but its pathogenesis remains unclear. PATIENTS CONCERNS We report a case of a 68-year-old man who noticed a painless mass on his second toe one and a half years ago. He visited the Department of Dermatology at our hospital. Magnetic resonance imaging revealed a soft tissue tumor, surrounding the distal aspect of the second toe. DIAGNOSIS A biopsy of the tumor was performed by a dermatologist, and it revealed a malignant giant cell tumor of the toe. INTERVENTIONS He was referred to our department and underwent lay amputation for wide-margin resection. OUTCOMES No recurrence or metastasis was observed 5 years after treatment. CONCLUSION : Malignant GCST should be treated with wide-margin resection immediately after its diagnosis.
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Sugita S, Segawa K, Kikuchi N, Takenami T, Kido T, Emori M, Akiyama Y, Takada K, Hinotsu S, Hasegawa T. Prognostic usefulness of a modified risk model for solitary fibrous tumor that includes the Ki-67 labeling index. World J Surg Oncol 2022; 20:29. [PMID: 35105348 PMCID: PMC8805435 DOI: 10.1186/s12957-022-02497-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/23/2022] [Indexed: 12/17/2022] Open
Abstract
Background Predicting the prognosis of patients with solitary fibrous tumor (SFT) is often difficult. The prognostic risk models developed by Demicco et al. are now the standard for evaluating the risk of SFT metastasis in the current World Health Organization classification of soft tissue and bone tumors. Methods In this study, we examined the prognostic usefulness of a modified version of the Demicco risk models that replaces the mitotic count with the Ki-67 labeling index. We compared the three-variable and four-variable Demicco risk models with our modified risk models using Kaplan–Meier curves based on data for 43 patients with SFT. Results We found a significant difference in metastasis-free survival when patients were classified into low-risk and intermediate/high-risk groups using the three-variable (P = 0.022) and four-variable (P = 0.046) Demicco models. There was also a significant difference in metastasis-free survival between the low-risk and intermediate/high-risk groups when the modified three-variable (P = 0.006) and four-variable (P = 0.022) models were used. Conclusion Modified risk models that include the Ki-67 labeling index are effective for prediction of the prognosis in patients with SFT.
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Affiliation(s)
- Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, 060-8543, Japan
| | - Keiko Segawa
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, 060-8543, Japan
| | - Noriaki Kikuchi
- Department of Surgical Pathology, Sunagawa City Medical Center, Sunagawa, Hokkaido, 073-0196, Japan
| | - Tomoko Takenami
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, 060-8543, Japan
| | - Tomomi Kido
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, 060-8543, Japan
| | - Makoto Emori
- Department of Orthopedic Surgery, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, 060-8543, Japan
| | - Yukinori Akiyama
- Department of Neurosurgery, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, 060-8543, Japan
| | - Kohichi Takada
- Department of Medical Oncology, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, 060-8543, Japan
| | - Shiro Hinotsu
- Department of Biostatistics and Data Management, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, 060-8543, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, 060-8543, Japan.
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Laurila RE, Böhling TO, Blomqvist CP, Karlsson C, Tukiainen EJ, Repo J, Sampo MM. Visual Counting and Automated Image-analytic Assessment of Ki-67 and their Prognostic Value in Synovial Sarcoma. CANCER DIAGNOSIS & PROGNOSIS 2022; 2:7-14. [PMID: 35400010 PMCID: PMC8962852 DOI: 10.21873/cdp.10070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Ki-67 is a widely used proliferation marker reflecting prognosis in various tumors. However, visual assessment and scoring of Ki-67 suffers from marked inter-observer and intra-observer variability. We aimed to assess the concordance of manual counting and automated image-analytic scoring methods for Ki-67 in synovial sarcoma. PATIENTS AND METHODS Tissue microarrays from 34 patients with synovial sarcoma were immunostained for Ki-67 and scored both visually and with 3DHistech QuantCenter. RESULTS The automated assessment of Ki-67 expression was in good agreement with the visually counted Ki-67 (r Pearson =0.96, p<0.001). In a Cox regression model automated [hazard ratio (HR)=1.047, p=0.024], but not visual (HR=1.063, p=0.053) assessment method associated high Ki-67 scores with worse overall survival. CONCLUSION The automated Ki-67 assessment method appears to be comparable to the visual method in synovial sarcoma and had a significant association to overall survival.
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Affiliation(s)
- Riikka E Laurila
- Department of Pathology, HUSLAB and University of Helsinki, Helsinki, Finland
| | | | - Carl P Blomqvist
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Örebro University, School of Health sciences, Örebro, Sweden
| | | | - Erkki J Tukiainen
- Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jussi Repo
- Department of Orthopedics and Traumatology, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Mika M Sampo
- Department of Pathology, HUSLAB and University of Helsinki, Helsinki, Finland
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14
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Kim HS, Kim HJ, Hwang HJ, Ahn JH, Do SH. Immunophenotyping of an Unusual Mixed-Type Extraskeletal Osteosarcoma in a Dog. Vet Sci 2021; 8:vetsci8120307. [PMID: 34941834 PMCID: PMC8707392 DOI: 10.3390/vetsci8120307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 11/17/2022] Open
Abstract
A 6-year-old female Maltese dog presented with a cervical mass without pain. The tumor was surrounded by a thick fibrous tissue and consisted of an osteoid matrix with osteoblasts and two distinct areas: a mesenchymal cell-rich lesion with numerous multinucleated giant cells and a chondroid matrix-rich lesion. The tumor cells exhibited heterogeneous protein expression, including a positive expression of vimentin, cytokeratin, RANKL, CRLR, SOX9, and collagen 2, and was diagnosed as extraskeletal osteosarcoma. Despite its malignancy, the dog showed no sign of recurrence or metastasis three months after the resection. Further analysis of the tumor cells revealed a high expression of proliferation- and metastasis-related biomarkers in the absence of angiogenesis-related biomarkers, suggesting that the lack of angiogenesis and the elevated tumor-associated fibrosis resulted in a hypoxic tumor microenvironment and prevented metastasis.
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Affiliation(s)
- Hyo-Sung Kim
- Department of Veterinary Clinical Pathology, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul 05029, Korea; (H.-S.K.); (H.-J.K.); (H.-J.H.)
| | - Han-Jun Kim
- Department of Veterinary Clinical Pathology, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul 05029, Korea; (H.-S.K.); (H.-J.K.); (H.-J.H.)
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90064, USA
| | - Hyun-Jeong Hwang
- Department of Veterinary Clinical Pathology, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul 05029, Korea; (H.-S.K.); (H.-J.K.); (H.-J.H.)
| | - Jong-Hyun Ahn
- Waltz Animal Hospital, Yeongdeungpo-gu, Seoul 07411, Korea;
| | - Sun-Hee Do
- Department of Veterinary Clinical Pathology, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul 05029, Korea; (H.-S.K.); (H.-J.K.); (H.-J.H.)
- Correspondence: ; Tel.: +82-2-450-3706
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15
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Machado I, Cruz J, Righi A, Gambarotti M, Ferrari C, Ruengwanichayakun P, Giner F, Rausell N, Lavernia J, Sugita S, Najera L, Suarez L, Sanjuan X, García JAN, García Del Muro FJ, Gómez-Mateo MC, Valladares MM, Ramos-Oliver I, Romagosa C, Parafioriti A, Elisabetta A, di Bernardo A, Navarro S, Hasegawa T, Arana E, Llombart-Bosch A. Ki-67 immunoexpression and radiological assessment of necrosis improves accuracy of conventional and modified core biopsy systems in predicting the final grade assigned to adult-soft tissue sarcomas. An international collaborative study. Pathol Res Pract 2021; 225:153562. [PMID: 34329836 DOI: 10.1016/j.prp.2021.153562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
Based on the French Federation Nationale des Centers de Lutte Contre le Cancer (FNCLCC) grading system, this study assesses the accuracy of conventional and modified core biopsy (CB) systems in predicting the final grade (low vs high) assigned to the resected specimen. Substituting Ki-67 immunoexpression for mitotic count, and radiological for histological assessment of necrosis, we used two modified FNCLCC CB grading systems: (1) Ki-67 immunoexpression alone, and (2) Ki-67 plus radiological assessment of necrosis. We graded 199 soft tissue sarcomas (STS) from nine centers, and compared the results for the conventional (obtained from local histopathology reports) and modified CB systems with the final FNCLCC grading of the corresponding resected specimens. Due to insufficient sample quality or lack of available radiologic data, five cases were not evaluated for Ki67 or radiological assessment of necrosis. The conventional FNCLCC CB grading system accurately identified 109 of the 130 high-grade cases (83.8%). The CB grading matched the final FNCLCC grading (low vs high) in 175 (87.9%) of the 199 resected tumors; overestimating the final grade in three cases and underestimating in 21 cases. Modified system 1 (Ki-67) accurately identified 117 of the 130 high-grade cases (90.0%). The CB grading matched the final FNCLCC grading (low vs high) in 175 (89.7%) of the 195 evaluated cases; overestimating seven and underestimating 13 cases. Modified system 2 (Ki-67 plus radiological necrosis) accurately identified 120 of the 130 high-grade cases (92.3%). This last matched the final FNCLCC grading (low vs high) in 177 (91.2%) of the 194 evaluated cases; overestimating seven and underestimating 10 cases. Modified system 2 obtained highest area under ROC curves, although not statistically significant. Underestimated CB grades did not correlate with histological subtypes, although many of the discrepant cases were myxoid tumors (myxofibrosarcomas or myxoid liposarcomas), leiomyosarcomas or undifferentiated pleomorphic/spindle cell sarcomas. Using modified FNCLCC CB grading systems to replace conventional mitotic count and histologic assessment of necrosis may improve the distinction between low and high-grade STS on CB. Our study confirms that classifying grade 1 as low grade and grades 2 and 3 as high grade improves correlation between CB and final grade by up to 21%, irrespective of CB system used. A higher than expected Ki-67 score in a low-grade sarcoma diagnosed on CB should raise concern that a higher-grade component may not have been sampled. Furthermore, correlation of all clinicopathological and radiological findings at multidisciplinary meetings is essential to assess the histological grade on CB as accurately as possible.
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Affiliation(s)
- Isidro Machado
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain; Pathology Department, Patologika, Hospital Quirón-Salud, Valencia, Spain.
| | - Julia Cruz
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Alberto Righi
- Pathology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marco Gambarotti
- Pathology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Cristina Ferrari
- Pathology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Francisco Giner
- Pathology Department, University Hospital La Fe, Valencia, Spain
| | - Nuria Rausell
- Pathology Department, University Hospital La Fe, Valencia, Spain
| | - Javier Lavernia
- Oncology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine. Japan
| | - Laura Najera
- Pathology Department, University Hospital Puerta de Hierro, Madrid, Spain
| | - Lola Suarez
- Pathology Department, University Hospital Puerta de Hierro, Madrid, Spain
| | - Xavier Sanjuan
- Pathology Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | | | | | | | | | - Cleofe Romagosa
- Pathology Department, Hospital Vall d'Hebron, Barcelona, Spain; Vall d'Hebron Research Institut (VHIR), Universitat Autónoma de Barcelona, Spain; Centro de Investigación Biomédica en RED (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonina Parafioriti
- Pathology Department, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy
| | - Armiraglio Elisabetta
- Pathology Department, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy
| | - Andrea di Bernardo
- Pathology Department, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy
| | - Samuel Navarro
- Pathology Department, University of Valencia, Valencia, Spain
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine. Japan
| | - Estanislao Arana
- Radiology Department, Instituto Valenciano de Oncología, Valencia, Spain
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Wang P, Li H, Hu Y, Peng X, Ye X, Xu D, Li A. Relationship Between Ultrasound Features and Ki-67 Labeling Index of Soft Tissue Sarcoma. Front Oncol 2021; 11:687878. [PMID: 34262871 PMCID: PMC8273548 DOI: 10.3389/fonc.2021.687878] [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: 03/30/2021] [Accepted: 06/07/2021] [Indexed: 01/15/2023] Open
Abstract
Objectives To explore the relationship between ultrasound (US) features and Ki-67 labeling index (LI) of soft tissue sarcoma (STS). Methods Forty-six patients with 47 STS lesions, between September 2014 and April 2020, were enrolled in the study. Point-biserial correlation analysis and Spearman’s correlation analysis were utilized to examining the relationship between the US features and the Ki-67 LI of STS. The differences of US features between high and low Ki-67 proliferation groups were statistically analyzed by independent t test, Wilcoxon rank-sum test, and Fisher’s exact test. The optimal cut-off points of US features revealing significant differences were estimated by the maximum Youden index. Results A moderate correlation between the vascular density grade and the Ki-67 LI (ρ = 0.409, P = 0.004) was found in this study. In addition, other ultrasound features were irrelevant to the Ki-67 LI. The cut-off for differentiating low- and high-proliferation groups was grade II according to the best Youden index. The area under receiver operating characteristic (ROC) curve was 0.74 (p = 0.011) with a sensitivity of 60.6% and specificity of 78.6%. Conclusions Only the vascular density grade of STS had a weak positive correlation with Ki-67 LI, and might be capable of predicting the proliferation of STS. Other ultrasonographic features of STS such as shape and tumor margin have no correlation with Ki-67 LI.
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Affiliation(s)
- Pingping Wang
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hai Li
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Hu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaojing Peng
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xinhua Ye
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Di Xu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ao Li
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Alizadeh E, Castle J, Quirk A, Taylor CDL, Xu W, Prasad A. Cellular morphological features are predictive markers of cancer cell state. Comput Biol Med 2020; 126:104044. [PMID: 33049477 DOI: 10.1016/j.compbiomed.2020.104044] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 11/24/2022]
Abstract
Even genetically identical cells have heterogeneous properties because of stochasticity in gene or protein expression. Single cell techniques that assay heterogeneous properties would be valuable for basic science and diseases like cancer, where accurate estimates of tumor properties is critical for accurate diagnosis and grading. Cell morphology is an emergent outcome of many cellular processes, potentially carrying information about cell properties at the single cell level. Here we study whether morphological parameters are sufficient for classification of single cells, using a set of 15 cell lines, representing three processes: (i) the transformation of normal cells using specific genetic mutations; (ii) metastasis in breast cancer and (iii) metastasis in osteosarcomas. Cellular morphology is defined as quantitative measures of the shape of the cell and the structure of the actin. We use a toolbox that calculates quantitative morphological parameters of cell images and apply it to hundreds of images of cells belonging to different cell lines. Using a combination of dimensional reduction and machine learning, we test whether these different processes have specific morphological signatures and whether single cells can be classified based on morphology alone. Using morphological parameters we could accurately classify cells as belonging to the correct class with high accuracy. Morphological signatures could distinguish between cells that were different only because of a different mutation on a parental line. Furthermore, both oncogenesis and metastasis appear to be characterized by stereotypical morphology changes. Thus, cellular morphology is a signature of cell phenotype, or state, at the single cell level.
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Affiliation(s)
| | | | - Analia Quirk
- Department of Chemical and Biological Engineering, USA; School of Biomedical Engineering, Colorado State University, Fort Collins, CO, 80523, USA
| | - Cameron D L Taylor
- Department of Chemical and Biological Engineering, USA; School of Biomedical Engineering, Colorado State University, Fort Collins, CO, 80523, USA
| | - Wenlong Xu
- Department of Chemical and Biological Engineering, USA
| | - Ashok Prasad
- Department of Chemical and Biological Engineering, USA; School of Biomedical Engineering, Colorado State University, Fort Collins, CO, 80523, USA.
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18
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Sassa N. Retroperitoneal tumors: Review of diagnosis and management. Int J Urol 2020; 27:1058-1070. [PMID: 32914475 DOI: 10.1111/iju.14361] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/27/2020] [Indexed: 12/30/2022]
Abstract
Retroperitoneal tumors are extremely rare tumors occurring in the retroperitoneum. Retroperitoneal tumors are divided into benign tumors and malignant tumors, including retroperitoneal sarcoma. Approximately 70-80% of primary retroperitoneal soft-tissue tumors are malignant; however, these only account for 0.1-0.2% of all malignancies. Retroperitoneal sarcoma is an orphan malignant disease with a low incidence. The information on benign retroperitoneal tumors is limited. The American Joint Committee on Cancer/TNM classification updated to the 8th edition in 2017. In 2010, three new drugs for soft tissue sarcoma were approved based on the results of phase III trials, but the histological subtypes of the patients enrolled in the trials of each drug differed. Recently, in addition to surgery for retroperitoneal sarcoma, the effectiveness of perioperative radiation therapy has become interesting. For malignant retroperitoneal tumors and retroperitoneal sarcoma, survival improvement and locoregional recurrence prevention can be undertaken by carrying out surgery to secure negative margins with wide and combined resection of some adjacent organs, and cooperation with a trained medical team comprising of radiologists, pathologists and medical oncologists in centralized hospitals. Some clinical trials aimed at further improving treatment results by adding preoperative chemotherapy and radiation therapy based on histological confirmation using a correct needle biopsy are in progress. In recent years, molecular profiling has been used to select eligible patients for chemotherapy. In the future, precision medicine with next-generation sequencing technology will be expected among the diverse and potential future treatments for retroperitoneal sarcoma. In this review, we summarized the current state of retroperitoneal tumors and retroperitoneal sarcoma.
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Affiliation(s)
- Naoto Sassa
- Department of Urology, Aichi Medical University Graduate School of Medicine, Nagakute, Aichi, Japan
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Lee JH, Yoon YC, Seo SW, Choi YL, Kim HS. Soft tissue sarcoma: DWI and DCE-MRI parameters correlate with Ki-67 labeling index. Eur Radiol 2019; 30:914-924. [PMID: 31630234 DOI: 10.1007/s00330-019-06445-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/12/2019] [Accepted: 09/10/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To examine the correlation of diffusion-weighted and dynamic contrast-enhanced magnetic resonance imaging (MRI) parameters with Ki-67 labeling index (LI) in soft tissue sarcoma (STS). METHODS The institutional review board approved this retrospective study, and the requirement for informed consent was waived. Thirty-six patients with STS who underwent 3.0-T MRI, including diffusion-weighted and dynamic contrast-enhanced MRI, between July 2011 and February 2018, were included in this study. The mean and minimum apparent diffusion coefficients (ADCs) (ADCmean and ADCmin, respectively), volume transfer constant, reflux rate, and volume fraction of the extravascular extracellular matrix of each lesion were independently analyzed by two readers. Their relationship with the Ki-67 LI was examined using Spearman's correlation analyses. Differences between low- and high-proliferation groups based on Ki-67 LI were evaluated statistically. Optimal cut-off points were determined using the area under the curve analysis for significant parameters. Interobserver agreement was assessed with the intraclass correlation coefficient. RESULTS ADCmean (ρ = - 0.333, p = 0.047) was significantly and inversely correlated with Ki-67 LI. The high-proliferation group showed a significantly lower ADCmean than did the low-proliferation group (median, 1.08 vs. 1.20; p = 0.048). When a cut-off ADCmean value of 1.16 × 10-3 mm2/s was used, the sensitivity, specificity, and area under the curve for differentiating low- and high-proliferation groups were 75.0%, 60.0%, and 0.712, respectively. Interobserver agreements between the two readers were almost perfect for all parameters. CONCLUSIONS ADCmean was correlated with Ki-67 LI and could help differentiate between STS with low and high proliferation potential. KEY POINTS • ADC meanwas significantly and inversely correlated with Ki-67 labeling index in soft tissue sarcoma. • In the high-proliferation group, ADC meanvalues were significantly lower than those of the low-proliferation group.
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Affiliation(s)
- Ji Hyun Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Young Cheol Yoon
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Sung Wook Seo
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yoon-La Choi
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyun Su Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea
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20
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Tanaka K, Mizusawa J, Naka N, Kawai A, Katagiri H, Hiruma T, Matsumoto Y, Tsuchiya H, Nakayama R, Hatano H, Emori M, Watanuki M, Yoshida Y, Okamoto T, Abe S, Asanuma K, Yokoyama R, Hiraga H, Yonemoto T, Morii T, Ae K, Nagano A, Yoshikawa H, Fukuda H, Ozaki T, Iwamoto Y. Ten-year follow-up results of perioperative chemotherapy with doxorubicin and ifosfamide for high-grade soft-tissue sarcoma of the extremities: Japan Clinical Oncology Group study JCOG0304. BMC Cancer 2019; 19:890. [PMID: 31492159 PMCID: PMC6728960 DOI: 10.1186/s12885-019-6114-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/30/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Soft-tissue sarcomas (STS) are rare malignant tumors those are resistant to chemotherapy. We have previously reported the 3-year follow-up result on the efficacy of perioperative chemotherapy with doxorubicin (DXR) and ifosfamide (IFM) for high-risk STS of the extremities (JCOG0304). In the present study, we analyzed the 10-year follow-up results of JCOG0304. METHODS Patients with operable, high-risk STS (T2bN0M0, AJCC 6th edition) of the extremities were treated with 3 courses of preoperative and 2 courses of postoperative chemotherapy, which consisted of 60 mg/m2 of DXR plus 10 g/m2 of IFM over a 3-week interval. The primary study endpoint was progression-free survival (PFS) estimated by Kaplan-Meier methods. Prognostic factors were evaluated by univariable and multivariable Cox proportional hazards model. RESULTS A total of 72 patients were enrolled between March 2004 and September 2008, with 70 of these patients being eligible. The median follow-up period was 10.0 years for all eligible patients. Local recurrence and distant metastasis were observed in 5 and 19 patients, respectively. The 10-year PFS was 65.7% (95% CI: 53.4-75.5%) with no PFS events being detected during the last 5 years of follow-up. The 10-year overall survival was 78.1% (95% CI: 66.3-86.2%). Secondary malignancy was detected in 6 patients. The subgroup analysis demonstrated that there was significant difference in survival with regard to primary tumor size. CONCLUSIONS Only a few long-term results of clinical trials for perioperative chemotherapy treatment of STS have been reported. Our results demonstrate that the 10-year outcome of JCOG0304 for patients with operable, high-risk STS of the extremities was stable and remained favorable during the last 5 years of follow-up. TRIAL REGISTRATION This trial was registered at the UMIN Clinical Trials Registry as C000000096 on August 30, 2005.
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Affiliation(s)
- Kazuhiro Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama, Yufu City, Oita 879-5593 Japan
| | - Junki Mizusawa
- JCOG Data Center, National Cancer Center Hospital, Tokyo, 104-0045 Japan
| | - Norifumi Naka
- Musculoskeletal Oncology Service, Osaka International Cancer Institute, Osaka, 541-8567 Japan
| | - Akira Kawai
- Department of Orthopaedic Surgery, National Cancer Center, Tokyo, 104-0045 Japan
| | - Hirohisa Katagiri
- Department of Orthopaedic Surgery, Shizuoka Cancer Center, Shizuoka, 411-0934 Japan
| | - Toru Hiruma
- Department of Orthopaedic Surgery, Kanagawa Cancer Center, Kanagawa, 241-0815 Japan
| | - Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, 812-8582 Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Ishikawa, 920-8641 Japan
| | - Robert Nakayama
- Department of Orthopaedic Surgery, Keio University, Tokyo, 160-0016 Japan
| | - Hiroshi Hatano
- Department of Orthopaedic Surgery, Niigata Cancer Center Hospital, Niigata, 951-8133 Japan
| | - Makoto Emori
- Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, 060-8556 Japan
| | - Munenori Watanuki
- Department of Orthopaedic Surgery, Tohoku University, Sendai, 980-8575 Japan
| | - Yukihiro Yoshida
- Department of Orthopaedic Surgery, Nihon University, Tokyo, 173-8610 Japan
| | - Takeshi Okamoto
- Department of Orthopaedic Surgery, Kyoto University, Kyoto, 606-8501 Japan
| | - Satoshi Abe
- Department of Orthopaedic Surgery, Teikyo University, Tokyo, 173-8606 Japan
| | - Kunihiro Asanuma
- Department of Orthopaedic Surgery, Mie University, Mie, 514-8507 Japan
| | - Ryohei Yokoyama
- Department of Orthopaedic Surgery, National Kyushu Cancer Center, Fukuoka, 811-1395 Japan
| | - Hiroaki Hiraga
- Department of Orthopaedic Surgery, Hokkaido Cancer Center, Sapporo, 003-0804 Japan
| | - Tsukasa Yonemoto
- Department of Orthopaedic Surgery, Chiba Cancer Center, Chiba, 260-8717 Japan
| | - Takeshi Morii
- Department of Orthopaedic Surgery, Kyorin University, Tokyo, 181-8611 Japan
| | - Keisuke Ae
- Department of Orthopaedic Surgery, Cancer Institute Hospital, Tokyo, 135-8550 Japan
| | - Akihito Nagano
- Department of Orthopaedic Surgery, Gifu University, Gifu, 501-1194 Japan
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Osaka University, Osaka, 565-0871 Japan
| | - Haruhiko Fukuda
- JCOG Data Center, National Cancer Center Hospital, Tokyo, 104-0045 Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University, Okayama, 700-0914 Japan
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Carvalho SD, Pissaloux D, Crombé A, Coindre JM, Le Loarer F. Pleomorphic Sarcomas: The State of the Art. Surg Pathol Clin 2019; 12:63-105. [PMID: 30709449 DOI: 10.1016/j.path.2018.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This article focuses on pleomorphic sarcomas, which are malignant mesenchymal tumors with complex genetic background at the root of their morphologic pleomorphism. They are poorly differentiated tumors that may retain different lines of differentiation, sometimes correlating with clinicopathological or prognostic features. Accurate diagnosis in this group of tumors relies on adequate sampling due to their heterogeneity and assessment with both microscopy and large panels of immunohistochemistry. Molecular analyses have a limited role in their diagnosis as opposed to translocation-related sarcomas but may provide theranostic and important prognostic information in the future.
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Affiliation(s)
- Sofia Daniela Carvalho
- Department of Pathology, Hospital de Braga, Sete Fontes-Sao Victor, 4710-243 Braga, Portugal; Department of Pathology, Institut Bergonié, 276 cours de l'Argonne, 33000, Bordeaux, France
| | - Daniel Pissaloux
- Department of Pathology, Centre Leon Berard, Promenade Lea Bullukian, 69376 Lyon, France
| | - Amandine Crombé
- Department of Radiology, Institut Bergonié, 276 cours de l'Argonne, 33000, Bordeaux, France
| | - Jean-Michel Coindre
- Department of Pathology, Institut Bergonié, 276 cours de l'Argonne, 33000, Bordeaux, France; University of Bordeaux, Talence, France
| | - François Le Loarer
- Department of Pathology, Hospital de Braga, Sete Fontes-Sao Victor, 4710-243 Braga, Portugal; University of Bordeaux, Talence, France.
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22
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Abstract
PURPOSE OF REVIEW Primary cardiac tumors are a rare disease, which may have severe clinical consequences. Malignant tumors may be misdiagnosed as mixomas, with improper treatment. The aim of this review is to report how to make a differential diagnosis using old and modern tools, the latest trends in tumor classification and treatment, and their possible impact on prognosis. RECENT FINDINGS Papillary fibroelastomas seem to be more frequent than previously reported, and surgery is also suggested in asymptomatic patients. A genetic background has been identified for some myxomas and angiosarcomas. Malignant tumors are now classified as soft-tissue sarcomas of other organs. Immunohistochemistry and molecular diagnosis aid in recognizing several subtypes of sarcomas, leading to the possibility of targeted chemotherapy. The reports of single-center and multicenter experiences, collecting a large number of treated patients, analyzed the impact on prognosis of different approaches. The best results for survival and event-free survival are obtained with the multimodality approach. SUMMARY Before referring a patient with cardiac tumor to the cardiac surgeon, a presumptive diagnosis of benignity or malignancy should be obtained. Malignant tumors should be referred to a cardiac tumor team with special expertise, in order to plan the best therapeutic approach.
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Sun D, Wu Y, Liu Y, Yang J. Primary cardiac myxofibrosarcoma: case report, literature review and pooled analysis. BMC Cancer 2018; 18:512. [PMID: 29720127 PMCID: PMC5932848 DOI: 10.1186/s12885-018-4434-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 04/25/2018] [Indexed: 12/18/2022] Open
Abstract
Background Primary cardiac myxofibrosarcoma is a very rare cardiac malignancy. The majority of publications are limited to case reports. No pooled analyses of primary cardiac myxofibrosarcoma cases are available. Little clinical features and outcome patterns are acknowledged. The purpose of this study is to identify the clinical characteristics and prognostic factors of primary cardiac myxofibrosarcoma. Case presentation A case report of primary cardiac myxofibrosarcoma was presented, and a review of English language literatures of primary cardiac myxofibrosarcomas were performed electronically. Demographics, clinicopathologic data, therapy and follow-up were summarized. The median survival time and the mean survival time were calculated by Kaplan-Meier method. Survival distribution and overall survival were figured by log-rank test and cox proportional hazards models. We present a case, and retrospectively analyzed additional 30 patients derived from 24 isolated articles. The cohort consisted of 18 male and 13 female patients. The age was 41.87 ± 17.89 years. Some common features were found in clinical presentations, pathologic features, treatments and outcome patterns of primary cardiac myxofibrosarcoma. There were special features in echocardiography, histological and immunohistochemical examinations, which should be considered in diagnosis of primary cardiac myxofibrosarcoma. The median survival time/mean survival time (MST) was 14/32.66 months. The median survival time/mean survival time (MST) was 14/32.66 months. Compared to the other groups, the following groups had shorter survival characteristics, including age ≥ 40 years (14/11.79 months), female (14/26.26 months), mass diameter ≥ 40 mm (14/14.64 months), high-grade (2/11.81 months), and no post-treatment (14/28.09 months). Statistical analyses revealed that primary cardiac myxofibrosarcomas were more likely to present with local recurrences and dismal metastases. Tumors ≥ 40 mm in size (P = 0.055, HR = 6.79) or with high-grade (P = 0.063, HR = 11.45) had significantly worse prognosis. Conclusions Primary cardiac myxofibrosarcomas were more likely to present with local recurrences and dismal metastases. Echocardiography, together with histological method should be considered in ordinary diagnosis. Tumors ≥ 40 mm in size or with high-grade had significantly worse prognosis, which should be early diagnosed and treated with rational surgery.
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Affiliation(s)
- Dandan Sun
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, 110001, Liaoning Province, China.
| | - Yupeng Wu
- 2nd Department of Neurosurgery, The People's Hospital of China Medical University and The People's Hospital of Liaoning Province, Shenyang, 110016, Liaoning Province, China
| | - Yan Liu
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, 110001, Liaoning Province, China
| | - Jun Yang
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, 110001, Liaoning Province, China
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