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Gutierrez D, Sánchez CA, Linares FB, Messa O. Retroperitoneal, Liver, and Lymph Node Metastasis from Proximal Tibial Osteosarcoma: A Case Report. Rev Bras Ortop 2024; 59:e637-e640. [PMID: 39239576 PMCID: PMC11374403 DOI: 10.1055/s-0041-1731360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/15/2021] [Indexed: 10/20/2022] Open
Abstract
The present study describes the case of a male adult with an osteosarcoma in the proximal tibia, treated with limb salvage with endoprosthesis and chemotherapy. The patient developed an unusual metastatic pattern compromising the liver, bone, and inguinal lymph nodes, without local recurrence in the tibia or pulmonary metastases. Osteosarcoma (OS) is the second most frequent primary bone tumor after multiple myeloma in adults. Frequent sites of metastases in case of disease progression are the lungs and bone. Extrapulmonary metastases are rare. The development of new schemes of chemotherapy have improved life expectancy in osteosarcoma patients but have also altered the usual patterns of metastases, resulting in unusual metastatic locations.
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Affiliation(s)
- Daniela Gutierrez
- Departamento de Ortopedia e Traumatologia, Pontificia Universidad Javeriana, Bogotá, Colômbia
| | - Carlos A Sánchez
- Departamento de Ortopedia e Traumatologia, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colômbia
| | - Francisco B Linares
- Departamento de Ortopedia e Traumatologia, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colômbia
- Departamento de Oncologia Ortopédica, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colômbia
| | - Oscar Messa
- Departamento de Patologia, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colômbia
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2
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Ong JLK, Jalaludin NFF, Wong MK, Tan SH, Angelina C, Sukhatme SA, Yeo T, Lim CT, Lee YT, Soh SY, Lim TKH, Tay TKY, Chang KTE, Chen ZX, Loh AH. Exosomal mRNA Cargo are biomarkers of tumor and immune cell populations in pediatric osteosarcoma. Transl Oncol 2024; 46:102008. [PMID: 38852279 PMCID: PMC11220529 DOI: 10.1016/j.tranon.2024.102008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/04/2024] [Accepted: 05/22/2024] [Indexed: 06/11/2024] Open
Abstract
Osteosarcoma is the commonest malignant bone tumor of children and adolescents and is characterized by a high risk of recurrence despite multimodal therapy, especially in metastatic disease. This suggests the presence of clinically undetected cancer cells that persist, leading to cancer recurrence. We sought to evaluate the utility of peripheral blood exosomes as a more sensitive yet minimally invasive blood test that could aid in evaluating treatment response and surveillance for potential disease recurrence. We extracted exosomes from the blood of pediatric osteosarcoma patients at diagnosis (n=7) and after neoadjuvant chemotherapy (n=5 subset), as well as from age-matched cancer-free controls (n=3). We also obtained matched tumor biopsy samples (n=7) from the cases. Exosome isolation was verified by CD9 immunoblot and characterized on electron microscopy. Profiles of 780 cancer-related transcripts were analysed in mRNA from exosomes of osteosarcoma patients at diagnosis and control patients, matched post-chemotherapy samples, and matched primary tumor samples. Peripheral blood exosomes of osteosarcoma patients at diagnosis were significantly smaller than those of controls and overexpressed extracellular matrix protein gene THBS1 and B cell markers MS4A1 and TCL1A. Immunohistochemical staining of corresponding tumor samples verified the expression of THBS1 on tumor cells and osteoid matrix, and its persistence in a treatment-refractory patient, as well as the B cell origin of the latter. These hold potential as liquid biopsy biomarkers of disease burden and host immune response in osteosarcoma. Our findings suggest that exosomes may provide novel and clinically-important insights into the pathophysiology of cancers such as osteosarcoma.
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Affiliation(s)
| | | | - Meng Kang Wong
- VIVA-KKH Paediatric Brain and Solid Tumor Programme, Children's Blood and Cancer Centre, KK Women's and Children's Hospital, Singapore, Singapore
| | - Sheng Hui Tan
- VIVA-KKH Paediatric Brain and Solid Tumor Programme, Children's Blood and Cancer Centre, KK Women's and Children's Hospital, Singapore, Singapore
| | - Clara Angelina
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sarvesh A Sukhatme
- Mechanobiology Institute, National University of Singapore, Singapore, Singapore
| | - Trifanny Yeo
- Mechanobiology Institute, National University of Singapore, Singapore, Singapore; Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore; Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Chwee Teck Lim
- Mechanobiology Institute, National University of Singapore, Singapore, Singapore; Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore; Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - York Tien Lee
- Duke NUS Medical School, Singapore, Singapore; VIVA-KKH Paediatric Brain and Solid Tumor Programme, Children's Blood and Cancer Centre, KK Women's and Children's Hospital, Singapore, Singapore; Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore, Singapore
| | - Shui Yen Soh
- Duke NUS Medical School, Singapore, Singapore; VIVA-KKH Paediatric Brain and Solid Tumor Programme, Children's Blood and Cancer Centre, KK Women's and Children's Hospital, Singapore, Singapore; Department of Paediatric Subspecialties Haematology/Oncology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Tony K H Lim
- Duke NUS Medical School, Singapore, Singapore; Department of Anatomic Pathology, Singapore General Hospital, Singapore, Singapore
| | - Timothy Kwang Yong Tay
- Duke NUS Medical School, Singapore, Singapore; Department of Anatomic Pathology, Singapore General Hospital, Singapore, Singapore
| | - Kenneth Tou En Chang
- Duke NUS Medical School, Singapore, Singapore; VIVA-KKH Paediatric Brain and Solid Tumor Programme, Children's Blood and Cancer Centre, KK Women's and Children's Hospital, Singapore, Singapore; Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Zhi Xiong Chen
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; VIVA-KKH Paediatric Brain and Solid Tumor Programme, Children's Blood and Cancer Centre, KK Women's and Children's Hospital, Singapore, Singapore; National University Cancer Institute, National University Health System, Singapore, Singapore; NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Amos Hp Loh
- Duke NUS Medical School, Singapore, Singapore; VIVA-KKH Paediatric Brain and Solid Tumor Programme, Children's Blood and Cancer Centre, KK Women's and Children's Hospital, Singapore, Singapore; Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore, Singapore.
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3
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Tong Y, Huang Z, Jiang L, Pi Y, Gong Y, Zhao D. Individualized assessment of risk and overall survival in patients newly diagnosed with primary osseous spinal neoplasms with synchronous distant metastasis. Front Public Health 2022; 10:955427. [PMID: 36072380 PMCID: PMC9441606 DOI: 10.3389/fpubh.2022.955427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/28/2022] [Indexed: 01/24/2023] Open
Abstract
Background The prognosis of patients with primary osseous spinal neoplasms (POSNs) presented with distant metastases (DMs) is still poor. This study aimed to evaluate the independent risk and prognostic factors in this population and then develop two web-based models to predict the probability of DM in patients with POSNs and the overall survival (OS) rate of patients with DM. Methods The data of patients with POSNs diagnosed between 2004 and 2017 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate logistics regression analyses were used to study the risk factors of DM. Based on independent DM-related variables, we developed a diagnostic nomogram to estimate the risk of DM in patients with POSNs. Among all patients with POSNs, those who had synchronous DM were included in the prognostic cohort for investigating the prognostic factors by using Cox regression analysis, and then a nomogram incorporating predictors was developed to predict the OS of patients with POSNs with DM. Kaplan-Meier (K-M) survival analysis was conducted to study the survival difference. In addition, validation of these nomograms were performed by using receiver operating characteristic (ROC) curves, the area under curves (AUCs), calibration curves, and decision curve analysis (DCA). Results A total of 1345 patients with POSNs were included in the study, of which 238 cases (17.70%) had synchronous DM at the initial diagnosis. K-M survival analysis and multivariate Cox regression analysis showed that patients with DM had poorer prognosis. Grade, T stage, N stage, and histological type were found to be significantly associated with DM in patients with POSNs. Age, surgery, and histological type were identified as independent prognostic factors of patients with POSNs with DM. Subsequently, two nomograms and their online versions (https://yxyx.shinyapps.io/RiskofDMin/ and https://yxyx.shinyapps.io/SurvivalPOSNs/) were developed. The results of ROC curves, calibration curves, DCA, and K-M survival analysis together showed the excellent predictive accuracy and clinical utility of these newly proposed nomograms. Conclusion We developed two well-validated nomograms to accurately quantify the probability of DM in patients with POSNs and predict the OS rate in patients with DM, which were expected to be useful tools to facilitate individualized clinical management of these patients.
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Affiliation(s)
- Yuexin Tong
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, Changchun, China
| | - Zhangheng Huang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Liming Jiang
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yangwei Pi
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yan Gong
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, Changchun, China
| | - Dongxu Zhao
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, Changchun, China,*Correspondence: Dongxu Zhao
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Li W, Dong S, Wang B, Wang H, Xu C, Zhang K, Li W, Hu Z, Li X, Liu Q, Wu R, Yin C. The Construction and Development of a Clinical Prediction Model to Assess Lymph Node Metastases in Osteosarcoma. Front Public Health 2022; 9:813625. [PMID: 35071175 PMCID: PMC8770939 DOI: 10.3389/fpubh.2021.813625] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/06/2021] [Indexed: 12/23/2022] Open
Abstract
Background: This study aimed to construct a clinical prediction model for osteosarcoma patients to evaluate the influence factors for the occurrence of lymph node metastasis (LNM). Methods: In our retrospective study, a total of 1,256 patients diagnosed with chondrosarcoma were enrolled from the SEER (Surveillance, Epidemiology, and End Results) database (training cohort, n = 1,144) and multicenter dataset (validation cohort, n = 112). Both the univariate and multivariable logistic regression analysis were performed to identify the potential risk factors of LNM in osteosarcoma patients. According to the results of multivariable logistic regression analysis, A nomogram were established and the predictive ability was assessed by calibration plots, receiver operating characteristics (ROCs) curve, and decision curve analysis (DCA). Moreover, Kaplan-Meier plot of overall survival (OS) was plot and a web calculator visualized the nomogram. Results: Five independent risk factors [chemotherapy, surgery, lung metastases, lymphatic metastases (M-stage) and tumor size (T-stage)] were identified by multivariable logistic regression analysis. What's more, calibration plots displayed great power both in training and validation group. DCA presented great clinical utility. ROCs curve provided the predictive ability in the training cohort (AUC = 0.805) and the validation cohort (AUC = 0.808). Moreover, patients in LNN group had significantly better survival than that in LNP group both in training and validation group. Conclusion: In this study, we constructed and developed a nomogram with risk factors, which performed well in predicting risk factors of LNM in osteosarcoma patients. It may give a guide for surgeons and oncologists to optimize individual treatment and make a better clinical decision.
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Affiliation(s)
- Wenle Li
- Department of Orthopedics, Xianyang Central Hospital, Xianyang, China.,Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
| | - Shengtao Dong
- Department of Spine Surgery, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Bing Wang
- Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
| | - Haosheng Wang
- Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, China
| | - Chan Xu
- Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
| | - Kai Zhang
- Department of Orthopedics, Xianyang Central Hospital, Xianyang, China.,Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
| | - Wanying Li
- Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
| | - Zhaohui Hu
- Department of Spine Surgery, Liuzhou People's Hospital, Liuzhou, China
| | - Xiaoping Li
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China
| | - Qiang Liu
- Department of Orthopedics, Xianyang Central Hospital, Xianyang, China
| | - Rilige Wu
- College of Information and Electrical Engineering, China Agricultural University, Beijing, China
| | - Chengliang Yin
- Faculty of Medicine, Macau University of Science and Technology, Macau, Macao SAR, China
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Establishment of an Autophagy-Related Clinical Prognosis Model for Predicting the Overall Survival of Osteosarcoma. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5428425. [PMID: 34604383 PMCID: PMC8485141 DOI: 10.1155/2021/5428425] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/09/2021] [Accepted: 08/27/2021] [Indexed: 12/29/2022]
Abstract
Purpose Osteosarcoma is the most common primary and highly invasive bone tumor in children and adolescents. The purpose of this study is to construct a multi-gene expression feature related to autophagy, which can be used to predict the prognosis of patients with osteosarcoma. Materials and methods. The clinical and gene expression data of patients with osteosarcoma were obtained from the target database. Enrichment analysis of autophagy-related genes related to overall survival (OS-related ARGs) screened by univariate Cox regression was used to determine OS-related ARGs function and signal pathway. In addition, the selected OS-related ARGs were incorporated into multivariate Cox regression to construct prognostic signature for the overall survival (OS) of osteosarcoma. Use the dataset obtained from the GEO database to verify the signature. Besides, gene set enrichment analysis (GSEA) were applied to further elucidate the molecular mechanisms. Finally, the nomogram is established by combining the risk signature with the clinical characteristics. Results Our study eventually included 85 patients. Survival analysis showed that patients with low riskScore had better OS. In addition, 16 genes were included in OS-related ARGs. We also generate a prognosis signature based on two OS-related ARGs. The signature can significantly divide patients into low-risk groups and high-risk groups, and has been verified in the data set of GEO. Subsequently, the riskScore, primary tumor site and metastasis status were identified as independent prognostic factors for OS and a nomogram were generated. The C-index of nomogram is 0.789 (95% CI: 0.703~0.875), ROC curve and calibration chart shows that nomogram has a good consistency between prediction and observation of patients. Conclusions ARGs was related to the prognosis of osteosarcoma and can be used as a biomarker of prognosis in patients with osteosarcoma. Nomogram can be used to predict OS of patients and improve treatment strategies.
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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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7
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Cleary MX, Fayad LM, Ahlawat S. Popliteal lymph nodes in patients with osteosarcoma: are they metastatic? Skeletal Radiol 2020; 49:1807-1817. [PMID: 32519180 DOI: 10.1007/s00256-020-03498-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the prevalence, imaging appearance, and significance of popliteal lymph nodes (PLN) on magnetic resonance imaging (MRI) in patients with distal femoral or proximal tibial osteosarcoma (OS). METHOD AND MATERIALS This study included consecutive patients with OS presenting from May 2016 to March 2018. Inclusion criteria were patients with distal femoral or proximal tibial OS with MRI and pathology at our institution. On MRI, two radiologists recorded primary tumor features (size, location, signal, extra-compartmental extension), and PLN characteristics (mean size, presence/absence of fatty hilum, mineralization, PET/bone scintigraphy avidity, contrast enhancement, and diffusion restriction). Tumor histology, stage, and clinical follow-up were recorded. Descriptive statistics were provided. RESULTS Sixteen patients with OS (age 20 ± 10 (range10-40) years, 10/16 male) were included. Although 81% (13/16) of the patients had PLNs at presentation (size range 0.3-3.6 cm), fewer patients had extra-compartmental spread: intra-articular extension 50% (8/16), skip lesions 19% (3/16), lung metastases 31% (5/16), and osseous metastases 12% (2/16). Four (25% (4/16)) patients had PLN ≥ 1 cm; two were histologically proven reactive. One was presumed metastatic due to rapid development, mineralization, and FDG-avidity on PET/CT. The other ≥ 1 cm PLNs along with all twelve (75% (12/16)) that were < 1 cm in mean diameter were presumed non-metastatic with documented stability for at least 12 months of follow-up. CONCLUSION PLNs are frequently visible on MRI in patients with OS but are rarely (prevalence = 6%) metastatic. Features on MRI which may suggest metastatic PLNs include large size > 1 cm and loss of a fatty hilum.
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Affiliation(s)
- Mark X Cleary
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA
| | - Laura M Fayad
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA
| | - Shivani Ahlawat
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
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8
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Andión Catalán M, Buendía López S, Camarena Pavón N, Rubio San Simón A, Cañas Maciá T, Azorín Cuadrillero D. Composite sarcoma of bone with focal rhabdomyosarcoma and lymph node metastasis in an adolescent. Pediatr Blood Cancer 2020; 67:e28679. [PMID: 32860659 DOI: 10.1002/pbc.28679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 11/10/2022]
Abstract
Composite sarcoma of bone is a very rare entity that primarily affects adolescent and young adult patients. It usually combines areas of liposarcoma and osteosarcoma, and up to 60% of cases have metastatic disease at diagnosis. It is a highly aggressive pathology with intrinsic resistance to bone sarcoma conventional treatments. The prognosis is poor, with long-term survival rates not exceeding 30%. We present the case of an adolescent female diagnosed with an aggressive composite sarcoma of bone with rhabdomyosarcoma foci and loco-regional lymph node involvement.
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Affiliation(s)
- Maitane Andión Catalán
- Pediatric Hematology-Oncology and Hematopoietic Stem Cell Transplantation Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Susana Buendía López
- Pediatric Hematology-Oncology and Hematopoietic Stem Cell Transplantation Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Natalia Camarena Pavón
- Pediatric Hematology-Oncology and Hematopoietic Stem Cell Transplantation Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Alba Rubio San Simón
- Pediatric Hematology-Oncology and Hematopoietic Stem Cell Transplantation Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Teresa Cañas Maciá
- Pediatric Radiology Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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Luo Y, Zeng A, Fang A, Song L, Fan C, Zeng C, Ye T, Chen H, Tu C, Xie Y. Nifuroxazide induces apoptosis, inhibits cell migration and invasion in osteosarcoma. Invest New Drugs 2019; 37:1006-1013. [PMID: 30680584 DOI: 10.1007/s10637-019-00724-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/03/2019] [Indexed: 02/05/2023]
Abstract
Osteosarcoma is the most common primary malignancy of bone and characterized by an appendicular primary tumor with a high rate of metastasis to the lungs. Unfortunately, there is no effective strategy to treat osteosarcoma in current clinical practice. In this study, the anticancer effects and potential mechanisms of nifuroxazide, an oral nitrofuran antibiotic, on two osteosarcoma cell lines were investigated. The results of the antiproliferative activity in vitro showed that nifuroxazide inhibited cell proliferation of UMR106 and MG63 cells in a dose- and time-dependent manner. Interestingly, nifuroxazide showed low toxicity to non-tumor cells (HEK 293 T). In addition, ROS-mitochondrial mediated apoptosis was observed after treatment of nifuroxazide. Moreover, nifuroxazide could significantly inhibit osteosarcoma cells migration and invasion via p-Stat3, MMP-2 and MMP-9 mediated signaling pathway. Taken together, our results suggested that nifuroxazide could be a promising agent for osteosarcoma treatment by inhibiting cell proliferation, inducing cell apoptosis and impairing cell migration and invasion.
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Affiliation(s)
- Yi Luo
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Anqi Zeng
- Sichuan Academy of Chinese Medicine Sciences, Chengdu, Sichuan Province, 610064, People's Republic of China
| | - Aiping Fang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Linjiang Song
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Chen Fan
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Chenjuan Zeng
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Tinghong Ye
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Hao Chen
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Healthy Science Center, Memphis, TN, 38163, USA
| | - Chongqi Tu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Yongmei Xie
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China.
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10
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Berhe S, Danzer E, Meyers P, Behr G, LaQuaglia MP, Price AP. Unusual abdominal metastases in osteosarcoma. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018; 28:13-16. [PMID: 29085778 PMCID: PMC5659360 DOI: 10.1016/j.epsc.2017.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Intraabdominal metastases in the setting of osteosarcoma are very rare. We describe a case of a 17-year-old boy with high-grade right distal femur osteosarcoma who two years after diagnosis developed extensive intra abdominal metastases involving the omentum, peritoneum, bowel serosa, psoas muscles and abdominal soft tissue. Awareness of and surveillance for unusual patterns of metastasis may allow for earlier detection, intervention, and palliative care decision-making, which may affect survival and quality of life. This report underlines the need for prospective studies evaluating surveillance guidelines for patients after medical and surgical management of osteosarcoma, especially in cases complicated by pulmonary metastases.
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Affiliation(s)
- Simon Berhe
- Pediatric Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Enrico Danzer
- Pediatric Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paul Meyers
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gerald Behr
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michael P LaQuaglia
- Pediatric Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anita P Price
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Sannino G, Marchetto A, Kirchner T, Grünewald TGP. Epithelial-to-Mesenchymal and Mesenchymal-to-Epithelial Transition in Mesenchymal Tumors: A Paradox in Sarcomas? Cancer Res 2017; 77:4556-4561. [PMID: 28811330 DOI: 10.1158/0008-5472.can-17-0032] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 05/15/2017] [Accepted: 07/07/2017] [Indexed: 11/16/2022]
Abstract
The epithelial-to-mesenchymal transition (EMT) is a reversible process comprised of various subprograms via which epithelial cells reduce their intercellular adhesions and proliferative capacity while gaining a mesenchymal phenotype with increased migratory and invasive properties. This process has been well described in several carcinomas, which are cancers of epithelial origin, and is crucial to metastatic tumor cell dissemination and drug resistance. In contrast, the precise role of EMT-related processes in tumors originating from mesenchymal tissues, such as bone and soft-tissues sarcomas, is still largely unclear. In fact, although the existence of the EMT in sarcomas appears paradoxical because these cancers are, by definition, mesenchymal ab initio, accumulating evidence suggests that many sarcomas can undergo EMT-related processes, which may be associated with aggressive clinical behavior. These processes may be especially operative in certain sarcoma subtypes, such as carcinosarcomas displaying a biphenotypic morphology with characteristics of both mesenchymal and epithelial tumors. In this review, we discuss findings regarding the potential existence of EMT-related processes in sarcomas and propose that sarcomas can reside in a metastable state, enabling them to become either more mesenchymal or epithelial under specific conditions, which likely has important clinical implications. Cancer Res; 77(17); 4556-61. ©2017 AACR.
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Affiliation(s)
- Giuseppina Sannino
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Aruna Marchetto
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Thomas Kirchner
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Thomas G P Grünewald
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany. .,Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
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Immune infiltration and PD-L1 expression in the tumor microenvironment are prognostic in osteosarcoma. Sci Rep 2016; 6:30093. [PMID: 27456063 PMCID: PMC4960483 DOI: 10.1038/srep30093] [Citation(s) in RCA: 195] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/10/2016] [Indexed: 12/11/2022] Open
Abstract
Osteosarcoma patient survival has remained stagnant for 30 years. Novel therapeutic approaches are needed to improve outcomes. We examined the expression of Programmed Death Ligand 1 (PD-L1) and defined the tumor immune microenvironment to assess the prognostic utility in osteosarcoma. PD-L1 expression in osteosarcoma was examined in two patient cohorts using immunohistochemistry (IHC) (n = 48, n = 59) and expression was validated using quantitative real time PCR (n = 21) and western blotting (n = 9). IHC was used to determine the presence of tumor infiltrating lymphocytes and antigen-presenting cells (APCs) in the tumor. Expression of PD-L1 was correlated with immune cell infiltration and event-free-survival (EFS). The 25% of primary osteosarcoma tumors that express PD-L1 were more likely to contain cells that express PD-1 than PD-L1 negative tumors (91.7% vs 47.2%, p = 0.002). Expression of PD-L1 was significantly associated with the presence of T cells, dendritic cells, and natural killer cells. Although all immune cell types examined were present in osteosarcoma samples, only infiltration by dendritic cells (28.3% vs. 83.9%, p = 0.001) and macrophages (45.5% vs. 84.4%, p = 0.031) were associated with worse five-year-EFS. PD-L1 expression was significantly associated with poorer five-year-EFS (25.0%. vs. 69.4%, p = 0.014). Further studies in osteosarcoma are needed to determine if targeting the PD-L1:PD-1 axis improves survival.
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Dirik Y, Çınar A, Yumrukçal F, Eralp L. Popliteal lymph node metastasis of tibial osteoblastic osteosarcoma. Int J Surg Case Rep 2014; 5:840-4. [PMID: 25462047 PMCID: PMC4245687 DOI: 10.1016/j.ijscr.2014.09.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 09/12/2014] [Accepted: 09/18/2014] [Indexed: 11/04/2022] Open
Abstract
Lymph node metastasis of osteosarcoma, which is a rare entity. Metastatic patterns could not be clearly explained. The effects of lymph node metastasis on prognosis are also not clearly defined and further studies are needed.
INTRODUCTION We report a case with lymph node metastasis of osteosarcoma, which is a rare entity in comparison to hematogeneous lung or bone metastasis. PRESENTATION OF CASE Twenty-seven years old male patient referred to our clinic complaining of ongoing left knee pain and swelling since one month without a history of prior trauma. Magnetic resonance imaging (MRI) revealed a mass of malignant nature which causes more prominent expansion and destruction of the bone distally with periosteal reaction. A lymphadenomegaly 16 mm × 13 mm in diameter was also present in the popliteal fossa having the same signal pattern with the primary lesion. Thirteen weeks following the first referral of the patient, wide resection and reconstruction with modular tumor prosthesis was performed. Popliteal lymph node was excised through the same incision. Pathologic examination of the resected speciman reported osteoblastic osteosarcoma. The lymph node extirpated from the popliteal fossa was reported to be a metastasis of the primary tumor. DISCUSSION Osteosarcoma of the long bones is the most common primary malignant bone neoplasm of both childhood and adulthood. Osteosarcomas commonly metastasize hematogeneously to the lungs and bones. Lymph node metastasis is a rare entity. Similar studies report rates between 2.3% and 4%. It is not clearly explained, how lymph node metastasis in osteosarcoma occurs despite lack of lymphatic drainage in normal cortical and spongious bone. CONCLUSION Lymph node metastasis of osteosarcoma is a rare entity and metastatic patterns could not be clearly explained. On the other hand, the effects of lymph node metastasis on prognosis are also not clearly defined and further studies are needed.
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Affiliation(s)
- Yalın Dirik
- Memorial Şişli Hospital, Orthopaedics and Traumatology, Piyalepaşa Bulv., Okmeydanı, Şişli, 34385 İstanbul, Turkey.
| | - Arda Çınar
- Memorial Şişli Hospital, Orthopaedics and Traumatology, Piyalepaşa Bulv., Okmeydanı, Şişli, 34385 İstanbul, Turkey.
| | - Feridun Yumrukçal
- Memorial Şişli Hospital, Orthopaedics and Traumatology, Piyalepaşa Bulv., Okmeydanı, Şişli, 34385 İstanbul, Turkey.
| | - Levent Eralp
- Istanbul University, Istanbul School of Medicine Orthopaedics and Traumatology, Turgut Özal Millet Caddesi, Çapa Tıp Fakültesi, Çapa - Cerrahpaşa, Fatih, Pk: 34098 İstanbul, Turkey.
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Thampi S, Matthay KK, Goldsby R, DuBois SG. Adverse impact of regional lymph node involvement in osteosarcoma. Eur J Cancer 2013; 49:3471-6. [PMID: 23867123 DOI: 10.1016/j.ejca.2013.06.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 06/12/2013] [Accepted: 06/20/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Metastatic dissemination in osteosarcoma occurs haematogenously, though regional lymph node involvement is rarely reported. We investigated incidence, patient characteristics and survival for patients with osteosarcoma and regional lymph node involvement at diagnosis. METHODS We identified 2748 cases of high-grade osteosarcoma with available information regarding regional lymph node involvement in the Surveillance Epidemiology and End Results database from 1973 to 2009. Demographics were compared using chi-squared tests or t-tests. Overall survival was estimated using Kaplan-Meier method and compared with log-rank tests. Multivariate analysis of overall survival was performed using Cox proportional hazards methods. RESULTS There were 74 patients (2.7%) with regional lymph node involvement at diagnosis of whom 19 (0.7%) were pathologically confirmed. Patients with regional node involvement were more likely to have extraskeletal tumours, distant metastases, tumours arising outside the lower extremity (p<0.0001 for all comparisons) and larger tumours (p=0.033). Five-year overall survival in those with and without regional node involvement was 10.9% (95% confidence interval (CI) 4.6-20.4) and 54.3% (95% CI 52.2-56.4; p<0.0001). In multivariate analysis, regional node involvement remained predictive of inferior survival after controlling for differences in metastatic status, age, tumour site and extraskeletal origin (hazard ratio 2.05, 95% CI 1.57-2.67; p<0.0001). Similar survival results were found when the analysis was restricted to patients with pathologically confirmed positive or negative regional lymph nodes. CONCLUSION This analysis confirms that regional node involvement is a significant adverse prognostic factor that is independent of metastatic status, extraskeletal origin, age and tumour site.
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Affiliation(s)
- Sheila Thampi
- Department of Pediatrics, University of California, San Francisco School of Medicine, 505 Parnassus Ave, San Francisco, CA 94143, United States
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