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Huang W, Deng HY, Li D, Li P, Xu K, Zhang YX, Weng JH, Zhou Q. Characteristics and prognosis of primary pulmonary osteosarcoma: a pooled analysis. J Cardiothorac Surg 2022; 17:240. [PMID: 36171612 PMCID: PMC9520935 DOI: 10.1186/s13019-022-02010-6] [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: 08/14/2021] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary pulmonary osteosarcoma (PPOS) is an uncommon malignancy originating from the lung with low incidence, and its clinical characteristics and prognosis have not been systematically reported. Therefore, we aimed to recognize the prognostic factors and constructed a survival prediction model for PPOS. METHODS We collected the data from the Surveillance, Epidemiology, and End Results database and systematic review of previous studies. Demographical and clinical characteristics, radiographic manifestations, treatment modalities, and prognosis were analyzed. A prediction model via nomogram was constructed and then evaluated by the concordance index (C-index) and the receiver operating characteristic (ROC) curve. RESULTS A total of 49 cases were included for analysis with a median age of 67 years old (range 33-94 years), of which 32 (65.3%) were male. The median size was 6 cm (range 1.8-25 cm), and the median overall survival (OS) was eight months (interquartile range 4.5-12 months) with a 1-year OS rate of 30.8%. Tumor size over 7 cm (hazard ratio [HR] = 2.98; P = 0.018) and those without microscopic findings of osteoid found in the tumors (HR = 2.11; P = 0.048) were referred to a poor OS, while surgery was associated with an improved OS (HR = 0.20; P < 0.001). The C-index of the nomogram prediction model was 0.771, and the area under curve, sensitivity and specificity of the ROC curve were 0.818, 0.848 and 0.800, respectively. CONCLUSIONS Patients with PPOS had a poor prognosis, and tumor size was mostly prognostic. Surgery seemed to be an effective treatment, and the prediction model with a nomogram in our study could effectively predict the prognosis of patients with PPOS.
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Affiliation(s)
- Weijia Huang
- Lung Cancer Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, People's Republic of China.,West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Han-Yu Deng
- Lung Cancer Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Deyan Li
- Operation Room, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Peiwei Li
- West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Kai Xu
- Lung Cancer Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, People's Republic of China.,West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Yu-Xiao Zhang
- West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Jia-Hui Weng
- West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Qinghua Zhou
- Lung Cancer Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, People's Republic of China.
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Choi JH, Ro JY. Mesenchymal Tumors of the Mediastinum: An Update on Diagnostic Approach. Adv Anat Pathol 2021; 28:351-381. [PMID: 34050062 DOI: 10.1097/pap.0000000000000306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mesenchymal tumors of the mediastinum are a heterogenous group of rare tumors with divergent lineages. Mediastinal mesenchymal tumors are diagnostically challenging due to their diversity and morphologic overlap with nonmesenchymal lesions arising in the mediastinum. Accurate histologic diagnosis is critical for appropriate patient management and prognostication. Many mediastinal mesenchymal tumors affect distinct age groups or occur at specific mediastinal compartments. Neurogenic tumors, liposarcoma, solitary fibrous tumor, and synovial sarcoma are common mesenchymal tumors in the mediastinum. Herein, we provide an update on the diagnostic approach to mediastinal mesenchymal tumors and a review of the histologic features and differential diagnosis of common benign and malignant mesenchymal tumors of the mediastinum.
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Affiliation(s)
- Joon Hyuk Choi
- Department of Pathology, Yeungnam University College of Medicine, Daegu, South Korea
| | - Jae Y Ro
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University, Houston, TX
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3
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Olsen RR, Ireland AS, Kastner DW, Groves SM, Spainhower KB, Pozo K, Kelenis DP, Whitney CP, Guthrie MR, Wait SJ, Soltero D, Witt BL, Quaranta V, Johnson JE, Oliver TG. ASCL1 represses a SOX9 + neural crest stem-like state in small cell lung cancer. Genes Dev 2021; 35:847-869. [PMID: 34016693 PMCID: PMC8168563 DOI: 10.1101/gad.348295.121] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/12/2021] [Indexed: 12/21/2022]
Abstract
ASCL1 is a neuroendocrine lineage-specific oncogenic driver of small cell lung cancer (SCLC), highly expressed in a significant fraction of tumors. However, ∼25% of human SCLC are ASCL1-low and associated with low neuroendocrine fate and high MYC expression. Using genetically engineered mouse models (GEMMs), we show that alterations in Rb1/Trp53/Myc in the mouse lung induce an ASCL1+ state of SCLC in multiple cells of origin. Genetic depletion of ASCL1 in MYC-driven SCLC dramatically inhibits tumor initiation and progression to the NEUROD1+ subtype of SCLC. Surprisingly, ASCL1 loss promotes a SOX9+ mesenchymal/neural crest stem-like state and the emergence of osteosarcoma and chondroid tumors, whose propensity is impacted by cell of origin. ASCL1 is critical for expression of key lineage-related transcription factors NKX2-1, FOXA2, and INSM1 and represses genes involved in the Hippo/Wnt/Notch developmental pathways in vivo. Importantly, ASCL1 represses a SOX9/RUNX1/RUNX2 program in vivo and SOX9 expression in human SCLC cells, suggesting a conserved function for ASCL1. Together, in a MYC-driven SCLC model, ASCL1 promotes neuroendocrine fate and represses the emergence of a SOX9+ nonendodermal stem-like fate that resembles neural crest.
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Affiliation(s)
- Rachelle R Olsen
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA
| | - Abbie S Ireland
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA
| | - David W Kastner
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA
| | - Sarah M Groves
- Department of Biochemistry, Vanderbilt University, Nashville, Tennessee 37212, USA
| | - Kyle B Spainhower
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA
| | - Karine Pozo
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Demetra P Kelenis
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Christopher P Whitney
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA
| | - Matthew R Guthrie
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA
| | - Sarah J Wait
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA
| | - Danny Soltero
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA
| | - Benjamin L Witt
- Department of Pathology, University of Utah, Salt Lake City, Utah 84112, USA
- ARUP Laboratories at University of Utah, Salt Lake City, Utah 84108, USA
| | - Vito Quaranta
- Department of Biochemistry, Vanderbilt University, Nashville, Tennessee 37212, USA
| | - Jane E Johnson
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
- Hamon Center for Therapeutic Oncology Research, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Trudy G Oliver
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA
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Qi L, Wan L, Ren X, Zhang W, Tu C, Li Z. The Role of Chemotherapy in Extraskeletal Osteosarcoma: A Propensity Score Analysis of the Surveillance Epidemiology and End Results (SEER) Database. Med Sci Monit 2020; 26:e925107. [PMID: 32792473 PMCID: PMC7446278 DOI: 10.12659/msm.925107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/15/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Incidence of extraskeletal osteosarcoma (ESOS) is extremely low and the prognosis remains unclear. We conducted this study to explore prognostic factors and the role of chemotherapy in ESOS. MATERIAL AND METHODS We screened data from the Surveillance Epidemiology and End Results (SEER) database (1975-2016). Three hundred ten patients with ESOS were included and 49.4% (107/310) of them underwent chemotherapy. We performed logistic regression analysis to investigate potential factors determining selection of chemotherapy. An inverse probability of treatment weighting (IPTW) and propensity score matching (PSM)-adjusted Kaplan-Meier curve was created and log-rank test and Cox regression analysis were performed to compare overall survival (OS) and cancer-specific survival (CSS) in patients treated with and without chemotherapy. Subgroup analysis also was conducted based on age, tumor site, stage, size, and surgery. RESULTS Chemotherapy in ESOS was not associated with improved OS in the unmatched cohort (HR, 0.764; 95% CI, 0.555-1.051; p=0.098). The insignificant treatment effect of chemotherapy was also noted in IPTW-adjusted (HR, 0.737; 95% CI, 0.533-1.021; p=0.066) and PSM-adjusted (HR, 0.804; 95% CI, 0.552-1.172; p=0.257) Cox regression analysis. The insignificant treatment effect was consistent across all subgroups and there was no significant heterogeneity of chemotherapy effect (all p for interaction >0.05). CONCLUSIONS The study suggested that chemotherapy has no significant benefit on prognosis of patients with ESOS. These findings should be considered when making treatment decisions about patients with ESOS.
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Affiliation(s)
- Lin Qi
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China
- Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital, Changsha, Hunan, P.R. China
| | - Lu Wan
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China
- Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital, Changsha, Hunan, P.R. China
- Vaccine and Immunotherapy Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, U.S.A
| | - Xiaolei Ren
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China
- Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital, Changsha, Hunan, P.R. China
| | - Wenchao Zhang
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China
- Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital, Changsha, Hunan, P.R. China
| | - Chao Tu
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China
- Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital, Changsha, Hunan, P.R. China
| | - Zhihong Li
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China
- Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital, Changsha, Hunan, P.R. China
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Xin S, Wei G. Prognostic factors in osteosarcoma: A study level meta-analysis and systematic review of current practice. J Bone Oncol 2020; 21:100281. [PMID: 32140401 PMCID: PMC7047183 DOI: 10.1016/j.jbo.2020.100281] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/10/2020] [Accepted: 02/10/2020] [Indexed: 12/23/2022] Open
Abstract
Background A consensus has not yet been reached regarding the abilities of gender, age, tumor size, tumor location, histologic subtypes, and surgery in the prediction of survival in osteosarcoma. We aimed to disclose their prognostic significance by conducting a meta-analysis of all the published data from the last decade. Materials and Methods Electronic database searches were conducted in PubMed, Embase, and Web of Science for relevant articles published within the last ten years. The pooled hazard ratio (HR) and corresponding 95% confidence interval (CI) were obtained to evaluate the prognostic values of the target factors. Results A total of 18,126 patients from 40 studies were eventually included. Results indicated that gender (male vs. female: 1.21, 95% CI, 1.11–1.32; female vs. male: 0.85, 95% CI, 0.75–0.98), age (12–20 vs. ≤12: 1.37, 95% CI, 1.13–1.65; ≥20 vs. <20: 1.29, 95% CI, 1.08–1.55; ≥40 vs. <40: 1.63, 95% CI, 1.21–2.20; ≥50 vs. <25: 2.60, 95% CI, 1.92–3.53; ≥60 vs. <60: 1.11, 95% CI, 1.06–1.18), tumor location (non-extremities vs. extremities: 2.10, 95% CI, 1.76–2.51; proximal vs. distal femur: 3.68, 95% CI: 1.51–8.96; proximal vs. distal humerus: 3.15, 95% CI: 1.53–6.49), tumor size (≥5 vs. <5: 1.42, 95% CI, 1.09–1.86; >8 vs. ≤8: 1.55, 95% CI, 1.07–2.24; >9 vs. ≤9: 1.44, 95% CI, 1.05–1.96), chemotherapy response (poor vs. good: 2.45, 95% CI, 2.02–2.97; good vs. poor: 0.41, 95% CI, 0.34–0.48), and surgery (yes vs. no: 0.45, 95% CI, 0.36–0.57; amputation vs. salvage: 2.34, 95% CI, 1.47–3.74) were significantly associated with overall survival in osteosarcoma patients. Conclusion The meta-analysis demonstrated that male patients, older age, large tumor size, non-extremity osteosarcoma, proximal osteosarcoma, poor chemotherapy response, no surgical treatment, and amputation surgery were correlated with a poor prognosis in osteosarcoma patients.
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Affiliation(s)
- Sun Xin
- Orthopedic Oncology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing 100044, China
| | - Guo Wei
- Orthopedic Oncology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing 100044, China
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Joo S, Song JW, Na KJ, Park S, Park IK, Kim YT, Kang CH. Primary Extraskeletal Osteosarcoma in the Anterior Mediastinum: A Case Report and Review. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2019; 52:243-246. [PMID: 31404412 PMCID: PMC6687048 DOI: 10.5090/kjtcs.2019.52.4.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/16/2019] [Accepted: 03/20/2019] [Indexed: 11/16/2022]
Abstract
Extraskeletal osteosarcoma (ESOS) is a malignant soft tissue neoplasm producing osteoid, without any continuity with the bone or periosteum. Primary ESOS presenting in the mediastinum is an extremely rare, yet aggressive malignant tumor associated with a poor prognosis. We report a case of primary ESOS arising from the thymus in a 63-year-old male patient.
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Affiliation(s)
- Seohee Joo
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Won Song
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kwon Joong Na
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Samina Park
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - In Kyu Park
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Tae Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Hyun Kang
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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99mTc-MDP Bone Scan and 18F-FDG PET/CT Imaging of Multiple Extraskeletal Osteosarcomas. Clin Nucl Med 2018; 43:e412-e413. [DOI: 10.1097/rlu.0000000000002235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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